rfa form workers comp requests in California use one official document, DWC Form RFA. Your treating physician fills it out and sends it to the claims administrator to ask for approval of medical treatment. You, the injured worker, do not have to file it yourself. Still, knowing how it works can help you follow your care and spot delays early. This guide explains the form in plain English, one step at a time.
What the Rfa Form Workers Comp Is For
In California, a treating doctor can’t simply order most treatment and expect it to be paid. The doctor has to ask first. Under the rfa form workers comp rules, that request goes on DWC Form RFA. For example, requests for physical therapy, an MRI, surgery, or a prescription typically go on this form.
The form starts utilization review, often called UR. UR is how the claims administrator decides whether treatment is medically necessary. Reviewers typically compare the request against California’s medical treatment guidelines. As a result, a clear and complete form with good medical notes gives your request the best chance. Here are the key facts in one place.
| Item | Details |
|---|---|
| Form number | DWC Form RFA |
| Form title | Request for Authorization for Medical Treatment (8 CCR 9785.5) |
| Who files | The treating physician, to the claims administrator; starts utilization review |
| Where filed | Sent to the claims administrator (not filed with the DWC) |
| Fee | None |
| Agency | California Division of Workers’ Compensation (DWC) |
| Official PDF | https://www.dir.ca.gov/dwc/DWCPropRegs/IMR/IMR_FormRFAClean.pdf |
Who Files the Rfa Form Workers Comp and When
The treating physician files the form. In most cases, that is the primary treating doctor on your claim. You do not need to sign it or mail it. You can ask your doctor’s office for a copy, though. Many workers keep one so they know the date it was sent.
Your doctor sends a new rfa form workers comp request whenever new or continued treatment needs approval. That can happen at your first visit or months later. Each new treatment typically needs its own request. Your claim also needs to be started. If you haven’t done that yet, see our guide on how to file a California workers comp claim.
Sometimes a doctor needs to send a request again. For example, the first request may have been missing information. The form has a box for marking a resubmission. Ask your doctor to attach updated notes to every rfa form workers comp request. Clear notes make a quick decision more likely.
How to Fill It Out and Where to Send It
The form has several sections. First, the doctor marks the type of request: new, resubmission, or expedited review. Next come your details, the doctor’s details, and the claims administrator’s details. The most important section lists the treatment requested. It includes the diagnosis, the billing codes, and how often and for how long care is needed.
The most common reason an rfa form workers comp request stalls is missing paperwork. The form must come with a medical report that explains why the treatment is needed. Other common problems include a missing doctor signature, blank fields, or the wrong claim number. Sending it to the wrong adjuster address also causes delays. In most cases, the claims administrator will tell the doctor what is missing.
Doctors can send the form by fax, email, or mail, depending on what the claims administrator accepts. Electronic sending is usually faster and leaves a clear time stamp. The form goes to the claims administrator, not the DWC. You can see the blank official DWC Form RFA PDF here. The DWC also lists it on its official DWC forms page.
What Happens After You File
The claims administrator sends back a utilization review decision. The decision can approve, change, or deny the request. If it’s approved, the treatment can go ahead. If the rfa form workers comp request is changed or denied, the letter must explain why. It must also come with an application for Independent Medical Review, called IMR.
In IMR, an outside doctor looks at the decision again. You, the worker, typically sign and send that application yourself. There is a strict deadline to ask for IMR, and it starts on the date of the UR decision. Read the letter closely and act quickly. To learn more about the state agency, see our California workers comp board guide. You can also review the California workers comp requirements.
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A delay with an rfa form workers comp request can feel stressful when you’re in pain. Try to stay steady. Keep copies, write down the dates, and call your doctor’s office if you hear nothing. This page does not estimate settlements. Any settlement figure would be illustrative only, and every case is different.
Frequently Asked Questions
Can I fill out the rfa form workers comp myself?
No. Your treating physician fills out and signs the form. However, you can ask your doctor’s office to send it promptly and to give you a copy.
What if my doctor’s rfa form workers comp request is denied?
Read the utilization review letter carefully. It explains the reason and should include the IMR application. Many California claimants ask the DWC or a licensed attorney for help with the IMR deadline.
Does it cost anything to file DWC Form RFA?
There is no fee for DWC Form RFA. The doctor sends it straight to the claims administrator. Check the current rules with the California DWC before you act.
Rfa form workers comp: Quick Recap
If you remember one thing about rfa form workers comp, make it this: the rule is set by the state (or the federal program), not by the insurer, and the official source is linked above. Every figure on this page about rfa form workers comp should be confirmed with the agency before you act on it.
Questions about rfa form workers comp that this page does not answer are usually answered for free by the state workers’ comp agency’s information line — and, for a disputed claim, by a licensed attorney in a first consultation.
See your state’s exact numbers
What you are owed depends on your state’s benefit caps and deadlines. Start with your state’s settlement and claim guides for the exact figures.
Sources & How to Verify
The figures on this page come from official government and industry sources. Workers’ comp benefit caps, deadlines, and rules change, so always confirm the exact figure with your state’s workers’ comp board or a licensed attorney before acting. Settlement estimates are illustrative, and every case is different.
- Your state workers’ comp board, division, or commission: the official source for your state’s exact caps, deadlines, and forms — search “[your state] workers compensation board”
- U.S. Department of Labor (OWCP): dol.gov — federal workers’ compensation overview
- NCCI: ncci.com — workers’ comp rating and benefit data
- Social Security Administration: ssa.gov — benefit-cap and SSDI offset data
- Insurance Information Institute: iii.org — neutral workers’ comp background
Content last reviewed October 2026. If you notice an outdated figure, please contact us.
Related Guides
- California Workers Comp Board
- How to File a California Workers Comp Claim
- California Workers Comp Requirements
- Workers Comp Settlements by State (All 50)
- Workers Comp Claims by State (All 50)
- More in This Category
- Settlements by Injury
- Benefits Explained
- Workers Comp Glossary
Informational only — not legal, medical, or financial advice. Workers Comp Explained is an independent educational resource, not a law firm, insurer, or medical or financial advisor, and this page does not provide legal, medical, or financial advice. Workers’ compensation benefits, deadlines, and rules vary by state and change over time, and settlement estimates are illustrative only. Always confirm the exact figure and any deadline with your state’s workers’ compensation board and a licensed attorney before you act.