Submission of Required Treatment Plans (DWC-25 Form)
and Medical Reports (s. 44013(4)(A), F.S.)

A provider rendering medical treatment and other physician services must submit treatment plans to the carrier in a format prescribed by the Division. The Division adopted the Florida Workers’ Compensation Uniform Medical Treatment/Status Reporting Form- DFS-F5-DWC-25 as the document providers shall use to request authorization for treatment and to report the medical status of the injured employee. The DWC-25 is also used to document the physician’s independent or consultative opinion related to an injured employee’s disability, permanent impairment or need for continuing medical treatment addressed in an Independent Medical Examination Report to the carrier.

DWC-25 Forms Submission Time Frames

Physicians, whether treating or non-treating physicians are required to submit the DWC-25 form in accordance with the time-frames established in the Billing Rule to recommend services or to request a referral for services, and to report the injured employee’s medical condition. The time-frames are:

• Treating physicians

  • The initial DWC-25 Form must be submitted within three (3) business days of the initial encounter. This initial form is to communicate the recommended treatment plan, or to request authorization for subsequent follow-up care, and to report the medical status.
  • Subsequent DWC-25 Forms must be submitted by the close of the business day following the date of the actionable event or at a maximum of 30 days from the submission of the prior DWC-25.
  • The interim DWC-25 Form also reports the medical status of the injured employee, updates medical treatment recommendations and requests authorization for subsequent follow-up care.
  • The final DWC-25 Form addressing the injured employee’s MMI date and PI rating must be submitted to the carrier by the close of the business day following the date of service.

• Non-treating physicians

  • The DWC-25 Form documenting the physician’s opinion or finding(s) resulting from an Independent Medical Examination (IME) must be submitted to the carrier with the IME report within ten (10) business days following the date of service.
  • The DWC-25 Form addressing the injured employee’s MMI date and PI rating must be submitted to the carrier by the close of the business day following the date of service.