Table 1.

Summary of California Reporting Requirements, Frequency, and Fee Schedule Amount

Report Name	Timeline	Frequency	2016 Allowance
Doctor's First Report of Occupational Injury or Illness (DFR)	Required within 5 days after initial examination of the injured worker	One-time requirement	No separate allowance
Primary Treating Physician's Progress Report (PR-2)	Required every 45 days or more frequently	Multiple; every 45 days or more frequently when warranted	Separate allowance of $12.14 per report
Request for Authorization (RFA)	Required with each request for treatment	Multiple; required with each request for treatment	No separate allowance
Permanent and Stationary (P&S) Report (PR-3 or PR-4)	Required once the injured worker's condition has become permanent and stationary	One-time requirement	The PR-3 and PR-4 are separately payable with a maximum allowable amount of $39.42 for the first page, and $24.25 for each additional page. The PR-3 and PR-4 are limited to six and seven pages, respectively, unless the payer and provider agree to a longer report.
Physician's Return-to-Work (RTW) and Voucher Report	Required once the injured worker's condition has become permanent and stationary, and due within 20 days of patient's last examination	One-time requirement	No separate allowance