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.
Chapter 4.5. Division of Workers' Compensation
Subchapter 1.6. Permanent Disability Rating Determination
§10161.1. Reproduction of Forms.
The Request for Summary Rating Determination of Qualified Medical Evaluator's Report, the Employee's Disability Questionnaire, and the Request for Summary Rating Determination of the Primary Treating Physician's Report may be reproduced by automated office equipment or other means as long as the printed content and layout of the form are identical to the specified form.
|| 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 2-21-95; operative 2-21-95. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 95, No. 8).
2. Amendment of section number filed 8-8-95; operative 8-8-95. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 95, No. 32).
3. Amendment of section and new Note filed 11-17-2008; operative 11-17-2008 pursuant to Government Code section 11343.4 (Register 2008, No. 47).
Go Back to Subchapter 1.6 Table of Contents