PR-2 and PR-4: what the treating physician must report, and when

The first report

Within five working days of the initial examination, the primary treating physician submits the Doctor’s First Report of Occupational Injury or Illness, Form 5021; so does each new primary treating physician after their first examination (8 CCR §9785(e)(1)–(2)).

PR-2: when something changes, and at least every 45 days

Unless good cause is shown, a progress report is due within 20 days when the employee’s condition changes significantly and unexpectedly; the treatment plan changes significantly (more treatment, surgery or hospitalization, a referral, a change in method or physical medicine, or DME); the employee can return to modified or regular work, or must leave work or change restrictions; the employee is released from care; the physician concludes permanent disability is likely to preclude the usual occupation; or the claims administrator reasonably requests necessary information (§9785(f)(1)–(7)).

With continuing treatment, a progress report is due no later than 45 days from the last report of any type even if nothing has happened; if there was an examination, it is signed and transmitted within 20 days of it (§9785(f)(8)).

The report goes on Form PR-2, or as a narrative titled “Primary Treating Physician’s Progress Report” in bold, with the same information under the same headings in the same order (§9785(f)(8)).

The primary treating physician also obtains secondary physicians’ reports and, unless good cause is shown, incorporates or comments on them within 20 days of receipt (§9785(e)(4)).

Permanent and stationary: PR-3 / PR-4

When the employee’s condition is permanent and stationary, the physician reports within 20 days of the examination any permanent impairment and limitations and any need for future medical care, on DWC Form PR-3 or PR-4 or in another manner providing everything 8 CCR §10682 requires (§9785(i)).

Under the rating schedule adopted on or after 1 January 2005, impairment is described in accordance with the AMA Guides, 5th Edition (Form PR-4). QMEs and AMEs may not use PR-3 or PR-4 for medical-legal evaluations (§9785(i)).

When the employee is permanent and stationary as to all conditions with permanent partial disability, the physician also completes the Physician’s Return-to-Work & Voucher Report (DWC-AD 10133.36) (§9785(j)).

How ChironAI™ OM helps

OM tracks every reporting duty on a case — Form 5021, PR-2, PR-4 — and who it must be served on; each morning it flags what is due or overdue and evaluates the 45-day PR-2 trigger. Chiron prepares a working draft of the PR-2 and PR-4 narrative from the case record, and the official forms, including PR-2, PR-4 and DWC-AD 10133.36, are rendered from case data. The physician reviews, edits and attests.