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Division 1. Department of Industrial Relations
Chapter 4.5. Division of Workers' Compensation
Subchapter 1.5. Injuries on or After January 1, 1990
Article 7.5. Supplemental Job Displacement Benefit

New query

§10133.57. Form DWC-AD 10133.57 “Supplemental Job Displacement Nontransferable Training Voucher Form for Injuries Occurring Between 1/1/04 - 12/31/12.”

Form DWC-AD 10133.57

Note: Authority cited: Sections 133, 4658.5 and 5307.3, Labor Code. Reference: Section 4658.5, Labor Code.


1. New section filed 6-6-2005; operative 8-1-2005 (Register 2005, No. 23).

2. Repealer and new form filed 11-17-2008; operative 11-17-2008 pursuant to Government Code section 11343.4 (Register 2008, No. 47).

3. Amendment of section heading and form filed 12-20-2012 as an emergency; operative 1-1-2013 pursuant to Government Code section 11346.1(d) (Register 2012, No. 51). A Certificate of Compliance must be transmitted to OAL by 7-1-2013 or emergency language will be repealed by operation of law on the following day.

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