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Chapter 4.5. Division of Workers' Compensation
Subchapter 1.8.5. Electronic Adjudication Management System Rules
Article 1. Definitions and General Provisions
(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 claim for reimbursement of expense or payment of service that is not allowable as a lien against compensation under Labor Code section 4903. Costs" include, but are not limited to:
(1) expenses and fees under Labor Code section 5710;
(2) costs under Labor Code section 5811 other than interpreter services rendered during a medical treatment appointment;
(3) any amount payable as a medical-legal expense under Labor Code section 4620 et seq.; and
(4) any amount payable under Labor Code section 4600 that would not be subject to a lien against the employee's compensation, including but not limited to any amount payable directly to the injured employee for reasonable transportation, meal, and lodging expenses and for temporary disability indemnity for each day of lost wages.
(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, including a proceeding following an order of consolidation, held in accordance with section 10770.1 for the purpose of assisting the parties in resolving disputed lien claims or claims of costs filed as liens or, if the dispute cannot be resolved, to frame the issues and stipulations and to list witnesses and exhibits 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 and to list witnesses and exhibits 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 a deceased employee; (2) a defendant; (3) an appellant from an independent medical review or independent bill review decision or an injured employee or provider seeking to enforce such a decision; (4) an interpreter filing a petition for costs in accordance with section 10451.3; or (5) a lien claimant where either (A) the underlying case of the injured employee or the dependent(s) of a deceased employee has been resolved or (B) the injured employee or the dependent(s) of a deceased 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 a lien claim filed in accordance with Labor Code section 4903(b) for medical treatment expenses incurred by or on behalf of the injured employee, as provided by Article 2 (commencing with Labor Code section 4600), including but not limited to expenses for interpreter services, copying and related services, and transportation services incurred in connection with medical treatment. It shall not include any amount payable directly to the injured employee.
(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.
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.
3. New subsections (h), (q), (v) and (hh)-(hh)(3), subsection relettering, amendment of newly designated subsections (t) and (aa) and amendment of Note refiled 6-26-2013 as an emergency; operative 7-1-2013 pursuant to Government Code section 11346.1(d) (Register 2013, No. 26). A Certificate of Compliance must be transmitted to OAL by 9-30-2013 or emergency language will be repealed by operation of law on the following day.
4. New subsections (h), (q), (v) and (hh)-(hh)(3), subsection relettering, amendment of newly designated subsections (t) and (aa) and amendment of Note refiled 9-30-2013 as an emergency; operative 10-1-2013 pursuant to Government Code section 11346.1(d) (Register 2013, No. 40). A Certificate of Compliance must be transmitted to OAL by 12-30-2013 or emergency language will be repealed by operation of law on the following day.
5. Certificate of Compliance as to 9-30-2013 order, including further amendment of subsections (h), (x), (y), (aa) and (hh), transmitted to OAL 11-8-2013 and filed 12-16-2013; amendments effective 12-16-2013 pursuant to Government Code section 11343.4(b)(3) (Register 2013, No. 51).