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