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Chapter 4.5. Division of Workers' Compensation
SUBCHAPTER 1.5. INJURIES ON OR AFTER JANUARY 1, 1990
ARTICLE 9. CLAIM FORM: AVAILABILITY, FILING, ACKNOWLEDGEMENT OF RECEIPT, DISMISSAL

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§ 10139. Workers' Compensation Claim Form (DWC 1) and Notice of Potential Eligibility.


Claim form (DWC 1)

Note: Authority cited: Sections 133 and 5307.3, Labor Code. Reference: Sections 132(a), 139.48, 139.6, 4600, 4600.3, 4601, 4604.5, 4616, 4650, 4656, 4658.5, 4658.6, 4700, 4701, 4702, 4703, 5400, 5401, 5401.7 and 5402, Labor Code.

HISTORY

1. Change without regulatory effect renumbering former section 10118.1 to section 10139 filed 4-7-2008 pursuant to section 100, title 1, California Code of Regulations (Register 2008, No. 15).

2. Amendment of section and Note filed 8-9-2010; operative 10-8-2010 (Register 2010, No. 33).