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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 https://www.dir.ca.gov/od_pub/disclaimer.html.
 
Chapter 4.5. Division of Workers' Compensation
Subchapter 2. Workers' Compensation Appeals Board--Rules and Practice Procedure
Article 16. Liens

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§ 10868. Notices of Representation for Lien Claimants.


(a) Whenever any lien claimant obtains representation after a lien has been filed, or changes such representation, the lien claimant shall, within 5 days, file and serve a notice of representation in accordance with rules 10390, 10400, 10401 and 10402. If a copy of the notice of representation is not in the record at the time of the hearing, the lien claimant's representative shall lodge a copy at the hearing and shall personally serve a copy on all parties appearing. Unless a representative signs an initial lien document on behalf of a lien claimant, a notice of representation is required.
(b) In addition to the requirements of rules 10390, 10400 and 10401, the notice shall:
(1) Include the caption, the case title (i.e., the name of the injured employee and the name of the defendant or primary defendant(s)) and the adjudication case number(s) to which the notice relates; and
(2) Set forth the full legal name, mailing address and telephone number of the lien claimant.
(c) The notice shall be verified by a declaration signed by the lien claimant and the lien claimant's representative under penalty of perjury stating:
(1) “I declare that the named initial or new representative has consented to represent the interests of the named lien claimant and that the named lien claimant has consented to this representation.”;
(2) “This representation began on ______________, _____, 20___.
(A) “I am not aware of any other attorney or non-attorney who was previously representing the lien claimant.”; or
(B) “I am aware that ________________ [specify person or entity] was previously representing the lien claimant. This Notice of Representation supersedes any previous Notice of Representation. I hereby certify that I have notified the previous attorney or non-attorney representative in writing.”;
(3) “By signing below, the representative affirms that they are not disqualified from appearing under Labor Code section 4907, WCAB rule 10445 (Cal. Code Regs., tit. 8, § 10445) or by any other rule, order or decision of the Workers' Compensation Appeals Board, the State Bar of California, or any court.”
(d) Any violation of this rule may give rise to monetary sanctions, attorney's fees and costs under Labor Code section 5813 and rule 10421.
Note: Authority cited: Sections 133, 5307, 5309 and 5708, Labor Code. Reference: Sections 130, 4907 and 5710, Labor Code; Sections 284, 285 and 286, Code of Civil Procedure; and Sections 10390 and 10445, title 8, California Code of Regulations.
HISTORY
1. New section filed 12-17-2019; operative 1-1-2020. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 2019, No. 51). For prior history, see Register 2002, No. 51.

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