Form 1010Medical Authorization / Treatment Request
Issued by Louisiana Office of Workers' Compensation (OWC)
Medical Authorization / Treatment Request (Form 1010) — state-prescribed clinician report used by the state workers’ comp agency.
Key facts
Clinicians fill out · Submitted to regulator · Employers file
- When it’s used
- Initial treatment; requests for treatment authorization beyond initial emergency care; changes in work status or restrictions; maximum medical improvement determination. Form 1010 for treatment authorization workflow (La. R.S. 23:1203).
- Who fills it out
- Treating physician of record. Louisiana allows APRNs and PAs to treat workers' compensation patients within their scope of practice. The treating physician selected from the employer's choice or employee's selection manages care.
- Who signs
- Louisiana allows APRNs and PAs to treat workers' compensation patients within their scope of practice. The treating physician selected from the employer's choice or employee's selection manages care.
- Where it goes
- Form 1010: submitted for treatment authorization requests. Physician reports as needed for claim proceedings and medical disputes. No fixed periodic physician work-status reporting interval.
- Electronic submission
- Supported — Louisiana Office of Workers' Compensation provides electronic filing for claim forms. Medical treatment authorization through carrier/employer processes.
- Narrative substitution
- Form 1010 is the prescribed treatment authorization form. Work-status reporting is primarily narrative-based through medical documentation to the employer/carrier.
Sources & citations
Every form we publish traces to an authoritative government source. We cite the issuing agency, the underlying statute, and the operative regulation so you can verify scope and signing authority for your own records.
Issuing agency
Louisiana Office of Workers' Comp
Statute
La. R.S. 23:1021 et seq.
Attribution. Researched and maintained in collaboration with the wc-hub workers’ compensation reporting project (LA). BlueHive does not modify the underlying government PDF; the file you download is the agency original.
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