Chapter 4.5. Division of Workers' Compensation
Subchapter 1.5. Injuries on or After January 1, 1990
Article 7. Vocational Rehabilitation

§10123. Reporting Requirements.

(a) Except for notices required by this article to be sent to an employee, all forms or correspondence submitted to the Rehabilitation Unit shall include:

(1) Rehabilitation Unit file number, or

(2) Case Initiation Document or promulgated form requesting action which includes the Rehabilitation Unit file number as the cover sheet for the information being submitted.

Documents which have neither a Rehabilitation Unit file number or a Case Initiation Document will be returned to the sender with instructions for proper filing.

(b) All forms, notices, reports and other communications subject to Labor Code section 139.5 and article 2.6commencing with Labor Code section 4635 are to be served simultaneously on all parties.

(c) All forms and reports as required by this article shall be submitted to the correct Rehabilitation Unit District Office in the manner prescribed by the Administrative Director.

(1) Incomplete forms or forms with incomplete information attached may be returned to the sender. Each form has instructions as to the reports/information which must be attached.

(2) A form filed without the attachments and a specific listing of all enclosures as required by the instruction section of the form is deemed incomplete and shall be denied or returned to sender for proper submission. All incomplete requests will be date stamped.

(3) The Rehabilitation Unit shall serve a copy of the transmittal information upon the other parties when a form is returned.

(d) Filing instructions and venue lists shall be provided upon request by the Rehabilitation Unit. Requests shall be submitted to:

REHABILITATION UNIT HEADQUARTERS
P. O. BOX 420603
SAN FRANCISCO, CA 94142

(e) All forms submitted to the Rehabilitation Unit shall bear original signatures and shall be on forms as issued by the Administrative Director or forms approved by the Administrative Director.

(1) No forms, notices or reports shall be forwarded to the Rehabilitation Unit when the claims administrator has raised a good faith issue of injury arising out of and occurring in the course of employment, until the claims administrator has accepted liability for the injury or there has been a finding of injury by the Workers' Compensation Appeals Board.

(2) Any requests for provision of rehabilitation services and for intervention/dispute resolution require confirmation by the employee or his/her representative that liability for the injury has been accepted.

Forms sent to the Rehabilitation Unit when a good faith issue of injury exists or where there has been no confirmation of acceptance of injury, shall be returned to the sender.

(f) All required notices shall be sent to the employee and his or her attorney, if any, on a timely basis by the claims administrator in the form and manner prescribed by the Administrative Director. Failure to provide notices timely shall subject the insurer, third party administrator or self-insured employer to administrative or civil penalties. The notices are timely when sent according to the requirements of Section 9813.

(g) The insurer shall advise the employer of a potential refund as described in Labor Code section 4638 no later than the required date of the initial notice of potential eligibility.

(h) The claims administrator shall retain a true copy of all notices sent to the employee and shall provide the unit with a copy upon request.

(i) When an employer, claims administrator or an employee chooses to be represented in matters pending before the Rehabilitation Unit, the represented party or representative shall notify the Rehabilitation Unit by completing and filing DWC Form RU-101, "Case Initiation Document." Notice of representation to the Appeals Board shall not be considered notice to the Rehabilitation Unit.

NOTE: Authority cited: Sections 133, 139.5 and 5307.3, Labor Code. Reference: Sections 139.5, 4636, 4637, 4638 and 4645, Labor Code.

HISTORY

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 Section 11351.

2. Change without regulatory effect amending section filed 1-22-91 pursuant to section 100, title 1, California Code of Regulations (Register 91, No. 10).

3. Amendment of subsections (a)(2), (c)(2), (d), (e), (e)(1) and (f), repealer of subsections (f)(1)-(g)(2) and subsection relettering, and amendment of newly designated subsections (g)-(i) filed 12-31-93; operative 1-1-94. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 93, No. 53).

4. Change without regulatory effect amending subsection (f) and Note filed 3-14-94 pursuant to title 1, section 100, California Code of Regulations (Register 94, No. 11).

5. Amendment of subsection (g) filed 2-21-95; operative 2-21-95. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 95, No. 8).