Wyoming's first medical report on a work injury comes from the provider who first treats the worker, covering history, exam findings, ICD-10 diagnosis, work-relatedness and work status. It satisfies the initial provider report required by W.S. 27-14-501, and an injury report must be on file before the Division pays benefits to the worker or the provider. The claims analyst contacts the provider while deciding whether to open the claim.
The initial treating health care provider (MD, DC, OD or other) completes the whole form, including the employee's first-person statement of cause and complaints, and signs it with an original signature. The employee and employer file their own Report of Injury separately.
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Health Care Provider Initial Medical Report
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Yes. DWS tells injured workers they can get treatment even without a claim number. Once the worker's Report of Injury is received, the Division assigns a nine-digit claim number, which the worker gives to every provider so bills go directly to Workers' Compensation. Leave the claim number blank on the report if unknown.
The initial treating health care provider, whose name and type (such as MD, DC or OD) go in item 32. Wyoming workers may choose a primary provider who is a doctor of medicine, chiropractic or osteopathy, an optometrist, podiatrist, psychologist or advanced practitioner of nursing.
No. It reports the injury and your findings, including whether the injury prevents regular work and an estimate of time loss. The Division treats claims for benefits separately, so a worker seeking temporary total disability files Form WCD-9, whose provider certification you complete after examining the worker.