Utah

Here is an impairment rating template compatible with the state’s rule set

Impairment Rating Template for AMA Guides 5th Edition

Administrative Rule Set

Here is a link to AMA Guides 5th Edition with Modifications

Physician’s Report

Physician’s Initial Report of Work Injury or Occupational Disease

Here is a link to Physician’s Initial Report

Permanent Partial Disability Worksheet

Here is a link to Permanent Partial Disability Worksheet

Labor Department

Here is a link to Industrial Accidents Division

Schedule of Medical Fees

Here is a link to Medical Fee Standards (located on right menu bar)

Employer’s First Report of Injury

Here is a link to First Report of Injury

Request for Authorization

Here is a link to Request for Medical Treatment/Carrier Response (Form 223)


Information on this page is subject to change as state rules and fee schedules are updated regularly. If there is any information that is incorrect or in need of revision, please contact us at info@rate-fast.com.

Information on this page is subject to change as state rules and fee schedules are updated regularly. If there is any information that is incorrect or in need of revision, please contact us.


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