1....Definitions

(d) “AMA Guides” means American Medical Association, Guides to the Evaluation of Permanent Impairment [Fifth Edition]. (f) “Appeals Board” means the ...more

10....Appointment of QMEs

(a) Applications for appointment as a QME shall be submitted on the form in section 100 (QME Form 100). Any application for appointment may be rejected if it is ...more

10.1....The Application for Appointment as Qualified Medical Evaluator Form. [Repealed]

Change without regulatory effect updating QME Application Form filed 6-27-95 pursuant to section 100, title 1, California Code of Regulations (Register 95, No. 26). ...more

10.1A....Reappointment Application as Qualified Medical Evaluator Form. [Repealed]

Change without regulatory effect adding new section filed 6-20-96 pursuant to section 100, title 1, California Code of Regulations (Register 96, No. 25). Change without ...more

10.2....The QME Fee Assessment Notice Form

QME Fee Assessment Form (Sample)   (. pdf format, 26K) NOTE Authority cited: Sections 133, 139 and 139. 2, Labor Code. Reference: Sections 139. 2, 4060, 4061 and ...more

10.5....[Reserved]

Note: Authority cited: Sections 139 and 139. 2. Reference: 8 U. S. C. Sections 1621, 1641 and 1642; Sections 139. 2, 5307. 3 and 5307. 4, Labor Code; and Section 11507 ...more

100....The Application for Appointment as Qualified Medical Evaluator Form

Reference: Sections 139. 2, 4060, 4061, 4062, 4062. 1 and 4062. 2, Labor Code; Sections 1798 et seq. , Civil Code; and Sections 6250 et seq. , Government Code. ...more

10001....Definitions. [Renumbered]

Note: Authority cited: Sections 133, 139. 48 and 5307. 3, Labor Code. Reference: Sections 139. 48 and 4658. 1, Labor Code; Henry v. WCAB (1998) 68 Cal. App. 4th 981. ...more

10002....Offer of Work; Adjustment of Permanent Disability Payments. [Renumbered]

HISTORY      .   New section filed 6-30-2006; operative 7-1-2006.   Submitted to OAL for filing with the Secretary of State and printing only pursuant ...more

10003....Form [DWC AD 10003 Notice of Offer of Work]. [Renumbered]

Note: Authority cited: Sections 133, 139. 48 and 5307. 3, Labor Code. Reference: Sections 139. 48 and 4658, Labor Code.  HISTORY      .   New section ...more

10004....Return to Work Program. [Renumbered]

Note: Authority cited: Sections 133, 139. 48 and 5307. 3, Labor Code. Reference: Sections 62. 5, 139. 48 and 5814. 6, Labor Code.  HISTORY      .   New ...more

10005....Form [DWC AD 10005 Request for Reimbursement of Accommodation Expenses]. [Renumbered]

Note: Authority cited: Sections 133, 139. 48 and 5307. 3, Labor Code. Reference: Sections 62. 5, 139. 48 and 5814. 6, Labor Code.  HISTORY      . ...more

10006....Notice to Employee. [Repealed]

NOTE: Authority cited: Sections 133, 138. 4, 139. 5 and 5307. 3, Labor Code. Reference: Chapter 1435, 1974 Stats. Repealer and new section filed 5-17-88; operative 7-1-88 ...more

10007....Reports to Bureau. [Repealed]

NOTE: Authority cited: Sections 133, 138. 4, 139. 5 and 5307. 3, Labor Code. Reference: Chapter 1435, 1974 Stats. Repealer and new section filed 5-17-88; operative 7-1-88 ...more

10007.1....Entitlement Issues [Repealed]

NOTE: Authority cited: Section 139. 5, Labor Code. Reference: Section 133, Labor Code. HISTORY   . New section filed 6-15-81; effective thirtieth day thereafter ...more

10008....Identification of Need for Vocational Rehabilitation Services. [Repealed]

NOTE: Authority cited: Sections 133, 138. 4, 139. 5 and 5307. 3, Labor Code. Reference: Chapter 1435, 1974 Stats. Repealer and new section filed 5-17-88; operative 7-1-88 ...more

10009....Initiation of Vocational Rehabilitation Services [Repealed]

NOTE: Authority cited: Sections 133, 138. 4, 139. 5 and 5307. 3, Labor Code. Reference: Chapter 1435, 1974 Stats. Repealer and new section filed 5-17-88; operative 7-1-88 ...more

10010....Independent Vocational Evaluators [Repealed]

NOTE: Authority cited: Sections 133, 138. 4, 139. 5 and 5307. 3, Labor Code. Reference: Chapter 1435, 1974 Stats. Repealer and new section filed 5-17-88; operative 7-1-88 ...more

10011....Vocational Rehabilitation Plans [Repealed]

NOTE: Authority cited: Sections 133, 138. 4, 139. 5 and 5307. 3, Labor Code. Reference: Chapter 1435, 1974 Stats. Repealer and new section filed 5-17-88; operative 7-1-88 ...more

10012....Plan Approval [Repealed]

NOTE: Authority cited: Sections 133, 138. 4, 139. 5 and 5307. 3, Labor Code. Reference: Chapter 1435, 1974 Stats. Repealer and new section filed 5-17-88; operative 7-1-88 ...more

10013....Entitlement Issues [Repealed]

NOTE: Authority cited: Sections 133, 138. 4, 139. 5 and 5307. 3, Labor Code. Reference: Chapter 1435, 1974 Stats. Repealer and new section filed 5-17-88; operative 7-1-88 ...more

10014....Bureau Resolution of Disputes [Repealed]

NOTE: Authority cited: Sections 133, 138. 4, 139. 5 and 5307. 3, Labor Code. Reference: Chapter 1435, 1974 Stats.   HISTORY  . Repealer and new section filed ...more

10015....Interruption of Services. [Repealed]

Note: Authority cited: Sections 133, 138. 4, 139. 5 and 5307. 3, Labor Code. Reference: Chapter 1435, 1974 Stats. Repealer and new section filed 5-17-88; operative 7-1-88 ...more

10016....Conclusion of Vocational Rehabilitation Services [Repealed]

NOTE: Authority cited: Sections 133, 138. 4, 139. 5 and 5307. 3, Labor Code. Reference: Chapter 1435, 1974 Stats. Repealer and new section filed 5-17-88; operative 7-1-88 ...more

10017....Reinstatement of Vocational Rehabilitation Benefits [Repealed]

NOTE: Authority cited: Sections 133, 138. 4, 139. 5 and 5307. 3, Labor Code. Reference: Chapter 1435, 1974 Stats. Repealer and new section filed 5-17-88; operative 7-1-88 ...more

10018....Vocational Rehabilitation Temporary Disability Indemnity [Repealed]

NOTE: Authority cited: Sections 133, 138. 4, 139. 5 and 5307. 3, Labor Code. Reference: Chapter 1435, 1974 Stats. New section filed 5-17-88; operative 7-1-88 (Register ...more

10019....Bureau File Retention [Repealed]

NOTE: Authority cited: Sections 133, 138. 4, 139. 5 and 5307. 3, Labor Code. Reference: Chapter 1435, 1974 Stats. New section filed 5-17-88; operative 7-1-88 (Register ...more

10020....Enforcement of Notice and Reporting Requirements [Repealed]

NOTE: Authority cited: Sections 133, 138. 4, 139. 5 and 5307. 3, Labor Code. Reference: Chapter 1435, 1974 Stats. New section filed 5-17-88; operative 7-1-88 (Register ...more

10021....Rehabilitation of Industrially Injured Inmates [Repealed]

NOTE: Authority cited: Sections 133, 138. 4, 139. 5 and 5307. 3, Labor Code. Reference: Chapter 1435, 1974 Stats. New section filed 5-17-88; operative 7-1-88 (Register ...more

101....The Alien Application Form. [Reserved]

HISTORY   . New section filed 4-14-2000; operative 5-14-2000 (Register 2000, No. 15). For prior history see Register 94, No. 31.   . Repealer filed 1-13-2009; ...more

10100....Definitions -Prior to January 1, 1994

The following definitions apply in Articles 1 through 7 of this Subchapter for injuries occurring on or after January 1, 1990 and before January 1, 1994. The ...more

10100.1....Definitions -On or After January 1, 1994

The following definitions apply in Articles 1 through 7 of this Subchapter for injuries occurring on or after January 1, 1994. The Administrative Director of the Division ...more

10100.2....Definitions

The following definitions apply in Articles 1 through 7 of this Subchapter for audits conducted on or after January 1, 2003.   For auditing purposes, any separate ...more

10101....Claim File-Contents

  Every claims administrator shall maintain a claim file of each work-injury claim including claims which were denied. All open claim files shall be kept at the ...more

10101.1....Claim File-Contents

  Every claims administrator shall maintain a claim file of each work-injury claim including claims which were denied. For injuries reported on or after June 19, 2009 ...more

10102....Retention of Claim Files

  (b) Open and closed claim files may be maintained in whole or in part in an electronic or other non-paper storage medium.   Note: Authority cited: Sections 59, ...more

10103....Claim Log -Contents and Maintenance

This section shall govern claim log maintenance prior to January 1, 1994.   (a) Every claims administrator shall produce a claim log of all work-injury claims ...more

10103.1....Claim Log -Contents and Maintenance

This section shall govern claim log maintenance on or after January 1, 1994.   (b) Each entry in the claim log shall contain at least the following information:   ...more

10103.2....Claim Log-Contents and Maintenance

  (b) Each entry in the claim log shall contain at least the following information:   (1) Name of injured worker.   (4) An indication whether the claim is an ...more

10104....Annual Report of Inventory

(a) Each claims administrator shall maintain, and shall file with the Administrative Director, an Annual Report of Inventory for each of its adjusting locations. The ...more

10105....Auditing, Discretion of the Administrative Director

To carry out the responsibility pursuant to Labor Code sections 129 or 129. 5, the Administrative Director or his/her representative shall audit claims administrators' ...more

10106....Random and Non-Random Audit Subject Selection; Complaint/Information Investigation

  (b) The final selection of audit subjects shall be within the discretion of the Audit Unit. The Audit Unit may investigate information or complaints instead of, or ...more

10106.1....Routine and Targeted Audit Subject Selection; Complaint Tracking; Appeal of Targeted Audit Selection

(2) Eligibility under this subsection for removal from the pool for routine audit subject selection shall not bar the targeted selection of the audit subject pursuant to ...more

10106.5....Civil Penalty Investigation

Notwithstanding California Code of Regulations, title 8, sections 10106. 1 and 10107. 1, if the Audit Unit has information indicating the possible existence of claims ...more

10107....Notice of Audit; Claim File Selection; Production of Claim Files; Auditing Procedure

The Notice shall inform the administrator of its selection for audit, and shall include a request to provide the Audit Unit with a claim log or logs. The audit subject ...more

10107.1....Notice of Audit; Claim File Selection; Production of Claim Files; Auditing Procedure

The Notice of Audit shall inform the claims administrator of its selection for audit, and may include a request to provide the Audit Unit with a claim log or logs. If the ...more

10108....Audit Violations-General Rules

(1) If, at the time of the audit, the claims administrator has failed to perform a required act, but remedies the failure prior to the receipt of the Notice of Audit ...more

10109....Duty to Conduct Investigation; Duty of Good Faith

  (b) A reasonable investigation must attempt to obtain the information needed to determine and timely provide each benefit, if any, which may be due the employee. The ...more

10110....Notice of Intention to Issue a Notice of Compensation Due; Notice of Compensation Due; Review by Workers' Compensation Appeals Board

  (b) The audit subject may file an Objection to the Notice of Intention within 14 days of receipt. The Objection shall state in detail the reasons the compensation ...more

10111....Schedule of Administrative Penalties for Injuries on or After January 1, 1990, but Before January 1, 1994

  (2) Failure to provide first permanent disability payment when due and/or within 14 days after temporary disability payments are terminated.   (3) Failure to ...more