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Chapter 4.5. Division of Workers' Compensation
Subchapter 1.5. Injuries on or After January 1, 1990
Article 2. Claims Administration and Recordkeeping

New Query

§10101. Claim File--Contents.

This section applies to maintenance of claims files for injuries occurring before January 1, 1994.
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 adjusting location for the file. The file shall contain but not be limited to:
(a) An employer date stamped copy of the Employee's Claim for Workers' Compensation Benefits, DWC Form 1, or documentation of reasonable attempts to obtain the form.

(b) Employers Report of Occupational Injury or Illness, DLSR Form 5020, or documentation of reasonable attempts to obtain it.

(c) Every notice or report sent to the Division of Workers' Compensation.

(d) A copy of every Doctor's First Report of Occupational Injury or Illness, DLSR Form 5021, or documentation of reasonable attempts to obtain them.

(e) The original or a copy of every medical report pertaining to the claim, or documentation of reasonable attempts to obtain them.

(f) All orders or awards of the Workers' Compensation Appeals Board pertaining to the claim.

(g) A record of payment of compensation.

(h) A copy of the application(s) for adjudication of claim filed with the Workers' Compensation Appeals Board, if any.

(i) Copies of all notices sent to the employee pursuant to the requirements of the Benefit Notice Program established by Labor Code Section 138.4 and the notices required by Article 2.6 of Chapter 2 of Part 2 of the Labor Code, commencing with Section 4635.

     Note: Authority cited: Sections 59, 129.5, 133, 138.4, 4603.5 and 5307.3, Labor Code. Reference: Sections 124, 129, 129.5, 138.3, 138.4, 139.5, 4061, 4453, 4454, 4600, 4603.2, 4621, 4622, 4636, 4637, 4641, 4643, 4644, 4650, 4701 through 4703.5, 5401, 6409 and 6409.1, Labor Code.  

1. New section filed 1-18-90; operative 1-18-90 (Register 90, No. 4). New section is exempt from review by OAL pursuant to Government Code Section11351.

2. Amendment of article heading, section heading, text and N ote filed 1-28-94; operative 1-28-94.  Submitted to OAL for printing only pursuant to  Government Code section 11351 (Register 94, No. 4).

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