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Completing the Request for Medical Service Reimbursement or Recommendation for Additional Conditions for Industrial Injury or Occupational Disease Instructions Please print or type this report. If
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this video tutorial is to assist you with completing the physicians report of workability the Medeco 14 it's a critical tool used to provide a medical snapshot of the injured workers capabilities and restrictions at a specific point in time it is no longer used solely for dates of disability once you submit the Medeco 14 the claim parties will work together to identify return to work opportunities that meet the medical needs and limitations you've provided BWC or the self-insuring employer will also determine if the injured worker is entitled to compensation based on your information as the treating physician you must submit emedco 14 for each office evaluation unless the worker has been awarded permanent and total disability has returned to work with no restrictions within seven days of the injury or you have released the worker to full duty but still treat them periodically please note if two physicians are treating the worker both must complete the medica 14 at each office evaluation unless the form submission expectations are met provide information based solely on your medical opinion from the evaluation of the injured workers medical state in relation to the conditions allowed in the claim that you will list in section 4 legal issues and the employers ability to accommodate modified work should not influence your responses before you begin we suggest you print a copy of the Medeco 14 so you can follow along then you can watch the tutorial for a specific section by clicking the appropriate link if you still have questions about the Medeco 14 visit the medical providers section on our website and look for a job aid under education training or call us at