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Title 8. Industrial Relations
Division 1. Department of Industrial Relations
Chapter 4.5. Division of Workers' Compensation
Subchapter 1.8.5. Electronic Adjudication Management System Rules
Article 1. Definitions and General Provisions

 

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§ 10205. Definitions.

(a) “Adjudication file” or “ADJ file” means a case file in which the jurisdiction of the Workers' Compensation Appeals Board has been invoked and which is maintained by the Division of Workers' Compensation in paper format, or electronic format, or both, including a temporary paper case file.

(b) “Administrative director” means the administrative director of the Division of Workers' Compensation or his or her designee.

(c) “Appeals board” means the commissioners and deputy commissioners of the Workers' Compensation Appeals Board acting en banc, in panels, or individually.

(d) “Applicant” means any person asserting a right to relief under the provisions of Labor Code section 5300.

(e) “Application for adjudication” or “application” means the initial pleading that asserts a right to relief under the provisions of Labor Code section 5300.

(f) “Central Registration Unit” is a unit within the Division of Workers' Compensation which maintains the website list of uniform names and addresses of claims administrators' offices and representatives' offices.

(g) “Claims administrator's office” means any office location that administers workers' compensation claims.

(h) “Cost” means any sum that is not included as an allowable lien under Labor Code section 4903 at the time of filing, but may be allowable under another section of the Labor Code. “Costs” include, but are not limited to: (1) deposition attorneys' and interpreters' fees under section 5710; (2) medical-legal expenses, including interpreters' fees, under section 4620 on or after January 1, 2013; (3) fees related to copy service or subpoena under section 5710; and (4) costs claimed under section 5811.

(i) “Declaration of readiness to proceed” or “declaration of readiness” means a request for a proceeding before the district office.

(j) “Declaration of readiness to proceed to expedited hearing” means a request for a proceeding before the district office pursuant to Labor Code section 5502(b).

(k) “Defendant” means any person against whom a right to relief is claimed.

(l) “District office” means a trial level workers' compensation court.

(m) “Document” is a pleading, petition, medical report, record, declaration, exhibit, or another filing submitted by a party or lien claimant, including an electronically scanned version of a document that was filed in paper form. Each medical report or other record having a different author and/or a different date of service is a separate “document.”

(n) “Document cover sheet” means Form 10232.1, which is placed on top of a document or set of documents filed at one time in a specific case.

(o) “Document separator sheet” means Form 10232.2, which is placed on top of each individual document, when one or more documents are being filed at the same time in the same case and placed on top of each individual attachment to each document being filed, when a document has one or more attachments.

(p) “Electronic Adjudication Management System” or “EAMS” means the computerized case management system used by the Division of Workers' Compensation to store and maintain adjudication files and to perform other case management functions.

(q) “Electronic filing” means electronic transmission of a document into EAMS in accordance with the provision of these regulations.

(r) “Electronic signature” means a signature electronically affixed by a workers' compensation administrative law judge or by the appeals board to any decision, findings, award, order or other document.

(s) “Fax” means a document that has been electronically served by a fax machine.

(t) To “file” a document means to either deliver a document or cause it to be delivered to the district office with venue or to the appeals board for the purpose of having it included in the adjudication file or to electronically file a document via EAMS in accordance with these regulations.

(u) “Hearing” means any trial, mandatory settlement conference, rating mandatory settlement conference, status conference, lien conference, or priority conference.

(v) “Initial lien” means any Labor Code section 4903(b) lien filed in a case on or after the effective date of these regulations by a lien claimant who has not previously filed a lien in the same case.

(w) “Lien claimant” means any person claiming payment under the provisions of Labor Code section 4903 or 4903.1.

(x) “Lien conference” means a proceeding for the purpose of assisting the parties in resolving disputed lien claims pursuant to Labor Code section 4903 or 4903.1 or, if the dispute cannot be resolved, to frame the issues and stipulations in preparation for a lien trial.

(y) “Mandatory settlement conference” means a proceeding to assist the parties in resolving their dispute or, if the dispute cannot be resolved, to frame the issues and stipulations in preparation for a trial.

(z) “Optical character recognition form” or “OCR form” means a paper form designed to be scanned so that its information is automatically extracted and stored in EAMS.

(aa) “Party” means: (1) a person claiming to be an injured employee or the dependent of an injured employee; (2) a defendant; or (3) a lien claimant or a petitioner for costs where either (A) the underlying case of the injured employee or the dependent of an injured employee has been resolved or (B) the injured employee or the dependent of an injured employee chooses not to proceed with his, her, or their case.

(bb) “Petition” means any document filed containing a request for action other than an application for adjudication, an answer or a declaration of readiness to proceed.

(cc) “Priority conference” means a proceeding in which the applicant is represented by an attorney and the issues in dispute at the time of the proceeding include employment and/or injury arising out of and in the course of employment.

(dd) “Product delivery unit” means the unit within the Division of Workers' Compensation. The units are abbreviated as follows: Adjudication Unit “ADJ”; Disability Evaluation Unit “DEU”; Subsequent Injuries Benefits Trust Fund “SIF”; Uninsured Employers' Benefits Trust Fund “UEF”; Vocational Rehabilitation “VOC; and Retraining and Return to Work Unit “RSU”. For each product delivery unit there is an area in EAMS in which the case management information related to that product delivery unit is stored. That area is called the “product delivery case.” “INT” is the integrated case, which is the umbrella for the individual product delivery cases for each unit residing in EAMS.

(ee) “Rating mandatory settlement conference” means a mandatory settlement conference conducted to facilitate the determination of the existence and extent of permanent disability through the use of informal ratings issued by the Disability Evaluation Unit, where the only unresolved issues are permanent disability and the need for future medical treatment.

(ff) “Representative's office” means any office location for a law firm, lawyer or representative of a party or lien claimant in a workers' compensation case.

(gg) “Regular hearing” means a trial.

(hh) “Section 4903(b) lien” means the medical treatment costs incurred by or on behalf of the injured employee, as provided by Article 2 (commencing with section 4600), consistent with Labor Code section 4903(b). A section 4903(b) lien includes, but is not limited to:

(1) A medical treatment lien, which includes every benefit required to be provided under section 4600, including claims for reimbursement when treatment for an occupational injury or illness has been paid by a health insurer or health care service plan (Labor Code section 4600).

(2) Transportation services expense incurred in connection with medical treatment (Labor Code section 4600).

(3) Interpreters' fees incurred in connection with medical treatment (Labor Code section 4600).

(ii) To “serve” a document means to personally deliver a copy of the document, or to send it in a manner permitted by these rules and the rules of the appeals board, to a party, lien claimant, or attorney who is entitled to a copy of the document.

(jj) “Status conference” means a proceeding set for the purpose of ascertaining if there are genuine disputes requiring resolution, of providing assistance to the parties in resolving disputes, of narrowing the issues, and of facilitating preparation for trial if a trial is necessary.

(kk) “Submission” means the closing of the record to the receipt of further evidence or argument.

(ll) “Trial” means a proceeding set for the purpose of receiving evidence.

(mm) “Venue” means the district office, as established by Labor Code section 5501.5 or 5501.6, at which any proceedings will be conducted and from which any district office orders, decisions, or awards will be issued.

(nn) “Workers' compensation administrative law judge” as defined in Labor Code section 123.7 includes pro tempore judges appointed pursuant to California Code of Regulations, title 8, section 10350.

Note: Authority cited: Sections 111, 133, 138.2(b), 4903.05, 4903.06 and 5307.3, Labor Code; and Stats. 2011, c. 559, §17 (A.B. 1426). Reference: Sections 110, 4903, 4903.05, 4903.06, 4903.1, 5300, 5404.5, 5500.3, 5501.5, 5501.6, 5502(b) and 5502(c), Labor Code.

HISTORY

1. New subchapter 1.8.5 (articles 1-8, sections 10205-10208.12) and article 1 (sections 10205-10205.2) and renumbering of former section 10210 to new section 10205, including amendment of section and Note, filed 12-10-2012 as a change without regulatory effect pursuant to section 100, title 1, California Code of Regulations by the Division of Workers' Compensation and as a file and print by the Workers' Compensation Appeals Board pursuant to Government Code section 11351 (Register 2012, No. 50).

2. New subsections (h), (q), (v) and (hh)-(hh)(3), subsection relettering, amendment of newly designated subsections (t) and (aa) and amendment of Note filed 12-31-2012 as an emergency; operative 1-1-2013 pursuant to Government Code section 11346.1(d) (Register 2013, No. 1). 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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