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California Division of Workers' Compensation
SETTLEMENT OF PROSPECTIVE VOCATIONAL REHABILITATION SERVICES
Purpose:
To record the agreement between the employee and the employer to settle prospective vocational rehabilitation services for injuries on or after 1/1/03.
Submitted by:
Any party.
When Submitted:
When the parties have agreed to settle prospective vocational rehabilitation services.
Where Submitted:
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.
Form Completion:
Identifying data completed by claims administrator
Signature of employee, employee's representative and claims administrator
Accompanying documents:
None.
Rehabilitation Unit Action:
The Rehabilitation Unit shall either issue a determination based on the record, request additional information, or set the matter for formal conference.
Copy:
All parties
NOTE
Authority cited: Sections 133, 138.4, 139.5 and 5307.3, Labor Code. Reference: Sections 139.5 and 4646, Labor Code.
HISTORY
1. New section and new Form RU-122 and 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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