| Title |
Last Updated |
| Fee Disclosure Statement |
May 30, 2015 |
| Faculty Disclosure Of Commercial Interest |
May 30, 2015 |
| Exhibit And Witness Cover Sheet |
May 30, 2015 |
| Employers Signed Statement Of Abatement Of Serious Violations |
May 30, 2015 |
| Employers Signed Statement Of Abatement Of Regulatory And-Or General Violations |
May 30, 2015 |
| Employers Report Of Occupational Injury Or Illness |
May 30, 2015 |
| DWC Petition For Suspension Or Revocation Of Medical Provider Network (Part B) |
May 30, 2015 |
| DWC Petition For Suspension Or Revocation Of Medical Provider Network (Part A) |
May 30, 2015 |
| DWC Medical Provider Network Complaint Form |
May 30, 2015 |
| Disclaimer |
May 30, 2015 |
| Description Of Employees Job Duties |
May 30, 2015 |
| Declaration Statement Of Compliance With Labor Code Sections 139.3 And 4906(g) |
May 30, 2015 |
| Declaration Regarding Protection Of Mental Health Record |
May 30, 2015 |
| Declaration Of Custodian Of Records |
May 30, 2015 |
| Data Entry Sheet |
May 30, 2015 |
| Cover Page For Medical Provider Network Application |
May 30, 2015 |
| Course Evaluation For Administrative Director |
May 30, 2015 |
| Consultative Rating Request |
May 30, 2015 |
| Compromise And Release (Dependancy Claim) |
May 30, 2015 |
| Complaint About A Workers Compensation Administrative Law Judge |
May 30, 2015 |
| Case Initiation Document |
May 30, 2015 |
| Authorization For Representation Non-Attorney (Prevailing Wage Hearings) |
May 30, 2015 |
| Attachment Page |
May 30, 2015 |
| Arbitration Submittal Orders |
May 30, 2015 |
| Arbitration Submittal Form |
May 30, 2015 |
| Arbitration Submittal Form |
May 30, 2015 |
| Application For Independent Medical Review |
May 30, 2015 |
| Application For Adjudication Of Claim (Death Cases) |
May 30, 2015 |
| Application For Accreditation Or Re-Accreditation As Education Provider |
May 30, 2015 |
| Application For Access To WCAB Index Cards And Computer By DWC Staff |
May 30, 2015 |
| AME Or QME Declaration OF Service Of Medical-Legal Report |
May 30, 2015 |
| Agreement Of Assumption And Guarantee Of Workers Compensation Liabilities |
May 30, 2015 |
| Affidavit Of Defendant Re Resolution Of Liens |
May 30, 2015 |
| Additional Panel Request |
May 30, 2015 |
| Annual Report Of Inventory For Claims Reported During Calendar Year |
October 1, 2014 |
| Audit Referral Form |
June 24, 2013 |
| Order Dismissing Lien Claim For Failure To Pay Lien Activation Fee |
March 22, 2013 |
| Request For QME Panel Under Labor Code 4062.1 Unrepresented (Attachment) |
February 5, 2013 |
| Request For QME Panel Under Labor Code 4062.1 Unrepresented (Attachment) |
February 5, 2013 |
| Request For QME Panel Under Labor Code 4062.1 Represented (Attachment) |
February 5, 2013 |
| Request For Independent Bill Review |
January 25, 2013 |
| Request For Authorization For Medical Treatment |
January 25, 2013 |
| Notice Of Offer Of Regular Work For Injuries (Between 1-1-04 And 12-31-12) |
January 23, 2013 |
| Subpoena Duces Tecum (Signed By Judge Thomas Clarke) |
January 18, 2013 |
| Subpoena Duces Tecum (Signed By Judge Thomas Clarke) |
January 18, 2013 |
| Subpoena (Signed By Judge Thomas Clarke) |
January 18, 2013 |
| Subpoena (Signed By Judge Thomas Clarke) |
January 18, 2013 |
| Finding And Order Second QME Panel (Represented Case) |
January 17, 2013 |
| Update Of WCAB Official Address Record |
November 9, 2012 |
| Supplement To Minutes Of Hearing-Order-Order And Decision On Request For Continuance |
October 19, 2012 |
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