Respondents Response To Claimants CC Form A Application {CC-Form-10A}

CC-FORM-10A - RESPONDENT’S RESPONSE TO CLAIMANT’S CC-FORM-A APPLICATION FOR CHANGE OF PHYSICIAN. This form is used in Oklahoma workers' compensation cases by the respondent (typically the employer or insurance carrier) to respond to a claimant's request for a change of physician. This form provides the claimant with a list of three qualified physicians who can treat the specific injury or condition for which the change of physician is sought. It is only used if the worker is not covered by a Certified Workplace Medical Plan (CWMP). The form requires the respondent to certify the information provided, and it must be submitted to both the Workers’ Compensation Commission and the claimant (or the claimant's attorney). www.FormsWorkflow.com