What Is a PR-4 Report in a California Workers' Comp Claim?

What Is a PR-4 Report in a California Workers' Comp Claim?

Your PR-4 is the Primary Treating Physician's Permanent and Stationary Report, the form your treating doctor sends your claims administrator once your injury is not expected to improve much more, stating your lasting impairment and any future medical care you need.

Your treatment after a California work injury runs through one doctor the law calls your primary treating physician, or PTP. While you are healing, that doctor sends your claims administrator (the insurer or third party handling your benefits) a string of PR-2 progress reports under 8 CCR 9785. A PR-4 is the report your PTP files once that updating stops, because your doctor has decided your condition has leveled off.

The law calls that point permanent and stationary, often shortened to P&S. It does not mean your care is over. It means your doctor expects your condition to stay about the same for the next year, so it is time to measure what the injury left behind.

Below: what the report actually covers, how a PR-4 differs from the older PR-3 form and from your PR-2 updates, how to get your own copy, what to do if it is wrong or missing, and what comes next in your claim.

What does a PR-4 report actually cover?

Your PR-4 states the lasting impairment your injury left, describes it using the AMA Guides, and says whether you still need future medical care.

Title 8 of the California Code of Regulations, section 9785(i), gives your PTP 20 days from your permanent and stationary exam to send this report. DWC Form PR-4 asks your doctor to list your diagnosis, describe the impairment left in each injured body part, and say whether you need continuing or future medical care because of the injury.

When the primary treating physician determines that the employee's condition is permanent and stationary, the physician shall, unless good cause is shown, report within 20 days from the date of examination any findings concerning the existence and extent of permanent impairment and limitations and any need for continuing and/or future medical care resulting from the injury.

For injuries rated under the schedule California adopted in 2005 and later, your doctor must describe that impairment using the AMA Guides to the Evaluation of Permanent Impairment, Fifth Edition. That description becomes the medical starting point for your permanent disability rating, covered further down this page.

A PR-4 is not a medical-legal report from a qualified medical evaluator (QME) or agreed medical evaluator (AME). Section 9785 bars QMEs and AMEs from using Form PR-3 or PR-4 for their own evaluations. A QME or AME exam is a separate process from your PTP's PR-4.

How is the PR-4 different from a PR-3, or from your PR-2 updates?

A PR-2 is an ongoing update while you are still being treated. PR-3 and PR-4 are both the permanent and stationary report, written for two different rating schedules.

All three forms share the same regulation and the same treating physician, but each one answers a different question at a different point in your claim.

In practice, Form PR-3 is now unusual. The DWC's forms page still lists it, but it belongs to the rating schedule California used before 2005. Almost every claim reaching that point today uses the PR-4 instead. Your injury date decides which form fits, not a choice you or your doctor makes.

How do you get a copy of your PR-4, and what should you check?

Your PTP sends the PR-4 straight to your claims administrator, not to you, so ask your doctor's office for a copy and compare it with what you remember from the exam.

Section 9785 routes every report in this series to your claims administrator, the same as your PR-2 updates. Nobody has to mail you a copy automatically. Ask your PTP's office for one soon after your exam, or request it as part of your claims file.

A separate rule gives you another path to see it. 8 CCR 9812 requires your claims administrator to send you a copy of the medical report behind a benefit decision, such as a notice about your permanent disability, along with that notice. If your claims administrator sends you a permanent disability decision, check whether the attached report is the actual PR-4.

When your copy arrives, read it against what you remember from the exam. Confirm every injured body part is listed, your work restrictions match what your doctor told you, and the future medical care section reflects any ongoing treatment you still expect to need.

What can you do if your PR-4 is wrong, late, or missing?

A plain factual mistake is worth raising with your PTP directly. A real disagreement about your impairment rating goes through a qualified medical evaluator, not a letter to your doctor.

Start with the easy fix. If your PR-4 lists the wrong body part, an outdated job title, or a detail your doctor simply got wrong, contact the PTP's office in writing, name the exact error, and ask for a correction before your claims administrator relies on it.

A deeper disagreement, such as a lower impairment finding than you expected or a missing future-care finding, is not something you settle by letter. California Labor Code section 4061 sends that kind of dispute to another doctor. If you are represented by an attorney, section 4062.2 gives you a panel of three qualified medical evaluators, with each side striking one name. If you are not represented, section 4062.1 gives you a panel of three and lets you choose one. Either way, put your objection in writing first. If you are represented, the law will not let either side request that panel until at least 10 days after that written objection is mailed.

A report that never arrives is a different problem from one you disagree with. Ask your PTP's office for the missing report and a date, then tell your claims administrator in writing that you are waiting on it. Section 9785(k) sends a dispute about the reporting duty itself, rather than its medical content, to Labor Code section 4603 or 4604 instead.

What happens after your PR-4 report is final?

A final PR-4 starts your permanent disability rating, and it can also start the clock on a job retraining voucher if you cannot return to your old work.

Once your PR-4 states a permanent impairment, that finding becomes the medical starting point for your permanent disability rating. See this site's Labor Code 4660.1 guide for how California turns that impairment into a rating, and eventually a payment schedule.

If your PR-4 shows permanent work limits, section 9785(j) also requires your PTP to complete a Physician's Return-to-Work & Voucher Report when the injury leaves permanent partial disability. That second form is what starts your employer's 60 days to offer you suitable work. See this site's SJDB voucher guide for what happens if no suitable offer arrives in time.

A final PR-4 often also opens a settlement conversation, since both sides now have a number to work from.

What should you do with your PR-4 report?

Ask your PTP's office for a copy soon after your permanent and stationary exam, and check it against what your doctor told you at the visit. Yazdchi Law P.C. serves injured workers across California from its Palmdale office. If your PR-4 is wrong, late, or is being used to cut your benefits short, call (661) 273-1780 or use the contact form for a free consultation. If a workers' compensation attorney takes your case, the fee request is usually 15% to 18%, a workers' compensation judge must approve it, and Labor Code section 4906 governs it; see this site's fee guide for more. Yazdchi Law reviews each workers' compensation matter on its own facts before deciding whether it can help.