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Division 1. Department of Industrial Relations
Chapter 4.5. Division of Workers' Compensation
Subchapter 1.5. Injuries on or After January 1, 1990
Article 7.5. Supplemental Job Displacement Benefit
§10133.33. Form [DWC-AD 10133.33 “Description of Employee's Job Duties Form.”]
Prior to any medical evaluation declaring the employee permanent and stationary, the physician may be sent Form [DWC- AD 10133.33, “Description of Employee's Job Duties.”]
This form may be produced without a logo and may be produced on the claim's administrator's letterhead.
Note: Authority cited: Sections 133 and 4658.7, Labor Code. Reference: Sections 4658.6 and 4658.7, Labor Code.
1. New section filed 12-20-2012 as an emergency; operative 1-1-2013 pursuant to Government Code section 11346.1(d) (Register 2012, No. 51). A Certificate of Compliance must be transmitted to OAL by 7-1-2013 or emergency language will be repealed by operation of law on the following day.
2. New section 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 A Certificate of Compliance must be transmitted to OAL by 9-30-2013 or emergency language will be repealed by operation of law on the following day.
3. Certificate of Compliance as to 7-1-2013 order, including amendment of form, transmitted to OAL 9-27-2013 and filed 11-8-2013; amendments operative 1-1-2014 (Register 2013, No. 45).
4. Change without regulatory effect amending section filed 2-5-2014 pursuant to section 100, title 1, California Code of Regulations (Register 2014, No. 6).
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