DWC 25 Form – Florida Workers Compensation Uniform Medical Treatment/Status Report Form
DWC 25 Form
A DWC 25 form is a state regulatory document used by the medical provider to inform about the medical evaluation, work status, treatment plan, and precautions for the injured worker. It is only applicable in Florida state to meet the workers’ compensation criteria during a workplace injury.
The accurate information on this form ensures that injured workers receive adequate medical care within the legal framework. You can obtain this form by clicking the download button below or fill out it here and press the print button for a quick printout. Moreover, you will learn how to fill out this form effectively, its importance, and additional details to meet the workers’ compensation criteria.

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Why is the DWC 25 Fillable Form Important?
The key objectives of this form are as follows that plays a vital role in understanding and ensuring the claim process.
Streamlined Communication
This form helps to streamline communication between healthcare providers, insurance adjusters, injured workers, and employers. It ensures transparency in the medical treatment and claims process.
Legal Compliance
The Florida state regulations ensure the completion of this form by medical providers within a specific timeframe. The non-submission of the document within the required timeframe may cause delays or denial of claims.
Accurate Claims Process
This form helps the insurance providers assess the validity of claims and the approval process without any delays.
How To Download DWC 25 Florida Workers Compensation Uniform Medical Treatment/Status Reporting Form
Visit Forms Dude
- You must type www.formsdude.com in any web browser.
- Press the DWC Forms at the menu bar and explore this form.
- Also, type the form’s name (DWC 25 Form) in the search bar and press enter.
- Click the download button to save it immediately.
- You can also fill out this form here and press the print button for an instant printout.
Step-by-Step Instructions for Filling Out the Blank DWC 25 Form
These step-by-step instructions will help you complete this form immediately with accuracy:
1- Injured Employee Details
You must write in the first part of the form about the insurer’s name, physician’s visit/review date, patient’s name, date of birth, date of accident, and employer’s name.
2- Clinical Assessment/Determinations
In the first section, if there is a first visit of the physician, you must check the boxes for answers related to the type of injury, treatment is compulsory for injury, diagnosis, and details of major causes.
3- Patient’s Classification Level
In the second section of the form, tick the level according to the condition of the patient.
4- Management Treatment Plan
In the third section of the form, write the physician’s recommendation for treatment plan.
5- Functional Limitations and Restrictions
In the fourth section, follow the functional limitations and restrictions for the injured employee after returning to the workplace.
6- Maximum Medical Improvement
In this section, after the check-up, you will learn the patient’s current condition and whether there has been any improvement.
7- Follow up
Get the next appointment date with the physician.
8- Attestation Statement
In the last section of the form, write the physician’s name, specialty, and license number, and get a signature with the date.
Additional Details to Consider While Filling Out DWC 25 Form
You must ensure these additional details while filling out this form:
Incomplete or Inaccurate Information
You must ensure that all information provided on this form is complete and accurate. The misleading information may cause delays or cancellation of the claim.
Delays in Submission
According to Florida state regulations, an injured worker must submit this form within the timeframe of 30 days. The delay in submission may cause a denial of the claims.
Dispute Over Work Restrictions
You must enhance the communication to reduce the disputes for disagreeing with medical recommendations.
FAQs
What is the DWC 25 Form?
It is a legal document often required by the Florida Division of Workers Compensation to get the physician’s recommendation for a workplace injury to the employee.
When is the DWC 25 Required?
It is often required to report the initial evaluation of injured workers, any change in the treatment plan, any change in functional abilities, and to check the final medical status.
Can an Injured Worker Access the DWC 25?
Yes, he must consult his insurance carrier or the physician to provide this form.
What Information Does the DWC 25 Require?
You must gather comprehensive details about the worker’s injury, work restrictions, treatment plan, current conditions, and the physician’s recommendations.