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 1. Administrative Director--Administrative Rules
Article 3.6. Independent Medical Review

New Query

§ 9768.5. Physician Contract Application Form


Physician Contract Application (Independent Medical Reviewer) DWC Form 9768.5

Note: Authority cited: Sections 133 and 4616, Labor Code. Reference: Section 4616.4, Labor Code.Authority cited: Sections 133 and 4616, Labor Code. Reference: Section 4616.4, Labor Code.
HISTORY
1. New section filed 12-31-2004 as an emergency; operative 1-1-2005 (Register 2004, No. 53). A Certificate of Compliance must be transmitted to OAL by 5-2-2005 or emergency language will be repealed by operation of law on the following day.
2. Certificate of Compliance as to 12-31-2004 order, including amendment of section, transmitted to OAL 4-29-2005 and filed 6-10-2005 (Register 2005, No. 23).
3. Change without regulatory effect amending form filed 10-18-2006 pursuant to section 100, title 1, California Code of Regulations (Register 2006, No. 42).
4. Change without regulatory effect amending form filed 5-21-2007 pursuant to section 100, title 1, California Code of Regulations (Register 2007, No. 21).


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