Go
Back to Article 7. Vocational Rehabilitation, Table of Contents | New query |
California Division of Workers' Compensation
EMPLOYEE STATEMENT OF DECLINATION
OF VOCATIONAL REHABILITATION SERVICES
Purpose:
To record the employee's declination of rehabilitation services for injuries on or after 1/1/94.
Submitted by:
Claims Administrator
When submitted:
When the employee chooses to decline vocational rehabilitation services.
Where submitted:
With the RU-105 to the applicable Rehabilitation Unit district office
Form completion:
Identifying data completed by Claims Administrator; signature of employee and attorney, if represented.
Accompanying documents:
Notice of Termination of Rehabilitation Services (RU-105)
A copy of the Notice of Potential Eligibility.
Rehabilitation Unit action:
If the employee objects to the Notice of Termination, the Rehabilitation Unit shall, within 30 days, schedule a conference or otherwise obtain the employee's reason for objection together with substantiating evidence and issue its decision.
Copy:
All parties.
NOTE
Authority cited: Sections 133, 139.5 and 5307.3, Labor Code. Reference: Sections 4641 and 4644, Labor Code.
HISTORY
1. New section, relocation and amendment of Form RU-107-A from section 10133 to
section 10133.19, and new form filing instructions filed 1-29-2003; operative
1-29-2003 pursuant to Government Code section 11343.4 (Register 2003, No. 5).
Go
Back to Article 7. Vocational Rehabilitation, Table of Contents
| The above information is provided free of charge by the Department of Industrial Relations from its web site at www.dir.ca.gov. |