|This information is provided free of charge by the Department of Industrial Relations from its web site at www.dir.ca.gov. These regulations are for the convenience of the user and no representation or warranty is made that the information is current or accurate. See full disclaimer at http://www.dir.ca.gov/od_pub/disclaimer.html.|
(a) Employee's Disability Questionnaire (DWC AD Form 100 (DEU)).
(b) Request for Summary Determination of Qualified Medical Evaluator's Report (DWC AD Form 101 (DEU)).
(c) Request for Summary Determination of Primary Treating Physician's Report (DWC AD Form 102 (DEU)).
TABULAR OR GRAPHIC MATERIAL SET FORTH AT THIS POINT IS NOT DISPLAYABLE
|Note: Authority cited: Sections 133 and 5307.3, Labor Code. Reference: Sections 124, 4061, 4062, 4062.01, 4062.1, 4062.2, 4062.5, 4064, 4067, 4660, 4662, 4663 and 4664, Labor Code.|
1. New section filed 4-25-91; operative 4-25-91 (Register 91, No. 26). New section is exempt from review by OAL pursuant to Government Code section11351.
2. Repealer and new DEU Form 100 filed 1-28-94; operative 1-28-94. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 94, No. 4).
3. Editorial correction restoring inadvertently omitted subsection (b) (Register 95, No. 8).
4. Amendment of subsections (a), (b) and forms 100 and 101; and new subsection (c) and form 102 filed 2-21-95; operative 2-21-95. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 95, No. 8).
5. Certificate of Compliance as to 12-31-2004 order, including further amendment of section and forms and amendment of Note, transmitted to OAL 4-29- 2005 and filed 6-10-2005 (Register 2005, No. 23).
6. Amendment of section, including repealer and new DEU Form 100, DEU Form 101 and DEU Form 102, filed 11-17-2008; operative 11-17-2008 pursuant to Government Code section 11343.4 (Register 2008, No. 47).
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