Scott, I have posted on this before.
We can't bring a DWF in and see the mark up.
Many people have a working drawing, then a sheet that xrefs the working drawing.
So tell me, how do you get a marked up sheet (titleblock drawing) into your working model? Most importantly, with the markups showing. Tell me is something has changed?
To answer the posters question, I use ADR and AutoCAD MEP. I am fortunate to have dual monitors. I load the marked up DWF in ADR in one screen and I open the working drawing in MEP in the other screen. As I complete a mark up I select it and use the pulldown to set is as "Done". If there is simple lines added, I change the color to a yeloow (like a highlighter) so I know it is done. In this manner it is just digital paper.