This section applies to any request for authorization of medical treatment, submitted under Article 5.5.1 of this Subchapter, for an occupational injury or illness occurring prior to January 1, 2013 where the request for authorization is received prior to July 1, 2013.
"You have a right to disagree with decisions affecting your claim. If you have questions about the information in this notice, please call me (insert claims adjuster's name in parentheses) at (insert telephone number). However, if you are represented by an attorney, please contact your attorney instead of me.
and
"For information about the workers' compensation claims process and your rights and obligations, go to www.dwc.ca.gov or contact an information and assistance (I&A) officer of the state Division of Workers' Compensation. For recorded information and a list of offices, call toll-free 1-800-736-7401."
Either
"If you want further information, you may contact the local state Information and Assistance office by calling [enter district I & A office telephone number closest to the injured worker] or you may receive recorded information by calling 1-800-736-7401.
or
"If you want further information, you may contact the local state Information and Assistance office closest to you. Please see attached listing (attach a listing of I&A offices and telephone numbers) or you may receive recorded information by calling 1-800-736-7401."
and
"You may also consult an attorney of your choice. Should you decide to be represented by an attorney, you may or may not receive a larger award, but, unless you are determined to be ineligible for an award, the attorney's fee will be deducted from any award you might receive for disability benefits. The decision to be represented by an attorney is yours to make, but it is voluntary and may not be necessary for you to receive your benefits."
"You have a right to disagree with decisions affecting your claim. If you have questions about the information in this notice, please call me (insert claims adjuster's name in parentheses) at (insert telephone number). However, if you are represented by an attorney, please contact your attorney instead of me.
and
"For information about the workers' compensation claims process and your rights and obligations, go to www.dwc.ca.gov or contact an information and assistance (I&A) officer of the state Division of Workers' Compensation. For recorded information and a list of offices, call toll-free 1-800-736-7401."
In addition, the non-physician provider of goods or services identified in the request for authorization, and for whom contact information has been included, shall be notified in writing of the decision modifying, delaying, or denying a request for authorization that shall not include the rationale, criteria or guidelines used for the decision.
"If you disagree with the utilization review decision and wish to dispute it, you must send written notice of your objection to the claims administrator within 20 days of receipt of the utilization review decision in accordance with Labor Code section 4062. You must meet this deadline even if you are participating in the claims administrator's internal utilization review appeals process."
"You have a right to disagree with decisions affecting your claim. If you have questions about the information in this notice, please call me (insert claims adjuster's or appropriate contact's name in parentheses) at (insert telephone number). However, if you are represented by an attorney, please contact your attorney instead of me.
and
"For information about the workers' compensation claims process and your rights and obligations, go to www.dwc.ca.gov or contact an information and assistance (I&A) officer of the state Division of Workers' Compensation. For recorded information and a list of offices, call toll-free 1-800-736-7401."
Cal. Code Regs. Tit. 8, § 9792.9
2. New section refiled 4-6-2005 as an emergency; operative 4-12-2005 (Register 2005, No. 14). A Certificate of Compliance must be transmitted to OAL by 8-10-2005 or emergency language will be repealed by operation of law on the following day.
3. Certificate of Compliance as to 4-6-2005 order, including amendment of section, transmitted to OAL 8-10-2005 and filed 9-22-2005 (Register 2005, No. 38).
4. Amendment of section heading, new first paragraph and new subsections (b)-(b)(2), subsection relettering, amendment of newly designated subsections (h)(2), (k) and (k)(7), new subsections (k)(8)(A)-(B) and (l)-(l)(9), subsection relettering, new subsection (o) 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.
5. Amendment of section heading, new first paragraph and new subsections (b)-(b)(2), subsection relettering, amendment of newly designated subsections (h)(2), (k) and (k)(7), new subsections (k)(8)(A)-(B) and (l)-(l)(9), subsection relettering, new subsection (o) and amendment of NOTE refiled 7-1-2013 as an emergency; operative 7-1-2013 (Register 2013, No. 27). 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.
6. Amendment of section heading, new first paragraph and new subsections (b)-(b)(2), subsection relettering, amendment of newly designated subsections (h)(2), (k) and (k)(7), new subsections (k)(8)(A)-(B) and (l)-(l)(9), subsection relettering, new subsection (o) and amendment of NOTE refiled 9-30-2013 as an emergency; operative 10-1-2013 (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.
7. Certificate of Compliance as to 9-30-2013 order, including further amendment of section heading, first paragraph and subsections (b)(1), (b)(2), (k) and (l)(6), transmitted to OAL 12-30-2013 and filed 2-12-2014; amendments effective 2-12-2014 pursuant to Government Code section 11343.4(b)(3) (Register 2014, No. 7).
Note: Authority cited: Sections 133, 4603.5 and 5307.3, Labor Code. Reference: Sections 4062, 4600, 4600.4, 4604.5, 4610 and 4610.5, Labor Code.
2. New section refiled 4-6-2005 as an emergency; operative 4-12-2005 (Register 2005, No. 14). A Certificate of Compliance must be transmitted to OAL by 8-10-2005 or emergency language will be repealed by operation of law on the following day.
3. Certificate of Compliance as to 4-6-2005 order, including amendment of section, transmitted to OAL 8-10-2005 and filed 9-22-2005 (Register 2005, No. 38).
4. Amendment of section heading, new first paragraph and new subsections (b)-(b)(2), subsection relettering, amendment of newly designated subsections (h)(2), (k) and (k)(7), new subsections (k)(8)(A)-(B) and (l)-(l)(9), subsection relettering, new subsection (o) 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.
5. Amendment of section heading, new first paragraph and new subsections (b)-(b)(2), subsection relettering, amendment of newly designated subsections (h)(2), (k) and (k)(7), new subsections (k)(8)(A)-(B) and (l)-(l)(9), subsection relettering, new subsection (o) and amendment of Note refiled 7-1-2013 as an emergency; operative 7-1-2013 (Register 2013, No. 27). 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.
6. Amendment of section heading, new first paragraph and new subsections (b)-(b)(2), subsection relettering, amendment of newly designated subsections (h)(2), (k) and (k)(7), new subsections (k)(8)(A)-(B) and (l)-(l)(9), subsection relettering, new subsection (o) and amendment of Note refiled 9-30-2013 as an emergency; operative 10-1-2013 (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.
7. Certificate of Compliance as to 9-30-2013 order, including further amendment of section heading, first paragraph and subsections (b)(1), (b)(2), (k) and (l)(6), transmitted to OAL 12-30-2013 and filed 2-12-2014; amendments effective 2-12-2014 pursuant to Government Code section 11343.4(b)(3) (Register 2014, No. 7).