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STATE OF CALIFORNIALABOR AND WORKFORCE DEVELOPMENT AGENCYDEPARTMENT OF INDUSTRIAL RELATIONSDIVISION OFWORKERS’ COMPENSATION-------------WORKERS' COMPENSATIONAPPEALS BOARDPOLICY AND PROCEDURAL MANUAL2013 Revisionwww.dir.ca.gov
Division of Workers' Compensation – Workers' Compensation Appeals BoardPOLICY AND PROCEDURAL MANUAL2013 RevisionState of CaliforniaMEMORANDUMDate:February 14, 2013To:WORKERS’ COMPENSATION ADMINISTRATIVE LAW JUDGESWorkers’ Compensation Appeals BoardFrom:RONNIE G. CAPLANEChairwomanWorkers’ CompensationAppeals BoardSubject:DWC/WCAB POLICY AND PROCEDURAL MANUAL2012 REVISIONDESTIE OVERPECKActing Administrative DirectorDivision of Workers’ CompensationThis Policy and Procedural Manual, which became operative as of October 6, 2003, with all prior versionsand sections rescinded and deemed inoperative as of October 6, 2003, has been amended.This is not a final document. The Appeals Board and the Administrative Director will entertain suggestionsfor additional sections or revisions of existing sections. Those suggestions may be forwarded toWORKERS' COMPENSATION APPEALS BOARDPost Office Box 429459San Francisco CA 94142-9459i
Division of Workers' Compensation – Workers' Compensation Appeals BoardPOLICY AND PROCEDURAL MANUAL2013 Revision2012-2013 REVISION COMMITTEEFREDERICK T. DIETRICHSecretary and Deputy Commissioner, Workers’ Compensation Appeals BoardRICHARD NEWMANChief Judge, Division of Workers’ CompensationMARK FUDEMAssociate Chief Judge, Central Region, Division of Workers CompensationELLEN FLYNNAssociate Chief Judge, Southern Region, Division of Workers CompensationTHOMAS E. CLARKEAssociate Chief Judge, Northern Region, Division of Workers CompensationDivision of Workers’ Compensation, SalinasPAIGE LEVYPresiding Workers’ Compensation JudgeDivision of Workers’ Compensation, Marina del Rey PROJECT MANAGERPAIGE LEVYPresiding Workers’ Compensation JudgeDivision of Workers’ Compensation, Marina del Rey The Revision Committee acknowledges and thanks the Workers’ Compensation SectionExecutive Committee of the The State Bar of California for their assistance with the 20122013 amendments, and also extends thanks to Annette Gabrielli for her administrativeassistance.ii
Division of Workers' Compensation – Workers' Compensation Appeals BoardPOLICY AND PROCEDURAL MANUAL2013 Revision2002-2003 REVISION COMMITTEEMERLE C. RABINEChairman, Workers’ Compensation Appeals BoardDENNIS J. HANNIGANSecretary and Deputy Commissioner, Workers’ Compensation Appeals BoardSTEVEN P. SIEMERSChief Judge, Division of Workers’ CompensationKENNETH PETERSENAssociate Chief Judge, Northern Region, Division of Workers CompensationMARK KAHNAssociate Chief Judge, Southern Region, Division of Workers CompensationTHOMAS E. CLARKEPresiding Workers’ Compensation Administrative Law JudgeDivision of Workers’ Compensation, SalinasBERTRAM COHENPresiding Workers’ Compensation Administrative Law JudgeDivision of Workers’ Compensation, StocktonLINDA MORGANPresiding Workers’ Compensation Administrative Law JudgeDivision of Workers’ Compensation, Van NuysELLEN L. FLYNNPresiding Workers’ Compensation Administrative Law JudgeDivision of Workers’ Compensation, AnaheimDONNA DAVIDWorkers’ Compensation Administrative Law JudgeDivision of Workers’ Compensation, Long BeachJACQUELINE DUNCANWorkers’ Compensation Administrative Law JudgeDivision of Workers’ Compensation, San FranciscoNORMAN DE LA TERREWorkers’ Compensation Administrative Law JudgeDivision of Workers’ Compensation, Santa Ana PROJECT MANAGERRICHARD NEWMANWorkers’ Compensation Administrative Law JudgeDivision of Workers’ Compensation, San Franciscoiii
Division of Workers' Compensation – Workers' Compensation Appeals BoardPOLICY AND PROCEDURAL MANUAL2013 RevisionINTRODUCTIONThis 2013 revision of the DWC/WCAB Policy and Procedural Manual was prepared underthe direction of the Administrative Director of the Division of Workers' Compensation(DWC) and Chairwoman of the Workers' Compensation Appeals Board (WCAB) pursuantto Labor Code Section 133, which section confers on the DWC Administrative Director andthe Appeals Board the power and jurisdiction "to do all things necessary or convenient inthe exercise of any power or jurisdiction conferred upon it under this code."This manual consists of policies and procedures that DWC/WCAB employees are requiredto follow and to assist the DWC and the WCAB in providing uniformity and direction to itsemployees in the day-to-day operation of the Board and its district offices.-o0o-iv
Division of Workers' Compensation – Workers' Compensation Appeals BoardPOLICY AND PROCEDURAL MANUAL2013 RevisionTABLE OF 01.1451.1501.1551.1601.1651.175Exparte Oral and Written CommunicationsPetitions for Automatic ReassignmentDeclarations of Readiness to ProceedScope and Redesignation of Expedited HearingsWalk-ThroughEmergency Petitions to StayCalendar Clerk Cancellation of HearingTrial PrioritiesEvidence, Hospital and Medical RecordsConference and Trial Minutes and Summary of EvidenceProcedures Following Submission of Formal Rating InstructionsTaking Cases Off Calendar and SubmissionsProcedures for Petitions for ReconsiderationReport of Workers' Compensation Judge on ReconsiderationReferral to WCJ for Hearing Following A Grant of ReconsiderationPetitions to RemoveReport of Workers' Compensation Judge on RemovalReport of Workers' Compensation Judge on DisqualificationCompromise and Release and Stipulations With Request for AwardSubmission of Settlement, Determination of Adequacy, and ApprovalUninsured Employers, Joinder and SettlementProcedure If Proposed Settlement Not Acted On Within 45 DaysVenue for Claims of DWC EmployeesSigning of Stipulations With Request for AwardDisposition of Lien Claims In SettlementsService of Settlements on Lien ClaimantsAppearance by Non-Attorney RepresentativesFraud Reporting By WCJsSelf-Insured Employers, Certificate of ConsentTranscript RequestsAttorney's Fees, Lien forDeath Cases – Findings and Award Where No Dependents ExistSubsequent Injuries Benefits Trust FundCourt DecorumAccommodationsMonetary SanctionsCarve Out Proceduresv
Division of Workers' Compensation – Workers' Compensation Appeals BoardPOLICY AND PROCEDURAL MANUAL2013 RevisionSubjectIndex No.ACCOMMODATIONSAPPEARANCE – Non-Attorney RepresentativeATTORNEY FEES – Lien forAUTOMATIC REASSIGNMENT – Petitions forCARVE OUT – ProceduresCOMMUNICATIONS – Exparte Oral and WrittenCOMPROMISE AND RELEASE AND STIPULATIONS WITH REQUEST FOR AWARDCOURT DECORUMDECLARATION OF READINESS TO PROCEEDDISQUALIFICATION, Report of Workers’ Compensation Judge onEVIDENCE – Hospital and Medical Records, Filing and Organization of Trial ExibitsFILE (Case File) – Procedure If Proposed Settlement Not Acted on Within 45 DaysFINDINGS AND AWARD – Death Cases Where No Dependents ExistFRAUD Reporting by WCJsHEARING – Calendar Clerk Cancellation ofHEARING – Trial PrioritiesHEARING, EXPEDITED – Scope and Redesignation ofHEARING – Taking Cases Off Cqalendar and SubmissionsMINUTES AND SUMMARY OF EVIDENCE – Conference and TrialRATING INSTRUCTIONS, FORMAL – Procedures Following Submission ofRECONSIDERATION – Procedures for Petition forRECONSIDERATION – Referral to WCJ for HearingRECONSIDERATION – Report of Workers’ Compensation Judge onREMOVAL, Report of Workers’ Compensation Judge onREMOVE, Petitions toSTAY, Emergency Petition toSANCTIONS, MonetarySELF-INSURED EMPLOYERS – Certificate of ConsentSETTLEMENT - Disposition of Lien ClaimsSETTLEMENT – Service on Lien ClaimantsSETTLEMENT – Submission of, Determination of Adequacy, ApprovalSTIPULATIONS WITH REQUEST FOR AWARD – Signing ofSTIPULATIONS WITH REQUEST FOR AWARD AND COMPROMISE AND RELEASESUBSEQUENT INJURIES BENEFITS TRUST FUNDTRANSCRIPT, RequestsUNINSURED EMPLOYERS, Joinder and SettlementVENUE – Claims of DWC 101.911.1001.901.1501.1351.931.971.25
Division of Workers' Compensation – Workers' Compensation Appeals BoardPOLICY AND PROCEDURAL MANUAL2013 Revision1.0EX PARTE ORAL AND WRITTEN COMMUNICATIONSIssued byMERLE C. RABINERICHARD P. GANNONChairmanAdministrative DirectorWorkers’ Compensation Appeals BoardDivision of Workers’ CompensationEffective: October 6, 2003When a WCJ receives an ex parte letter or other document from any party or lien claimant in acase pending before the WCJ, he or she shall serve copies of the letter or document on all otherparties to the case with a cover letter explaining that the letter or document was received ex partein violation of WCAB Rule 10324.1.0 EX PARTE ORAL AND WRITTEN COMMUNICATIONSRETURN TO TABLE OF CONTENTSPage 1 of 1
Division of Workers' Compensation – Workers' Compensation Appeals BoardPOLICY AND PROCEDURAL MANUAL2013 Revision1.5PETITIONS FOR AUTOMATIC REASSIGNMENTIssued byRONNIE G. CAPLANEChairwomanWorkers’ Compensation Appeals BoardDESTIE OVERPECKActing Administrative DirectorDivision of Workers’ CompensationAmended: February 1, 2013Effective: October 6, 2003Reassignments pursuant to WCAB Rule 10453 shall be made, to the extent possible, in such amanner that the identity of the WCJ to whom the case is reassigned is unpredictable. Use ofrandom rotation systems is encouraged.All WCJs in an office must be included in initial assignments to try cases. The fact that aparticular attorney, law firm, employer or carrier regularly challenges a particular WCJ is not asufficient reason to exclude that WCJ from an initial assignment to a case.Upon timely request to reassign, the matter shall promptly be reassigned to another WCJ. Ifanother WCJ is not available in the district office, the PWCJ shall advise the Chief Judge ordesignee thereof and request reassignment.1.5 PETITIONS FOR AUTOMATIC REASSIGNMENTRETURN TO TABLE OF CONTENTSPage 1 of 1
Division of Workers' Compensation – Workers' Compensation Appeals BoardPOLICY AND PROCEDURAL MANUAL2013 Revision1.10DECLARATIONS OF READINESS TO PROCEEDIssued byRONNIE G. CAPLANEChairwomanWorkers’ Compensation Appeals BoardDESTIE OVERPECKActing Administrative DirectorDivision of Workers’ CompensationAmended: February 1, 2013Effective: October 6, 2003A.Review of declarations of readiness to proceed (DORs) by the PWCJ or his or herdesignee is no longer required. However, review of the following categories of DORs ispermissible prior to calendaring:1.DORs filed by lien claimants, to determine whether the case-in-chief has beenresolved (see Labor Code Section; 4903.5(c) and 4903.6(c).2.DORs to proceed to expedited hearing, to determine whether an expeditedhearing is appropriate under Labor Code Section 5502(b).Otherwise, hearings shall be calendared on request. Nonetheless, if prior to ascheduled hearing both parties inform the WCJ that the disputes in issue havebeen resolved, the hearing shall be taken off calendar without requiringappearances by the parties.B.After trial and service of a recommended rating, a party may file a DOR, noting under“other issues” that the party wishes to cross-examine the disability evaluator and/orpresent rebuttal evidence. The DOR shall be delivered to the office of the WCJ who hasheard the case or shall be filed by mail to the personal attention of the WCJ. Upon receiptof the DOR, the WCJ shall schedule the case for trial pursuant to his or her discretionunder WCAB Rule 10420.1.10 DECLARATIONS OF READINESS TO PROCEEDRETURN TO TABLE OF CONTENTSPage 1 of 1
Division of Workers' Compensation – Workers' Compensation Appeals BoardPOLICY AND PROCEDURAL MANUAL2013 Revision1.20SCOPE AND REDESIGNATION OF EXPEDITED HEARINGSIssued byRONNIE G. CAPLANEChairwomanWorkers’ Compensation Appeals BoardDESTIE OVERPECKActing Administrative DirectorDivision of Workers’ CompensationAmended: February 1, 2013Effective: October 6, 2003An expedited hearing may be set upon request where an injury has been accepted ascompensable by the employer and the issues include medical treatment, treatment within anMPN, temporary disability indemnity or treatment for a disputed body part or parts. However, aWCJ assigned to a case involving a disputed body part or parts may re-designate the hearing as amandatory settlement conference, receive a pretrial conference statement pursuant to Labor CodeSection 5502(d)(3), close discovery, and schedule the case for trial on the issues presented, if theWCJ determines, after consultation with the PWCJ, that the case is not appropriate for expediteddetermination. Such re-designation may be appropriate where, for example, the direct and crossexamination of the applicant will be prolonged, or where there are multiple witnesses who willoffer extensive testimony.1.20 SCOPE AND REDESIGNATION OF EXPEDITED HEARINGSRETURN TO TABLE OF CONTENTSPage 1 of 1
Division of Workers' Compensation – Workers' Compensation Appeals BoardPOLICY AND PROCEDURAL MANUAL2013 Revision1.25 WALK-THROUGHSIssued byRONNIE G. CAPLANEChairwomanWorkers’ Compensation Appeals BoardDESTIE OVERPECKActing Administrative DirectorDivision of Workers’ CompensationAmended: February 1, 2013Effective: October 6, 2003Walk-through documents may only be filed at the district office having venue over the case,or one of the cases, pursuant to Rule 10280(g).Walk-through documents may include a Compromise and Release, Stipulations with Requestfor Award, Petition for Deposition Attorney Fees, or petition to compel attendance at medicalexamination or deposition.Walk-through settlements (i.e. Compromise and Release or Stipulations with Request forAward) may be presented to the judge by a party to the case, by an attorney who has filed aNotice of Representation, or by a non-attorney representative who has filed a letter ofauthorization in the case pursuant to Policy & Procedural Manual Index No. 1.120.Where a settlement signed by a non-attorney employee of a law firm is submitted to aworkers’ compensation judge for approval, the settlement need not be signed or specificallyauthorized by the supervising attorney, if the attorney has previously signed and filed aspecific authorization for the employee to sign settlement documents in the case or casesbeing settled. Pursuant to Labor Code Section 4903(a), no fee for legal services shall beawarded to any representative who is not an attorney.A party, law firm office, or a representative office is limited to presenting five (5) walkthrough documents to a district office per court day absent permission from the PresidingJudge.Conference dates may not be obtained by interpreters or other “independent contractors”employed by a party or law firm for the purpose of obtaining dates.1.25 WALK-THROUGHSRETURN TO TABLE OF CONTENTSPage 1 of 1
Division of Workers' Compensation – Workers' Compensation Appeals BoardPOLICY AND PROCEDURAL MANUAL2013 Revision1.26EMERGENCY PETITIONS TO STAYIssued byRONNIE G. CAPLANEChairwomanWorkers’ Compensation Appeals BoardDESTIE OVERPECKActing Administrative DirectorDivision of Workers’ CompensationEffective: February 1, 2013A party seeking to stay an action by another party may present a petition to the Presiding Judgeor a designee of the district office having venue. The petition must comply with the notice anddeclaration requirements of Rule 10281. If the Presiding Judge or designee determines that thepetitioner has timely complied with the requirements, the Presiding Judge or designee shall doone of the following:1)Deny the petition;2)Grant a temporary stay and set the petition for a formal hearing;3)Set the petition for a formal hearing, without either denying the petition or granting atemporary stay.1.26 EMERGENCY PETITIONS TO STAYRETURN TO TABLE OF CONTENTSPage 1 of 1
Division of Workers' Compensation – Workers' Compensation Appeals BoardPOLICY AND PROCEDURAL MANUAL2013 Revision1.30CALENDAR CLERK CANCELLATION OF HEARINGIssued byRONNIE G. CAPLANEChairwomanWorkers’ Compensation Appeals BoardDESTIE OVERPECKActing Administrative DirectorDivision of Workers’ CompensationAmended: February 1, 2013Effective: October 6, 2003When a workers’ compensation judge (WCJ) orders the cancellation of a hearing prior to thedate of hearing, the WCJ or the WCJ's secretary shall ensure the hearing is cancelled in EAMS.The calendar clerk will then substitute another proceeding, or proceedings, consistent withlegal notice requirements.The presiding workers’ compensation judge will periodically monitor the calendar forcompliance with this rule.1.30 CALENDAR CLERK CANCELLATION OF HEARINGRETURN TO TABLE OF CONTENTSPage 1 of 1
Division of Workers' Compensation – Workers' Compensation Appeals BoardPOLICY AND PROCEDURAL MANUAL2013 Revision1.35TRIAL PRIORITIESIssued byRONNIE G. CAPLANEChairwomanWorkers’ Compensation Appeals BoardDESTIE OVERPECKActing Administrative DirectorDivision of Workers’ CompensationAmended: February 1, 2013Effective: October 6, 2003The WCJ conducting a trial should proceed at the time scheduled, allowing a minimal amount oftime for settlement negotiations. The parties should be encouraged to appear earlier than thescheduled time to conduct negotiations. Where several trials are scheduled to begin at the sametime (e.g., 8:30 a.m. or 1:30 p.m.), and the parties in two or more of those cases are ready toproceed to trial, the trial judge will determine case priority with due consideration being given toan expeditious determination and the setting of priorities discussed below.PROCEEDING PRIORITIESCases set on the trial calendar shall be subject to the following priorities:1.Cases set for Expedited Hearing;2.Cases which are returned to the calendar for cross-examination of the disabilityevaluation specialist;3.Continued cases in which testimony has been received (The judges are encouraged tohave these cases set on the first available opening in their calendar with notice waived.);4.Cases in which the applicant is not working and is receiving no benefits and/or in whichthe applicant or any witnesses have traveled from out of state or a significant distancewithin the state to appear;5.Cases that were previously set for trial but did not commence;6.Cases in which no benefits have been furnished but the applicant is working;7.All other cases.1.35 TRIAL PRIORITIESRETURN TO TABLE OF CONTENTSPage 1 of 2
Division of Workers' Compensation – Workers' Compensation Appeals BoardPOLICY AND PROCEDURAL MANUAL2013 RevisionCases described in (2) and (3) should be used for filling in spaces created by orders taking offcalendar, calendar continuances or resolution of cases by settlement or stipulation. Continuancesare not favored and the parties should be fully prepared to present their evidence at the time oftrial, pursuant to Rule 10243. The presiding judge shall have authority to assign or transfer casesas necessary pursuant to WCAB Rule 10346, including the utilization of a "rotational calendar" toassign pending trials. When the first trial in order is about to commence, other cases scheduled atthe same time shall be referred to the PWCJ for assignment to other available WCJs, whenfeasible.1.35 TRIAL PRIORITIESRETURN TO TABLE OF CONTENTSPage 2 of 2
Division of Workers' Compensation – Workers' Compensation Appeals BoardPOLICY AND PROCEDURAL MANUAL2013 Revision1.40FILING AND ORGANIZATION OF TRIAL EXHIBITS –EVIDENCE, HOSPITAL AND MEDICAL RECORDSIssued byRONNIE G. CAPLANEChairwomanWorkers’ Compensation Appeals BoardDESTIE OVERPECKActing Administrative DirectorDivision of Workers’ CompensationAmended: February 1, 2013Effective: October 6, 2003The receipt and retention of voluminous hospital and medical records create a storage problemand make review by the WCAB difficult, and parties should be discouraged from filing anyunnecessary or duplicate documents. In accordance with WCAB Rule 10629, specific referenceshould be made to the rele
1.65 Report of Workers' Compensation Judge on Reconsideration 1.70 Referral to WCJ for Hearing Following A Grant of Reconsideration 1.75 Petitions to Remove 1.80 Report of Workers' Compensation Judge on Removal 1.85 Report of Workers' Compensation Judge on Disqualification 1.90 Compromise and Release and Stipulations With Request for Award
