Cal. Code Regs. Tit. 8, § 9982 - Allowable Services

(a) This schedule covers copy and related services for records relevant to an injured worker's claim, except contracted services.

(b) If the claims administrator fails to serve records in the employer's or insurer's possession requested by an injured worker or his or her representative within the time frames set forth in Labor Code section 5307.9, or fails to serve a copy of any subsequently-received medical report or medical-legal report within the timeframes set forth in section 10635, this schedule applies to obtaining those records.

(c) If the claims administrator fails to provide written notice, pursuant to Labor Code section 4055.2, to the injured worker of records which they are seeking by subpoena, this schedule applies to obtaining those records.

(d) There will be no payment for copy and related services that are:

(1) Provided within 30 days of a written 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.

(2) Provided by any person or entity which is not a registered professional photocopier.

(3) Provided by a medical provider, or by an agent of the provider, when the requesting party has employed a professional photocopier to obtain the records.

(e) The claims administrator is not liable for payment of:

(1) Records previously obtained by subpoena or authorization by the same party and served from the same source.

(2) Summaries, tabulations, or indexing of documents.

(3) Subpoenaed records obtainable from the Workers' Compensation Insurance Rating Bureau and/or the Employment Development Department that can be obtained without a subpoena at lower cost.

(4) Charges for records submitted to the Independent Medical Review Organization (IMRO) for independent medical review, where the submitted records are already in the possession of the injured worker or the injured worker's representative, or are duplicative of those submitted to the IMRO by the claims administrator.

(5) Charges for services related to, or cancellation of, a subpoena for records in the employer's, claims administrator's, or workers' compensation insurer's possession, with an order quashing the subpoena.

(6) More than four Certificates of No Record (CNR) on a claim with dates of service on or after July 15, 2022.

Notes

Cal. Code Regs. Tit. 8, § 9982

1. New section filed 4-30-2015; operative 7-1-2015 (Register 2015, No. 18).
2. Amendment of section and NOTE filed 6-15-2022; operative 7-15-2022. Exempt from the APA and OAL review pursuant to Government Code section 11340.9(g). Submitted to OAL for filing and printing only pursuant to Government Code section 11343.8 (Register 2022, No. 24).

Note: Authority cited: Section 5307.9, Labor Code. Reference: Section 5307.9, Labor Code; and Section 2019.030, Code of Civil Procedure.

1. New section filed 4-30-2015; operative 7/1/2015 (Register 2015, No. 18).
2. Amendment of section and Note filed 6-15-2022; operative 7/15/2022. Exempt from the APA and OAL review pursuant to Government Code section 11340.9(g). Submitted to OAL for filing and printing only pursuant to Government Code section 11343.8 (Register 2022, No. 24).