Louisiana Administrative Code
Title 40 - LABOR AND EMPLOYMENT
Part I - Workers' Compensation Administration
Subpart 2 - Medical Guidelines
Chapter 27 - Utilization Review Procedures
Section I-2718 - Utilization Review Forms

Universal Citation: LA Admin Code I-2718

Current through Register Vol. 50, No. 9, September 20, 2024

A. LWC Form 1010-Request of Authorization/ Carrier or Self Insured Employer Response

Click Here To View Image

B. LWC Form 1010A-First Request

Click Here To View Image

AUTHORITY NOTE: Promulgated in accordance with R.S. 23:1203.1.

Disclaimer: These regulations may not be the most recent version. Louisiana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.