Order To Report To Independent Medical Examiner
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Order To Report To Independent Medical Examiner Form. This is a California form and can be use in General Workers Comp.
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Tags: Order To Report To Independent Medical Examiner, WCAB-59, California Workers Comp, General
STATE OF CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF INDUSTRIAL ACCIDENTS WORKERS' COMPENSATION APPEALS BOARD Case No. Order to Report to Independent Medical Examiner TO: examination to Dr. examiner, appointed by this Board, on (Date) , you are hereby ordered to report for , an independent medical at o'clock M. at (Address) Dated Service by mail on parties as shown on Official Address Record effected on above date. Workers' Compensation Judge BY: UNLESS THIS APPOINTMENT IS KEPT, FURTHER PROCEEDINGS IN REGARD TO THIS CASE MAY BE SUSPENDED DIA WCAB FORM 59 (REV. 8-75) 2002 © American LegalNet, Inc.
