California Regulations 10133

• Amendment effective 1/29/03

[Repealed]

The forms and form filing instructions govern the procedures for the use and completion of the forms required by the Rehabilitation Unit. Unless otherwise specified each form may be used for all dates of injuries.

Form RU-90 "Treating Physician's Report of Disability Status" Form Filing Instructions

Form RU-91 "Description of Employee's Job Duties" Form Filing Instructions

Form RU-94 "Notice of Offer of Modified or Alternative Work" Form Filing Instructions

Form RU-102 "Vocational Rehabilitation Plan" Form Filing Instructions

Form RU-103 "Request for Dispute Resolution" Form Filing Instructions

Form RB-105RB-105 "Request for Conclusion of Rehabilitation Benefits" Form Filing Instructions

Form RU-105 "Notice of Termination of Vocational Rehabilitation Services" Form Filing Instructions

Form RB-107 "Statement of Decline of Vocational Rehabilitation Benefits" Form Filing Instructions

Form RU-107 "Employee Statement of Declination of Vocational Rehabilitation Services" Form Filing Instructions

Form RU-107A "Statement of Declination of Vocational Rehabilitation Services" Form Filing Instructions

Form RU-120 "Initial Evaluation Summary" Form Filing Instructions

Form RU-121 "Vocational Rehabilitation Progress Report" Form Filing Instructions

Form RU-122 "Settlement of Prospective Vocational Rehabilitation Services" Form Filing Instructions

Note: Authority Cited: Sections 133, 138.4, 139.5 and 5307.3, Labor Code. Reference: Sections 139.5, 4635, 4636, 4637, 4638, 4641, 4644, and 4646, Labor Code.