Virginia's Workers' Compensation Commission relies on this report for the treating physician's account of a work injury or occupational disease: how it happened, findings, diagnosis, treatment, periods of disability and any permanent defect. It answers whether the condition is related to the job and whether the patient has reached maximum medical improvement. The physician signs a certification of personal examination and treatment.
The treating physician completes and signs the whole report, including the patient's account of the injury, findings with X-ray and lab results, prior injuries and pre-existing conditions, referrals, disability dates and MMI status.
Download the current version from the source each time; forms change without notice.
Attending Physician's Report
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.
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The treating physician. The Commission's page states the form must be signed by the treating physician, and the signature sits under a certification that the physician personally examined and treated the patient. Staff can prepare the fields, but the signature and certification belong to the physician.
Upload it through the Commission's WebFile system if you have a valid, active account, or file it by mail or in person at a VWC office. Include the Jurisdiction Claim Number and the claim administrator number so it attaches to the right claim. Filings must be in English.