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California Division of Workers' Compensation
NOTICE OF TERMINATION OF REHABILITATION SERVICES
Purpose:
To notify the employee of the employer's termination of liability to provide rehabilitation services. It is not to be used for non-feasibility. This notice is not to be used for injuries prior to 1990.
Submitted by:
Claims Administrator to the injured employee and representative.
When submitted:
Within 10 days of the circumstances set forth in LC §4644(a).
Where submitted:
Original of the notice is sent to the employee and a copy to the applicable Rehabilitation Unit district office. The Rehabilitation Unit's venue is the same as the WCAB. If no WCAB case exists, file with a Rehabilitation Unit within the county where the injured employee resides.
Accompanying documents:
r RU-94 for DOI's on or after 1/1/94 where an offer of modified or alternate work has been accepted or
rejected.
r Agreed upon plans for represented injured workers whose date of injury is on or after 1/1/94. (See 1994-1999 rules - AR 10126b(3))
r All declination forms and Notice of Potential Eligibility.
r A copy of proof of service.
Rehabilitation Unit action:
When the employee objects to the notice of termination, the Rehabilitation Unit will hold a conference or otherwise obtain the employee's reason for objection and issue its decision.
Notes: Copies of medical or vocational reports are not required to be submitted to the Rehabilitation Unit when filing a copy of the RU-105 on injuries subsequent to 1/1/90.
All RU-105 Notices must have a “Proof of Service” as required by AR 10131(a). For further information of “Proof of Service” see 8 Cal 10514.
NOTE
Authority cited: Sections 133, 139.5 and 5307.3, Labor Code. Reference: Sections 4637 and 4644, Labor Code.
HISTORY
1. New section, relocation and amendment of Form RU-105 from section 10133
to section 10133.16, and new form filing instructions filed 1-29-2003; operative
1-29-2003 pursuant to Government Code section 11343.4 (Register 2003, No. 5).
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