reglab/statecodes huggingface dataset:
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 3.5 - ARBITRATION › Section 5275.

5275. (a) Disputes involving the following issues shall be submitted for arbitration:
(1) Insurance coverage.
(2) Right of contribution in accordance with Section 5500.5.
(b) By agreement of the parties, any issue arising under Division 1 (commencing with Section 50) or Division 4 (commencing with Section 3200) may be submitted for arbitration, regardless of the date of injury.
(Amended by Stats. 2002, Ch. 6, Sec. 70.5. Effective January 1, 2003.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 3.5 - ARBITRATION › Section 5276.

5276. (a) Arbitration proceedings may commence at any place and time agreed upon by all parties.
(b) If the parties cannot agree on a time or place to commence arbitration proceedings, the arbitrator shall order the date, time and place for commencement of the proceeding. Unless all parties agree otherwise, arbitration proceedings shall commence not less than 30 days nor more than 60 days from the date an arbitrator is selected.
(c) Ten days before the arbitration, each party shall submit to the arbitrator and serve on the opposing party reports, records and other documentary evidence on which that party intends to rely. If a party intends to rely upon excerpts of records or depositions, only copies of the excerpts shall be submitted to the arbitrator.
(Added by Stats. 1989, Ch. 892, Sec. 44.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 3.5 - ARBITRATION › Section 5277.

5277. (a) The arbitrator’s findings and award shall be served on all parties within 30 days of submission of the case for decision.
(b) The arbitrator’s award shall comply with Section 5313 and shall be filed with the appeals board office pursuant to venue rules published by the appeals board.
(c) The findings of fact, award, order, or decision of the arbitrator shall have the same force and effect as an award, order, or decision of a workers’ compensation judge.
(d) Use of an arbitrator for any part of a proceeding or any issue shall not bind the parties to the use of the same arbitrator for any subsequent issues or proceedings.
(e) Unless all parties agree to a longer period of time, the failure of the arbitrator to submit the decision within 30 days shall result in forfeiture of the arbitrator’s fee and shall vacate the submission order and all stipulations.
(f)  The presiding workers’ compensation judge may submit supplemental proceedings to arbitration pursuant to this part.
(Amended by Stats. 2006, Ch. 538, Sec. 490. Effective January 1, 2007.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 3.5 - ARBITRATION › Section 5278.

5278. (a) No disclosure of any offers of settlement made by any party shall be made to the arbitrator prior to the filing of the award.
(b) Article 7 (commencing with Section 11430.10) of Chapter 4.5 of Part 1 of Division 3 of Title 2 of the Government Code applies to a communication to the arbitrator or a potential arbitrator.
(Amended by Stats. 1995, Ch. 938, Sec. 75. Effective January 1, 1996. Operative July 1, 1997, by Sec. 98 of Ch. 938.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5300.

5300. All the following proceedings shall be instituted before the appeals board and not elsewhere, except as otherwise provided in Division 4:
(a) For the recovery of compensation, or concerning any right or liability arising out of or incidental thereto.
(b) For the enforcement against the employer or an insurer of any liability for compensation imposed upon the employer by this division in favor of the injured employee, his or her dependents, or any third person.
(c) For the determination of any question as to the distribution of compensation among dependents or other persons.
(d) For the determination of any question as to who are dependents of any deceased employee, or what persons are entitled to any benefit under the compensation provisions of this division.
(e) For obtaining any order which by Division 4 the appeals board is authorized to make.
(f) For the determination of any other matter, jurisdiction over which is vested by Division 4 in the Division of Workers’ Compensation, including the administrative director and the appeals board.
(Amended by Stats. 1994, Ch. 146, Sec. 152. Effective January 1, 1995.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5301.

5301. The appeals board is vested with full power, authority and jurisdiction to try and determine finally all the matters specified in Section 5300 subject only to the review by the courts as specified in this division.
(Amended by Stats. 1965, Ch. 1513.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5302.

5302. All orders, rules, findings, decisions, and awards of the appeals board shall be prima facie lawful and conclusively presumed to be reasonable and lawful, until and unless they are modified or set aside by the appeals board or upon a review by the courts within the time and in the manner specified in this division.
(Amended by Stats. 1965, Ch. 1513.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5303.

5303. There is but one cause of action for each injury coming within the provisions of this division. All claims brought for medical expense, disability payments, death benefits, burial expense, liens, or any other matter arising out of such injury may, in the discretion of the appeals board, be joined in the same proceeding at any time; provided, however, that no injury, whether specific or cumulative, shall, for any purpose whatsoever, merge into or form a part of another injury; nor shall any award based on a cumulative injury include disability caused by any specific injury or by any other cumulative injury causing or contributing to the existing disability, need for medical treatment or death.
(Amended by Stats. 1968, 1st Ex. Sess., Ch. 4.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5304.

5304. The appeals board has jurisdiction over any controversy relating to or arising out of Sections 4600 to 4605 inclusive, unless an express agreement fixing the amounts to be paid for medical, surgical or hospital treatment as such treatment is described in those sections has been made between the persons or institutions rendering such treatment and the employer or insurer.
(Amended by Stats. 1965, Ch. 1513.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5305.

5305. The Division of Workers’ Compensation, including the administrative director, and the appeals board have jurisdiction over all controversies arising out of injuries suffered outside the territorial limits of this state in those cases where the injured employee is a resident of this state at the time of the injury and the contract of hire was made in this state. Any employee described by this section, or his or her dependents, shall be entitled to the compensation or death benefits provided by this division.
(Amended by Stats. 2002, Ch. 6, Sec. 71. Effective January 1, 2003.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5306.

5306. The death of an employer subsequent to the sustaining of an injury by an employee shall not impair the right of the employee to proceed before the appeals board against the estate of the employer, and the failure of the employee or his dependents to cause the claim to be presented to the executor or administrator of the estate shall not in any way bar or suspend such right.
(Amended by Stats. 1965, Ch. 1513.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5307.

5307. (a) The appeals board may, by an order signed by four members, do all of the following:
(1) Adopt reasonable and proper rules of practice and procedure.
(2) Regulate and provide the manner in which, and by whom, minors and incompetent persons are to appear and be represented before it.
(3) Regulate and prescribe the kind and character of notices, where not specifically prescribed by this division, and the service thereof.
(4) Regulate and prescribe the nature and extent of the proofs and evidence.
(b) No rule or regulation of the appeals board pursuant to this section shall be adopted, amended, or rescinded without public hearings. Any written request filed with the appeals board seeking a change in its rules or regulations shall be deemed to be denied if not set by the appeals board for public hearing to be held within six months of the date on which the request is received by the appeals board.
(Amended by Stats. 2011, Ch. 559, Sec. 11. (AB 1426) Effective October 7, 2011.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5307.11.

5307.11. A health care provider or health facility licensed pursuant to Section 1250 of the Health and Safety Code, and a contracting agent, employer, or carrier may contract for reimbursement rates different from those in the fee schedule adopted and revised pursuant to Section 5307.1. When a health care provider or health facility licensed pursuant to Section 1250 of the Health and Safety Code, and a contracting agent, employer, or carrier contract for reimbursement rates different from those in the fee schedule, the medical fee schedule for that health care provider or health facility licensed pursuant to Section 1250 of the Health and Safety Code shall not apply to the contracted reimbursement rates. Except as provided in subdivision (b) of Section 5307.1, the official medical fee schedule shall establish maximum reimbursement rates for all medical services for injuries subject to this division provided by a health care provider or health care facility licensed pursuant to Section 1250 of the Health and Safety Code other than those specified in contracts subject to this section.
(Added by Stats. 2001, Ch. 252, Sec. 1. Effective January 1, 2002.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5307.12.

5307.12. (a) If a health care provider or health facility, licensed pursuant to Section 1250 of the Health and Safety Code, and an entity that provides physician network services, as defined in subdivision (b) of Section 4616.5, or an entity that provides ancillary network services, as defined in subdivision (c) of Section 4616.5, contract for a reimbursement rate that is more than 20 percent below the official medical fee schedule, excluding goods and pharmaceuticals, the entity that provides physician or ancillary network services shall provide the payor with a written disclosure, on a form promulgated by the administrative director, of the reimbursement amount paid to the provider.
(b) Before providing the disclosure required pursuant to subdivision (a), the entity that provides physician or ancillary network services may require the payor to sign a nondisclosure agreement with the entity that provides physician or ancillary network services agreeing to maintain the confidentiality of the disclosed information.
(c) A nondisclosure agreement signed pursuant to subdivision (b) shall not prohibit the division from obtaining the information disclosed pursuant to subdivision (a). This subdivision is declaratory of existing law.
(d) This section does not apply to an entity that provides physician or ancillary network services that discloses, or arranges for the disclosure of, the same pricing and payment information to both the health care provider or health facility and the person or entity paying for the services.
(e) This section shall become operative on July 1, 2021.
(Added by Stats. 2019, Ch. 647, Sec. 9. (SB 537) Effective January 1, 2020. Operative July 1, 2021, by its own provisions.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5307.2.

5307.2. The administrative director shall contract with an independent consulting firm, to the extent permitted by state law, to perform an annual study of access to medical treatment for injured workers. The study shall analyze whether there is adequate access to quality health care and products, including prescription drugs and pharmacy services, for injured workers and make recommendations to ensure continued access. If the administrative director determines, based on this study, that there is insufficient access to quality health care or products for injured workers, including access to prescription drugs and pharmacy services, the administrative director may make appropriate adjustments to medical, prescription drugs and pharmacy services, and facilities’ fees. When there has been a determination that substantial access problems exist, the administrative director may, in accordance with the notification and hearing requirements of Section 5307.1, adopt fees in excess of 120 percent of the applicable Medicare payment system fee, or in excess of 100 percent of the fees prescribed in the relevant Medi-Cal payment system, for the applicable services or products.
(Amended by Stats. 2008, Ch. 193, Sec. 1. Effective January 1, 2009.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5307.27.

5307.27. (a) The administrative director, in consultation with the Commission on Health and Safety and Workers’ Compensation, shall adopt, after public hearings, a medical treatment utilization schedule, that shall incorporate the evidence-based, peer-reviewed, nationally recognized standards of care recommended by the commission pursuant to Section 77.5, and that shall address, at a minimum, the frequency, duration, intensity, and appropriateness of all treatment procedures and modalities commonly performed in workers’ compensation cases. Evidence-based updates to the utilization schedule shall be made through an order exempt from Sections 5307.3 and 5307.4, and the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), but the administrative director shall allow at least a 30-day period for public comment and a public hearing. The administrative director shall provide responses to submitted comments prior to the effective date of the updates. All orders issued pursuant to this subdivision shall be published on the Internet Web site of the Division of Workers’ Compensation.
(b) On or before July 1, 2017, the medical treatment utilization schedule adopted by the administrative director shall include a drug formulary using evidence-based medicine. Nothing in this section shall prohibit the authorization of medications that are not in the formulary when the variance is demonstrated, consistent with subdivision (a) of Section 4604.5.
(c) The drug formulary shall include a phased implementation for workers injured prior to July 1, 2017, in order to ensure injured workers safely transition to medications pursuant to the formulary.
(d) This section shall apply to all prescribers and dispensers of medications serving injured workers under the workers’ compensation system.
(Amended by Stats. 2016, Ch. 868, Sec. 10. (SB 1160) Effective January 1, 2017.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5307.28.

5307.28. (a)  Prior to the adoption of a drug formulary as required by Section 5307.27, the administrative director shall meet and consult regarding the establishment of a formulary with stakeholders, including, but not limited to, employers, insurers, private sector employee representatives, public sector employee representatives, treating physicians actively practicing medicine, pharmacists, pharmacy benefit managers, attorneys who represent applicants, and injured workers.
(b) Commencing July 1, 2016, and concluding with the implementation of the formulary, the administrative director shall publish at least two interim reports on the Internet Web site of the Division of Workers’ Compensation describing the status of the creation of the formulary.
(Added by Stats. 2015, Ch. 525, Sec. 5. (AB 1124) Effective January 1, 2016.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5307.29.

5307.29. (a) The administrative director shall make provision for no less than quarterly updates to the drug formulary to allow for the provision of all appropriate medications, including those new to the market.
(b) Changes made to the list of drugs in the drug formulary described in Section 5307.27 shall be made through an order exempt from Sections 5307.3 and 5307.4, and the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code), informing the public of the changes and their effective date. All orders issued pursuant to this subdivision shall be published on the Internet Web site of the Division of Workers’ Compensation.
(c) The administrative director shall establish an independent pharmacy and therapeutics committee to review and consult with the administrative director on available evidence of the relative safety, efficacy, and effectiveness of drugs within a class of drugs in the updating of an evidence-based drug formulary, as required by Section 5307.27.
(1) The committee shall consist of six members and the Executive Medical Director of the Division of Workers’ Compensation. The committee shall consist of medical doctors or doctors of osteopathy holding a physician and surgeon license pursuant to Chapter 5 (commencing with Section 2000) of Division 2 of the Business and Professions Code, and pharmacists licensed pursuant to Chapter 9 (commencing with Section 4000) of Division 2 of the Business and Professions Code. A committee member shall have knowledge or expertise in one or more of the following:
(A) Clinically appropriate prescribing of covered drugs.
(B) Clinically appropriate dispensing and monitoring of covered drugs.
(C) Drug use review.
(D) Evidence-based medicine.
(2) Committee members shall not be employed by a pharmaceutical manufacturer, a pharmacy benefits management company, or a company engaged in the development of a pharmaceutical formulary for commercial sale during his or her term, and shall not have been so employed for 12 months prior to his or her appointment.
(3) A committee member shall not have a substantial financial conflict of interest pursuant to standards established by the administrative director. The administrative director may, in his or her sole discretion, disqualify a potential or current member of the committee if the administrative director determines that a substantial conflict of interest exists.
(4) A committee member shall agree to keep all proprietary information confidential to the extent required by existing law.
(Added by Stats. 2015, Ch. 525, Sec. 6. (AB 1124) Effective January 1, 2016.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5307.3.

5307.3. The administrative director may adopt, amend, or repeal any rules and regulations that are reasonably necessary to enforce this division, except where this power is specifically reserved to the appeals board.
No rule or regulation of the administrative director pursuant to this section shall be adopted, amended, or rescinded without public hearings. Any written request filed with the administrative director seeking a change in its rules or regulations shall be deemed to be denied if not set by the administrative director for public hearing to be held within six months of the date on which the request is received by the administrative director.
(Amended by Stats. 2011, Ch. 559, Sec. 12. (AB 1426) Effective October 7, 2011.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5307.4.

5307.4. (a) Public hearings required under Sections 5307 and 5307.3 shall be subject to the provisions of this section except to the extent that there is involved a matter relating to the management, or to personnel, or to public property, loans, grants, benefits, or to contracts, of the appeals board or the administrative director.
(b) Notice of the rule or regulation proposed to be adopted, amended, or rescinded, shall be given to such business and labor organizations and firms or individuals who have requested notice thereof. The notice shall include all of the following:
(1) A statement of the time, place, and nature of the public hearings.
(2) Reference to the legal authority under which the rule is proposed.
(3) Either the terms or substance of the proposed rule, or a description of the subjects and the issues involved.
(c) Except where the proposed rule or regulation has a significant impact on the public, this section shall not apply to interpretive rules, general statements of policy, or rules of agency organization.
(d) After notice required by this section, the appeals board or the administrative director shall give interested persons the opportunity to participate in the rulemaking through submission of written data, views, or arguments, with opportunity for oral presentation. If, after consideration of the relevant matter presented, the appeals board or the administrative director adopts a rule, it or he shall publish a concise, general statement of reasons for the adoption of the rule. The rule and statement of reasons shall be given to the same individuals and organizations who have requested notice of hearings.
(e) The notice required under this section shall be made not less than 30 days prior to the public hearing date.
(Added by Stats. 1977, Ch. 517.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5307.5.

5307.5. The appeals board or a workers’ compensation judge may:
(a) Appoint a trustee or guardian ad litem to appear for and represent any minor or incompetent upon the terms and conditions which it deems proper. The guardian or trustee shall, if required by the appeals board, give a bond in the form and of the character required by law from a guardian appointed by a superior court and in the amount which the appeals board determines. The bond shall be approved by the appeals board, and the guardian or trustee shall not be discharged from liability until he or she files an account with the appeals board or with the superior court and the account is approved. The trustee or guardian shall receive the compensation for his or her services fixed and allowed by the appeals board or by the superior court.
(b) Provide for the joinder in the same proceeding of all persons interested therein, whether as employer, insurer, employee, dependent, creditor, or otherwise.
(Amended by Stats. 1985, Ch. 326, Sec. 13.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5307.6.

5307.6. (a) The administrative director shall adopt and revise a fee schedule for medical-legal expenses as defined by Section 4620, which shall be prima facie evidence of the reasonableness of fees charged for medical-legal expenses at the same time he or she adopts and revises the medical fee schedule pursuant to Section 5307.1.
The schedule shall consist of a series of procedure codes, relative values, and a conversion factor producing fees which provide remuneration to physicians performing medical-legal evaluations at a level equivalent to that provided to physicians for reasonably comparable work, and which additionally recognizes the relative complexity of various types of evaluations, the amount of time spent by the physician in direct contact with the patient, and the need to prepare a written report.
(b) A provider shall not be paid fees in excess of those set forth in the fee schedule established under this section unless the provider provides an itemization and explanation of the fee that shows that it is both a reasonable fee and that extraordinary circumstances relating to the medical condition being evaluated justify a higher fee; provided, however, that in no event shall a provider charge in excess of his or her usual fee. The employer and employee shall have standing to contest fees in excess of those set forth in the fee schedule.
(c) In the event of a dispute between the provider and the employer, employee, or carrier concerning the fees charged, the provider may be allowed a reasonable fee for testimony if the provider testified pursuant to the employer’s or carrier’s subpoena and the judge or referee determines that the fee charged was reasonable and justified by extraordinary circumstances.
(d) (1) No provider may request nor accept any compensation, including, but not limited to, any kind of remuneration, discount, rebate, refund, dividend, distribution, subsidy, or other form of direct or indirect payment, whether in money or otherwise, from any source for medical-legal expenses if such compensation is in addition to the fees authorized by this section. In addition to being subject to discipline pursuant to the provisions of subdivision (k) of Section 139.2, any provider violating this subdivision is subject to disciplinary action by the appropriate licensing board.
(2) This subdivision does not apply to medical-legal expenses for which the administrative director has not adopted a fee schedule.
(Amended by Stats. 1993, Ch. 1242, Sec. 38. Effective January 1, 1994.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5307.7.

5307.7. (a) On or before January 1, 2013, the administrative director shall adopt, after public hearings, a fee schedule that shall establish reasonable fees paid for services provided by vocational experts, including, but not limited to, vocational evaluations and expert testimony determined to be reasonable, actual, and necessary by the appeals board.
(b) A vocational expert shall not be paid, and the appeals board shall not allow, vocational expert fees in excess of those that are reasonable, actual, and necessary, or that are not consistent with the fee schedule adopted by the administrative director.
(Amended by Stats. 2012, Ch. 363, Sec. 75. (SB 863) Effective January 1, 2013.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5307.8.

5307.8. (a) Notwithstanding Section 5307.1, the administrative director shall adopt, after public hearings, a schedule for payment of home health care services provided in accordance with Section 4600 that are not covered by a Medicare fee schedule and are not otherwise covered by the official medical fee schedule adopted pursuant to Section 5307.1. The schedule shall set forth fees and requirements for service providers, and may be based upon, but is not limited to, being based upon, either of the following:
(1) The maximum service hours and fees as set forth in regulations adopted pursuant to Article 7 (commencing with Section 12300) of Chapter 3 of Part 3 of Division 9 of the Welfare and Institutions Code.
(2) A state or federal home health care services fee schedule other than the schedule described in paragraph (1), including a fee schedule authorized for purposes of the Medi-Cal program or a fee schedule administered by the federal Office of Workers’ Compensation Programs.
(b) Fees shall not be provided for any services, including any services provided by a member of the employee’s household, to the extent the services had been regularly performed in the same manner and to the same degree prior to the date of injury. If appropriate, attorney’s fees for recovery of home health care services fees under this section may be awarded in accordance with Section 4906 and any applicable rules or regulations.
(Amended by Stats. 2015, Ch. 542, Sec. 5. (SB 542) Effective January 1, 2016.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5307.9.

5307.9. On or before December 31, 2013, the administrative director, in consultation with the Commission on Health and Safety and Workers’ Compensation, shall adopt, after public hearings, a schedule of reasonable maximum fees payable for copy and related services, including, but not limited to, records or documents that have been reproduced or recorded in paper, electronic, film, digital, or other format. The schedule shall specify the services allowed and shall require specificity in billing for these services, and shall not allow for payment for services provided within 30 days of a request by an injured worker or his or her authorized representative to an employer, claims administrator, or workers’ compensation insurer for copies of records in the employer’s, claims administrator’s, or workers’ compensation insurer’s possession that are relevant to the employee’s claim. The schedule shall be applicable regardless of whether payments of copy service costs are claimed under the authority of Section 4600, 4620, or 5811, or any other authority except a contract between the employer and the copy service provider.
(Added by Stats. 2012, Ch. 363, Sec. 77. (SB 863) Effective January 1, 2013.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5308.

5308. The appeals board has jurisdiction to determine controversies arising out of insurance policies issued to self-employing persons, conferring benefits identical with those prescribed by this division.
The appeals board may try and determine matters referred to it by the parties under the provisions of Title 9 (commencing with Section 1280) of Part 3 of the Code of Civil Procedure, with respect to controversies arising out of insurance issued to self-employing persons under the provisions of this division. Such controversies may be submitted to it by the signed agreement of the parties, or by the application of one party and the submission of the other to its jurisdiction, with or without an express request for arbitration.
The State Compensation Insurance Fund, when the consent of the other party is obtained, shall submit to the appeals board all controversies susceptible of being arbitrated under this section.
In acting as arbitrator under this section, the appeals board has all the powers which it may lawfully exercise in compensation cases, and its findings and award upon such arbitration have the same conclusiveness and are subject to the same mode of reopening, review, and enforcement as in compensation cases. No fee or cost shall be charged by the appeals board for arbitrating the issues presented under this section.
(Amended by Stats. 1967, Ch. 125.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5309.

5309. The appeals board may, in accordance with rules of practice and procedure which it shall adopt and upon the agreement of the parties, on the application of either, or of its own motion, and with or without notice, direct and order a workers’ compensation judge:
(a) To try the issues in any proceeding before it, whether of fact or of law, and make and file a finding, order, decision, or award based thereon.
(b) To hold hearings and ascertain facts necessary to enable the appeals board to determine any proceeding or to make any order, decision, or award that the appeals board is authorized to make under Divisions 4 or 5, or necessary for the information of the appeals board.
(c) To issue writs or summons, warrants of attachment, warrants of commitment, and all necessary process in proceedings for direct and hybrid contempt in a like manner and to the same extent as courts of record. For the purposes of this section, “hybrid contempt” means a charge of contempt which arises from events occurring in the immediate presence of the workers’ compensation judge for reasons which occur outside the presence of the workers’ compensation judge.
(Amended by Stats. 1988, Ch. 222, Sec. 1.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5310.

5310. The appeals board may appoint one or more workers’ compensation administrative law judges in any proceeding, as it may deem necessary or advisable, and may refer, remove to itself, or transfer to a workers’ compensation administrative law judge the proceedings on any claim. The administrative director may appoint workers’ compensation administrative law judges. Any workers’ compensation administrative law judge appointed by the administrative director has the powers, jurisdiction, and authority granted by law, by the order of appointment, and by the rules of the appeals board.
(Amended by Stats. 2011, Ch. 559, Sec. 13. (AB 1426) Effective October 7, 2011.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5311.

5311. Any party to the proceeding may object to the reference of the proceeding to a particular workers’ compensation judge upon any one or more of the grounds specified in Section 641 of the Code of Civil Procedure and the objection shall be heard and disposed of by the appeals board. Affidavits may be read and witnesses examined as to the objections.
(Amended by Stats. 1985, Ch. 326, Sec. 16.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5311.5.

5311.5. The administrative director shall require all workers’ compensation administrative law judges to participate in continuing education to further their abilities as workers’ compensation administrative law judges, including courses in ethics and conflict of interest. The director may coordinate the requirements with those imposed upon attorneys by the State Bar in order that the requirements may be consistent.
(Amended by Stats. 2011, Ch. 559, Sec. 14. (AB 1426) Effective October 7, 2011.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5312.

5312. Before entering upon his or her duties, the workers’ compensation judge shall be sworn, before an officer authorized to administer oaths, faithfully and fairly to hear and determine the matters and issues referred to him or her, to make just findings and to report according to his or her understanding.
(Amended by Stats. 1985, Ch. 326, Sec. 17.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5313.

5313. The appeals board or the workers’ compensation judge shall, within 30 days after the case is submitted, make and file findings upon all facts involved in the controversy and an award, order, or decision stating the determination as to the rights of the parties. Together with the findings, decision, order or award there shall be served upon all the parties to the proceedings a summary of the evidence received and relied upon and the reasons or grounds upon which the determination was made.
(Amended by Stats. 1985, Ch. 326, Sec. 18.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5315.

5315. Within 60 days after the filing of the findings, decision, order or award, the appeals board may confirm, adopt, modify or set aside the findings, order, decision, or award of a workers’ compensation judge and may, with or without further proceedings, and with or without notice, enter its order, findings, decision, or award based upon the record in the case.
(Amended by Stats. 1985, Ch. 326, Sec. 19.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5316.

5316. Any notice, order, or decision required by this division to be served upon any person either before, during, or after the institution of any proceeding before the appeals board, may be served in the manner provided by Chapter 5, Title 14 of Part 2 of the Code of Civil Procedure, unless otherwise directed by the appeals board. In the latter event the document shall be served in accordance with the order or direction of the appeals board. The appeals board may, in the cases mentioned in the Code of Civil Procedure, order service to be made by publication of notice of time and place of hearing. Where service is ordered to be made by publication the date of the hearing may be fixed at more than 30 days from the date of filing the application.
(Amended by Stats. 1965, Ch. 1513.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 1 - Jurisdiction › Section 5317.

5317. Any such notice, order or decision affecting the State or any county, city, school district, or public corporation therein, shall be served upon the person upon whom the service of similar notices, orders, or decisions is authorized by law.
(Enacted by Stats. 1937, Ch. 90.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 2 - Limitations of Proceedings › Section 5400.

5400. Except as provided by sections 5402 and 5403, no claim to recover compensation under this division shall be maintained unless within thirty days after the occurrence of the injury which is claimed to have caused the disability or death, there is served upon the employer notice in writing, signed by the person injured or someone in his behalf, or in case of the death of the person injured, by a dependent or someone in the dependent’s behalf.
(Enacted by Stats. 1937, Ch. 90.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 2 - Limitations of Proceedings › Section 5401.7.

5401.7. The claim form shall contain, prominently stated, the following statement:
“Any person who makes or causes to be made any knowingly false or fraudulent material statement or material representation for the purpose of obtaining or denying workers’ compensation benefits or payments is guilty of a felony.”
The statements required to be printed or displayed pursuant to Section 1871.2 of the Insurance Code may, but are not required to, appear on the claim form.
(Amended by Stats. 2022, Ch. 424, Sec. 30. (SB 1242) Effective January 1, 2023.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 2 - Limitations of Proceedings › Section 5402.

5402. (a) Knowledge of an injury, obtained from any source, on the part of an employer, the employer’s managing agent, superintendent, foreman, or other person in authority, or knowledge of the assertion of a claim of injury sufficient to afford opportunity to the employer to make an investigation into the facts, is equivalent to service under Section 5400.
(b) (1) If liability is not rejected within 90 days after the date the claim form is filed under Section 5401, the injury shall be presumed compensable under this division. The presumption of this subdivision is rebuttable only by evidence discovered subsequent to the 90-day period.
(2) Notwithstanding paragraph (1), for injuries or illnesses defined in Sections 3212 to 3212.85, inclusive, and Sections 3212.9 to 3213.2, inclusive, if the liability is not rejected within 75 days after the date the claim form is filed pursuant to Section 5401, the injury shall be presumed compensable under this division. The presumption of this subdivision is rebuttable only by evidence discovered subsequent to the 75-day period.
(c) Within one working day after an employee files a claim form under Section 5401, the employer shall authorize the provision of all treatment, consistent with Section 5307.27, for the alleged injury and shall continue to provide the treatment until the date that liability for the claim is accepted or rejected. Until the date the claim is accepted or rejected, liability for medical treatment shall be limited to ten thousand dollars ($10,000).
(d) Treatment provided under subdivision (c) does not give rise to a presumption of liability on the part of the employer.
(e) Upon appropriation by the Legislature, the Division of Workers’ Compensation shall identify and amend its existing data collection processes to include collection of the date on which the claimant is notified of acceptance, denial, or conditional denial of liability for a claim, consistent with this section.
(Amended by Stats. 2022, Ch. 835, Sec. 3. (SB 1127) Effective January 1, 2023.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 2 - Limitations of Proceedings › Section 5403.

5403. The failure to give notice under section 5400, or any defect or inaccuracy in a notice is not a bar to recovery under this division if it is found as a fact in the proceedings for the collection of the claim that the employer was not in fact misled or prejudiced by such failure.
(Enacted by Stats. 1937, Ch. 90.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 2 - Limitations of Proceedings › Section 5404.

5404. Unless compensation is paid within the time limited in this chapter for the institution of proceedings for its collection, the right to institute such proceedings is barred. The timely filing of an application with the appeals board by any party in interest for any part of the compensation defined by Section 3207 renders this chapter inoperative as to all further claims by such party against the defendants therein named for compensation arising from that injury, and the right to present such further claims is governed by Sections 5803 to 5805, inclusive.
(Amended by Stats. 1965, Ch. 1513.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 2 - Limitations of Proceedings › Section 5404.5.

5404.5. (a) Where a claim form has been filed prior to January 1, 1994, and where the claim is denied by the employer, the claim may be dismissed if there has been no activity for the previous 180 days and if the claims adjuster has served notice pursuant to Article 3 (commencing with Section 415.10) of Chapter 4 of Title 5 of the Code of Civil Procedure. The notice shall specify that the claim will be dismissed by operation of law unless an application for adjudication of the claim is filed within 180 days of service of the notice.
(b) Where a claim form has been filed prior to January 1, 1994, and where benefits have been furnished by the employer, the claim may be dismissed if there has been no activity for the previous 180 days and if the claims adjuster has served notice pursuant to Article 3 (commencing with Section 415.10) of Chapter 4 of Title 5 of the Code of Civil Procedure. The notice shall specify that the claim will be dismissed by operation of law unless an application for adjudication of the claim is filed within five years of the date of injury or within one year of the last furnishing of benefits, whichever is later.
(c) The administrative director may adopt rules of practice and procedure consistent with this section.
(d) The provisions of subdivisions (a) and (b) do not limit the jurisdiction of the appeals board.
(e) This section is applicable to injuries occurring before January 1, 1994.
(Amended by Stats. 1993, Ch. 1242, Sec. 40. Effective January 1, 1994.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 2 - Limitations of Proceedings › Section 5405.

5405. The period within which proceedings may be commenced for the collection of the benefits provided by Article 2 (commencing with Section 4600) or Article 3 (commencing with Section 4650), or both, of Chapter 2 of Part 2 is one year from any of the following:
(a) The date of injury.
(b) The expiration of any period covered by payment under Article 3 (commencing with Section 4650) of Chapter 2 of Part 2.
(c) The last date on which any benefits provided for in Article 2 (commencing with Section 4600) of Chapter 2 of Part 2 were furnished.
(Amended by Stats. 2002, Ch. 6, Sec. 78. Effective January 1, 2003.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 2 - Limitations of Proceedings › Section 5406.

5406. (a) Except as provided in Section 5406.5, 5406.6, or 5406.7, the period within which may be commenced proceedings for the collection of the benefits provided by Article 4 (commencing with Section 4700) of Chapter 2 of Part 2 is one year from:
(1) The date of death if death occurs within one year from date of injury.
(2) The date of last furnishing of any benefits under Chapter 2 (commencing with Section 4550) of Part 2, if death occurs more than one year from the date of injury.
(3) The date of death, if death occurs more than one year after the date of injury and compensation benefits have been furnished.
(b) Proceedings shall not be commenced more than one year after the date of death, nor more than 240 weeks from the date of injury.
(Amended by Stats. 2015, Ch. 303, Sec. 378. (AB 731) Effective January 1, 2016.)
2023 California Code › Labor Code - LAB › DIVISION 4 - WORKERS' COMPENSATION AND INSURANCE › PART 4 - COMPENSATION PROCEEDINGS › CHAPTER 2 - Limitations of Proceedings › Section 5406.5.

5406.5. In the case of the death of an asbestos worker or firefighter from asbestosis, the period within which proceedings may be commenced for the collection of the benefits provided by Article 4 (commencing with Section 4700) of Chapter 2 of Part 2 is one year from the date of death.
(Amended by Stats. 2003, Ch. 831, Sec. 1. Effective January 1, 2004.)