Self-Insured Employer Injured Worker Screening {BWC-3909}

BWC-3909 / MEDCO-8 - SELF-INSURED EMPLOYER/ INJURED WORKER SCREENING. This form is used by the Bureau of Workers' Compensation (BWC) to facilitate the Statewide Disability Evaluation System (SDES). It is specifically for scheduling medical examinations for injured workers who have received 90 consecutive days of temporary total disability compensation. The form helps identify the injured worker to be examined, track their medical progress, and determine whether continued benefits are necessary. It includes sections for injured worker and employer information, medical conditions, job requirements, accident details, and any relevant supporting documentation. Employers may also use the form to waive the 90-day examination if appropriate. www.FormsWorkflow.com