Last updated: 10/1/2025
Request For Screening {DWC-23}
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Description
Form DFS-F3-DWC-23 - REQUEST FOR SCREENING. The Florida Department of Financial Services (DFS) Division of Workers’ Compensation uses this form to request a reemployment screening for injured employees seeking services to return to suitable gainful employment. The injured worker completes personal details and indicates whether employment may be available, has been offered, or is unavailable under their permanent restrictions. The form may be filed by the employee, employer, or carrier, with appropriate signature and referral designation. Social Security numbers are required for database tracking under Chapter 440, Florida Statutes. Once filed, DFS evaluates eligibility for screening and determines what reemployment services—such as vocational training or job placement—may be provided. Rule 69L-22.0011, F.A.C. www.FormsWorkflow.com
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