Bulletin No. 02-03
January 7, 2003

Status of DWC Form 1, Poster, and Time of Hire Pamphlet Revisions


Assembly Bill 749 requires the DWC Administrative Director to prescribe the form and content of a new DWC 1 claim form (Labor Code 5401) and workers' compensation poster (Labor Code 3550).  This bill also modifies the information required in the time of hire pamphlet and requires the Administrative Director to develop these new employee informational documents in consultation with the Commission on Health and Safety and Workers' Compensation.

To help meet these requirements, DWC has convened a group of workers' compensation professionals from the insurance, applicant's attorney, and employer communities that has been working on the poster and the notice of potential eligibility on the claim form. After meeting several times, this group has developed a proposed set of final documents that should be filed with the Office of Administrative Law in January 2003. After going through the state rulemaking and public hearing process, we expect the final documents and regulations to be effective in spring 2003.

Workers' Compensation Poster

While regulations will not yet be in effect on January 1, 2003, posters submitted before or after January 1, 2003, which conform to the requirements imposed by passage of Assembly Bill 749 and other relevant statutes and regulations will be reviewed for approval purposes. The California Chamber of Commerce and the California Workers' Compensation Institute have already received approval for their posters and you can contact these organizations -- CWCI at 510-663-1063, web: http://www.cwci.org and the Chamber of Commerce at 800-331-8877, web: http://www.calchamberstore.com -- to order their approved posters.

At this time DWC intends to propose regulations which will allow the use of either a poster developed by the Administrative Director or a poster approved by the AD. Thus, other versions of the poster that comply with AB 749 and have been approved can be continue to be used, even after the adoption of the regulations. After the AD regulations are adopted, a party can still submit their own version of the poster for approval.

DWC 1 Claim Form

The new DWC 1 claim form and notice of potential eligibility for benefits is part of the same rulemaking package and has the same expected spring 2003 adoption date. The notice of potential eligibility for benefits is currently on the reverse side of the green, employee's temporary, receipt copy of the claim form. DWC plans to make the notice of potential eligibility a cover sheet, making the DWC 1 a five-page form. Parties can continue to use the existing DWC 1 claim form until the Office of Administrative Law approves the new one.

Time of Hire Pamphlet

Labor Code 3551 only requires the Administrative Director to prescribe the "content" of this pamphlet. This differs from the poster and claim form, which require the AD to prescribe the "form and content." The content requirement for this pamphlet is already established in Labor Code 3551 and Section 9880 of Title 8, California Code of Regulations. The AD's authority to approve this pamphlet is found in Section 9883, Title 8, California Code of Regulations.

The AD will continue to approve time of hire pamphlets submitted by employers, claims administrators, and private enterprises as long as the required information per the applicable statutes and regulations is included. This is the procedure that the AD has applied for the last several years.

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