"You have a right to disagree with decisions affecting your claim. If you have any questions about the information provided to you in this notice, please call, [insert either me, the adjuster's name or a specific claims department name and telephone number]. You also have the right to be represented by an attorney of your choice. However, if you are represented by an attorney, you should call your attorney, not me.
"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 (800) 736-7401."
"You have a right to disagree with decisions affecting your claim. If you have any questions regarding the information provided to you in this notice, please call, [insert either me, the adjuster's name or a specific claims department name and telephone number], or [insert name, title, and telephone of ombudsperson or mediator]. However, if you are represented by an attorney, you should call your attorney, not [insert me, or the specific claims department name], the ombudsperson, or mediator.
NOTE: For employees subject to an alternative dispute resolution (ADR) program under Labor Code section 3201.5, the claims administrator may include the following language if appropriate under the provisions of the ADR program:
"In accordance with the [insert union name] agreement, active participation by an attorney is not allowed in the Ombudsman and Mediation stages of the ADR workers' compensation process. However, you have the right to consult with an attorney and your right to obtain legal advice is not limited and you may obtain such at your own expense at any time. If the Ombudsman and Mediation stages of dispute resolution are unsuccessful and a written request for Arbitration has been timely filed, attorney participation is allowed.
"For information about the workers' compensation claims process and your rights and obligations, contact an information and assistance (I&A) officer of the state Division of Workers' Compensation. Be sure to inform the I&A officer that your claim is subject to an alternative dispute resolution program. For a list of offices, go to www.dwc.ca.gov or call (800) 736-7401."
Cal. Code Regs. Tit. 8, § 9810
2. Editorial correction of 7-15-83 order redesignating effective date to 8-1-83 pursuant to Government Code section 11346.2(d) filed 7-19-83 (Register 83, No. 30).
3. Editorial correction of 7-15-83 order filed 8-11-83 (Register 83, No. 33).
4. Amendment of article heading, section and NOTE filed 1-7-94; operative 1-7-94. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 94, No. 1).
5. Repealer of subsection (d) and subsection relettering filed 7-7-2004; operative 8-1-2004 pursuant to Government Code section 11343.4 (Register 2004, No. 28).
6. Repealer and new article heading and amendment of section and NOTE filed 12-11-2007; operative 4-9-2008 (Register 2007, No. 50).
7. Amendment of section and NOTE filed 8-24-2015; operative 1-1-2016 (Register 2015, No. 35).
Note: Authority cited: Sections 59, 124, 133, 138.3, 138.4, 4061(a), 4061(b), 4061(d) and 5307.3, Labor Code. Reference: Sections 1010.6 and 1013, Code of Civil Procedure; and Sections 138.4, 4061 and 4650(a)-(d), Labor Code.
2. Editorial correction of 7-15-83 order redesignating effective date to 8-1-83 pursuant to Government Code section 11346.2(d) filed 7-19-83 (Register 83, No. 30).
3. Editorial correction of 7-15-83 order filed 8-11-83 (Register 83, No. 33).
4. Amendment of article heading, section and Note filed 1-7-94; operative 1-7-94. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 94, No. 1).
5. Repealer of subsection (d) and subsection relettering filed 7-7-2004; operative 8-1-2004 pursuant to Government Code section 11343.4 (Register 2004, No. 28).
6. Repealer and new article heading and amendment of section and Note filed 12-11-2007; operative 4-9-2008 (Register 2007, No. 50).
7. Amendment of section and Note filed 8-24-2015; operative 1/1/2016 (Register 2015, No. 35).