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4900.  No claim for compensation, except as provided in Section 96,
is assignable before payment, but this provision does not affect the
survival thereof.


4901.  No claim for compensation nor compensation awarded, adjudged,
or paid, is subject to be taken for the debts of the party entitled
to such compensation except as hereinafter provided.



4902.  No compensation, whether awarded or voluntarily paid, shall
be paid to any attorney at law or in fact or other agent, but shall
be paid directly to the claimant entitled thereto unless otherwise
ordered by the appeals board.  No payment made to an attorney at law
or in fact or other agent in violation of this section shall be
credited to the employer.



4903.  The appeals board may determine, and allow as liens against
any sum to be paid as compensation, any amount determined as
hereinafter set forth in subdivisions (a) through (i).  If more than
one lien is allowed, the appeals board may determine the priorities,
if any, between the liens allowed.  The liens that may be allowed
hereunder are as follows:
   (a) A reasonable attorney's fee for legal services pertaining to
any claim for compensation either before the appeals board or before
any of the appellate courts, and the reasonable disbursements in
connection therewith.  No fee for legal services shall be awarded to
any representative who is not an attorney, except with respect to
those claims for compensation for which an application, pursuant to
Section 5501, has been filed with the appeals board on or before
December 31, 1991, or for which a disclosure form, pursuant to
Section 4906, has been sent to the employer, or insurer or
third-party administrator, if either is known, on or before December
31, 1991.
   (b) The reasonable expense incurred by or on behalf of the injured
employee, as provided by Article 2 (commencing with Section 4600)
and, to the extent the employee is entitled to reimbursement under
Section 4621, medical-legal expenses as provided by Article 2.5
(commencing with Section 4620) of Chapter 2 of Part 2.
   (c) The reasonable value of the living expenses of an injured
employee or of his or her dependents, subsequent to the injury.
   (d) The reasonable burial expenses of the deceased employee, not
to exceed the amount provided for by Section 4701.
   (e) The reasonable living expenses of the spouse or minor children
of the injured employee, or both, subsequent to the date of the
injury, where the employee has deserted or is neglecting his or her
family.  These expenses shall be allowed in the proportion that the
appeals board deems proper, under application of the spouse, guardian
of the minor children, or the assignee, pursuant to subdivision (a)
of Section 11477 of the Welfare and Institutions Code, of the spouse,
a former spouse, or minor children.  A collection received as a
result of a lien against a workers' compensation award imposed
pursuant to this subdivision for payment of child support ordered by
a court shall be credited as provided in Section 695.221 of the Code
of Civil Procedure.
   (f) The amount of unemployment compensation disability benefits
that have been paid under or pursuant to the Unemployment Insurance
Code in those cases where, pending a determination under this
division there was uncertainty whether the benefits were payable
under the Unemployment Insurance Code or payable hereunder; provided,
however, that any lien under this subdivision shall be allowed and
paid as provided in Section 4904.
   (g) The amount of unemployment compensation benefits and extended
duration benefits paid to the injured employee for the same day or
days for which he or she receives, or is entitled to receive,
temporary total disability indemnity payments under this division;
provided, however, that any lien under this subdivision shall be
allowed and paid as provided in Section 4904.
   (h) The amount of family temporary disability insurance benefits
that have been paid to the injured employee pursuant to the
Unemployment Insurance Code for the same day or days for which that
employee receives, or is entitled to receive, temporary total
disability indemnity payments under this division, provided, however,
that any lien under this subdivision shall be allowed and paid as
provided in Section 4904.
   (i) The amount of indemnification granted by the California
Victims of Crime Program pursuant to Article 1 (commencing with
Section 13959) of Chapter 5 of Part 4 of Division 3 of Title 2 of the
Government Code.
   (j) The amount of compensation, including expenses of medical
treatment, and recoverable costs that have been paid by the Asbestos
Workers' Account pursuant to the provisions of Chapter 11 (commencing
with Section 4401) of Part 1.



4903.1.  (a) The appeals board, arbitrator, or settlement conference
referee, before issuing an award or approval of any compromise of
claim, shall determine, on the basis of liens filed with it pursuant
to subdivision (b) or (c), whether any benefits have been paid or
services provided by a health care provider, a health care service
plan, a group disability policy, including a loss of income policy, a
self-insured employee welfare benefit plan, or a hospital service
contract, and its award or approval shall provide for reimbursement
for benefits paid or services provided under these plans as follows:

   (1) When the referee issues an award finding that an injury or
illness arises out of and in the course of employment, but denies the
applicant reimbursement for self-procured medical costs solely
because of lack of notice to the applicant's employer of his need for
hospital, surgical, or medical care, the appeals board shall
nevertheless award a lien against the employee's recovery, to the
extent of benefits paid or services provided, for the effects of the
industrial injury or illness, by a health care provider, a health
care service plan, a group disability policy, a self-insured employee
welfare benefit plan, or a hospital service contract.
   (2) When the referee issues an award finding that an injury or
illness arises out of and in the course of employment, and makes an
award for reimbursement for self-procured medical costs, the appeals
board shall allow a lien, to the extent of benefits paid or services
provided, for the effects of the industrial injury or illness, by a
health care provider, a health care service plan, a group disability
policy, a self-insured employee welfare benefit plan, or a hospital
service contract.
   (3) When the referee issues an award finding that an injury or
illness arises out of and in the course of employment and makes an
award for temporary disability indemnity, the appeals board shall
allow a lien as living expense under Section 4903, for benefits paid
by a group disability policy providing loss of time benefits. Such
lien shall be allowed to the extent that benefits have been paid for
the same day or days for which temporary disability indemnity is
awarded and  shall not exceed the award for temporary disability
indemnity.  No lien shall be allowed hereunder unless the group
disability policy provides for reduction, exclusion, or coordination
of loss of time benefits on account of workers' compensation
benefits.
   (4) When the parties propose that the case be disposed of by way
of a compromise and release agreement, in the event the lien
claimant, other than a health care provider, does not agree to the
amount allocated to it, then the referee shall determine the
potential recovery and reduce the amount of the lien in the ratio of
the applicant's recovery to the potential recovery in full
satisfaction of its lien claim.
   (b) When a compromise of claim or an award is submitted to the
appeals board, arbitrator, or settlement conference referee for
approval, the parties shall file with the appeals board, arbitrator,
or settlement conference referee any liens served on the parties.
   (c) Any lien claimant under Section 4903 or this section shall
file its lien with the appeals board in writing upon a form approved
by the appeals board.  The lien shall be accompanied by a full
statement or itemized voucher supporting the lien and justifying the
right to reimbursement and proof of service upon the injured worker,
or if deceased, upon the worker's dependents, the employer, the
insurer, and the respective attorneys or other agents of record.
   (d) The appeals board shall file liens required by subdivision (c)
immediately upon receipt.  Numbers shall be assigned pursuant to
subdivision (c) of Section 5500.


4903.2.  Where a lien claimant is reimbursed pursuant to subdivision
(f) or (g) of Section 4903 or Section 4903.1, for benefits paid or
services provided, the appeals board may award an attorney's fee to
the applicant's attorney out of the lien claimant's recovery if the
appeals board determines that all of the following occurred:
   (a) The lien claimant received notice of all hearings following
the filing of the lien and received notice of intent to award the
applicant's attorney a fee.
   (b) An attorney or other representative of the lien claimant did
not participate in the proceedings before the appeals board with
respect to the lien claim.
   (c) There were bona fide issues respecting compensability, or
respecting allowability of the lien, such that the services of an
attorney were reasonably required to effectuate recovery on the claim
of lien and were instrumental in effecting the recovery.
   (d) The case was not disposed of by compromise and release.
   The amount of the attorney's fee out of the lien claimant's
recovery shall be based on the extent of applicant's attorney's
efforts on behalf of the lien claimant.  The ratio of the amount of
the attorney's fee awarded against the lien claimant's recovery to
that recovery shall not exceed the ratio of the amount of the
attorney's fee awarded against the applicant's award to that award.




4903.3.  The director, as administrator of the Uninsured Employers
Fund, may, in his discretion, provide compensation, including medical
treatment, from the Uninsured Employers Fund in cases to which the
director is a party before the issuance of any award, if such
compensation is not being provided to the applicant.
   The appeals board shall determine and allow as a first lien
against any sum to be paid as compensation the amount of
compensation, including the cost of medical treatment, provided by
the director pursuant to this section.



4903.4.  When a dispute arises concerning a lien for expenses
incurred by or on behalf of the injured employee as provided by
Article 2 (commencing with Section 4600) of Chapter 2 of Part 2, the
appeals board may resolve the dispute in a separate proceeding, which
may include binding arbitration upon agreement of the employer, lien
claimant, and the employee, if the employee remains a party to the
dispute, according to the rules of practice and procedure.



4903.5.  (a) No lien claim for expenses as provided in subdivision
(b) of Section 4903 may be filed after six months from the date on
which the appeals board or a workers' compensation administrative law
judge issues a final decision, findings, order, including an order
approving compromise and release, or award, on the merits of the
claim, after five years from the date of the injury for which the
services were provided, or after one year from the date the services
were provided, whichever is later.
   (b) Notwithstanding subdivision (a), any health care provider,
health care service plan, group disability insurer, employee benefit
plan, or other entity providing medical benefits on a nonindustrial
basis, may file a lien claim for expenses as provided in subdivision
(b) of Section 4903 within six months after the person or entity
first has knowledge that an industrial injury is being claimed.
   (c) The injured worker shall not be liable for any underlying
obligation if a lien claim has not been filed and served within the
allowable period.  Except when the lien claimant is the applicant as
provided in Section 5501, a lien claimant shall not file a
declaration of readiness to proceed in any case until the
case-in-chief has been resolved.
   (d) This section shall not apply to civil actions brought under
the Cartwright Act (Chapter 2 (commencing with Section 16700) of Part
2 of Division 7 of the Business and Professions Code), the Unfair
Practices Act (Chapter 4 (commencing with Section 17000) of Part 2 of
Division 7 of the Business and Professions Code), or the federal
Racketeer Influenced and Corrupt Organization Act (Chapter 96
(commencing with Section 1961) of Title 18 of the United States Code)
based on concerted action with other insurers that are not parties
to the case in which the lien or claim is filed.



4903.6.  (a) Except as necessary to meet the requirements of Section
4903.5, no lien claim or application for adjudication shall be filed
under subdivision (b) of Section 4903 until the expiration of one of
the following:
   (1) Sixty days after the date of acceptance or rejection of
liability for the claim, or expiration of the time provided for
investigation of liability pursuant to subdivision (b) of Section
5402, whichever date is earlier.
   (2) The time provided for payment of medical treatment bills
pursuant to Section 4603.2.
   (3) The time provided for payment of medical-legal expenses
pursuant to Section 4622.
   (b) No declaration of readiness to proceed shall be filed for a
lien under subdivision (b) of Section 4903 until the underlying case
has been resolved or where the applicant chooses not to proceed with
his or her case.
   (c) The appeals board shall adopt reasonable regulations to ensure
compliance with this section, and shall take any further steps as
may be necessary to enforce the regulations, including, but not
limited to, impositions of sanctions pursuant to Section 5813.
   (d) The prohibitions of this section shall not apply to lien
claims, applications for adjudication, or declarations of readiness
to proceed filed by or on behalf of the employee, or to the filings
by or on behalf of the employer.


4904.  (a) If notice is given in writing to the insurer, or to the
employer if uninsured, setting forth the nature and extent of any
claim that is allowable as a lien, the claim is a lien against any
amount thereafter payable as compensation, subject to the
determination of the amount and approval of the lien by the appeals
board.  When the Employment Development Department has served an
insurer or employer with a lien claim, the insurer or employer shall
notify the Employment Development Department, in writing, as soon as
possible, but in no event later than 15 working days after commencing
disability indemnity payments.  When a lien has been served on an
insurer or an employer by the Employment Development Department, the
insurer or employer shall notify the Employment Development
Department, in writing, within 10 working days of filing an
application for adjudication, a stipulated award, or a compromise and
release with the appeals board.
   (b) (1) In determining the amount of lien to be allowed for
unemployment compensation disability benefits under subdivision (f)
of Section 4903, the appeals board shall allow the lien in the amount
of benefits which it finds were paid for the same day or days of
disability for which an award of compensation for any permanent
disability indemnity resulting solely from the same injury or illness
or temporary disability indemnity, or both, is made and for which
the employer has not reimbursed the Employment Development Department
pursuant to Section 2629.1 of the Unemployment Insurance Code.
   (2) In determining the amount of lien to be allowed for
unemployment compensation benefits and extended duration benefits
under subdivision (g) of Section 4903, the appeals board shall allow
the lien in the amount of benefits which it finds were paid for the
same day or days for which an award of compensation for temporary
total disability is made.
   (3) In determining the amount of lien to be allowed for family
temporary disability insurance benefits under subdivision (h) of
Section 4903, the appeals board shall allow the lien in the amount of
benefits that it finds were paid for the same day or days for which
an award of compensation for temporary total disability is made and
for which the employer has not reimbursed the Employment Development
Department pursuant to Section 2629.1 of the Unemployment Insurance
Code.
   (c) In the case of agreements for the compromise and release of a
disputed claim for compensation, the applicant and defendant may
propose to the appeals board, as part of the compromise and release
agreement, an amount out of the settlement to be paid to any lien
claimant claiming under subdivision (f), (g), or (h) of Section 4903.
  If the lien claimant objects to the amount proposed for payment of
its lien under a compromise and release settlement or stipulation,
the appeals board shall determine the extent of the lien claimant's
entitlement to reimbursement on its lien and make and file findings
on all facts involved in the controversy over this issue in
accordance with Section 5313.  The appeals board may approve a
compromise and release agreement or stipulation which proposes the
disallowance of a lien, in whole or in part, only where there is
proof of service upon the lien claimant by the defendant, not less
than 15 days prior to the appeals board action, of all medical and
rehabilitation documents and a copy of the proposed compromise and
release agreement or stipulation.  The determination of the appeals
board, subject to petition for reconsideration and to the right of
judicial review, as to the amount of lien allowed under subdivision
(f), (g), or (h) of Section 4903, whether in connection with an award
of compensation or the approval of a compromise and release
agreement, shall be binding on the lien claimant, the applicant, and
the defendant, insofar as the right to benefits paid under the
Unemployment Insurance Code for which the lien was claimed.  The
appeals board may order the amount of any lien claim, as determined
and allowed by it, to be paid directly to the person entitled, either
in a lump sum or in installments.
   (d) Where unemployment compensation disability benefits, including
family temporary disability insurance benefits, have been paid
pursuant to the Unemployment Insurance Code while reconsideration of
an order, decision, or award is pending, or has been granted, the
appeals board shall determine and allow a final amount on the lien as
of the date the board is ready to issue its decision denying a
petition for reconsideration or affirming, rescinding, altering or
amending the original findings, order, decision, or award.
   (e) The appeals board may not be prohibited from approving a
compromise and release agreement on all other issues and deferring to
subsequent proceedings the determination of a lien claimant's
entitlement to reimbursement if the defendant in any of these
proceedings agrees to pay the amount subsequently determined to be
due under the lien claim.



4904.1.  The payment of liens as provided in Section 4904, shall in
no way affect the commencement of immediate payments on any balance
of the award to the injured claimant where an installment payment for
his disability has been determined.



4905.  Where it appears in any proceeding pending before the appeals
board that a lien should be allowed if it had been duly requested by
the party entitled thereto, the appeals board may, without any
request for such lien having been made, order the payment of the
claim to be made directly to the person entitled, in the same manner
and with the same effect as though the lien had been regularly
requested, and the award to such person shall constitute a lien
against unpaid compensation due at the time of service of the award.



4906.  (a) No charge, claim, or agreement for the legal services or
disbursements mentioned in subdivision (a) of Section 4903, or for
the expense mentioned in subdivision (b) of Section 4903, is
enforceable, valid, or binding in excess of a reasonable amount.  The
appeals board may determine what constitutes a reasonable amount.
   (b) No attorney or agent shall demand or accept any fee from an
employee or dependent of an employee for the purpose of representing
the employee or dependent of an employee in any proceeding of the
division, appeals board, or any appellate procedure related thereto
until the amount of the fee has been approved or set by the appeals
board.
   (c) Any fee agreement shall be submitted to the appeals board for
approval within 10 days after the agreement is made.
   (d) In establishing a reasonable attorney's fee, consideration
shall be given to the responsibility assumed by the attorney, the
care exercised in representing the applicant, the time involved, and
the results obtained.
   (e) At the initial consultation, an attorney shall furnish the
employee a written disclosure form promulgated by the administrative
director which shall clearly and prominently describe the procedures
available to the injured employee or his or her dependents.  The
disclosure form shall describe this section, the range of attorney's
fees customarily approved by the appeals board, and the attorney's
fees provisions of Section 4064 and the extent to which an employee
may receive compensation without incurring attorney's fees.  The
disclosure form shall include the telephone number of the
administrative director together with the statement that the employee
may receive answers at that number to questions concerning
entitlement to compensation or the procedures to follow to receive
compensation.  A copy of the disclosure form shall be signed by the
employee and the attorney and sent to the employer, or insurer or
third-party administrator, if either is known, by the attorney within
15 days of the employee's and attorney's execution thereof.
   (f) The disclosure form set forth in subdivision (e) shall
contain, prominently stated, the following statement:
   "Any person who makes or causes to be made any knowingly false or
fraudulent material statement or representation for the purpose of
obtaining or denying worker's compensation benefits or payments is
guilty of a felony."
   (g) The employee, the insurer, the employer, and the attorneys for
each party shall sign and file with the board a statement, with the
application or answer, under penalty of perjury that they have not
violated Section 139.3 and that they have not offered, delivered,
received, or accepted any rebate, refund, commission, preference,
patronage dividend, discount, or other consideration, whether in the
form of money or otherwise, as compensation or inducement for any
referred examination or evaluation.



4907.  The privilege of any person, including attorneys admitted to
practice in the Supreme Court of the state to appear in any
proceeding as a representative of any party before the appeals board,
or any of its referees, may, after a hearing, be removed, denied, or
suspended by the appeals board for a violation of this chapter or
for other good cause.



4908.  A claim for compensation for the injury or death of any
employee, or any award or judgment entered thereon, has the same
preference over the other debts of the employer, or his estate and of
the insurer which is given by the law to claims for wages.  Such
preference is for the entire amount of the compensation to be paid.
This section shall not impair the lien of any previous award.



4909.  Any payment, allowance, or benefit received by the injured
employee during the period of his incapacity, or by his dependents in
the event of his death, which by the terms of this division was not
then due and payable or when there is any dispute or question
concerning the right to compensation, shall not, in the absence of
any agreement, be an admission of liability for compensation on the
part of the employer, but any such payment, allowance, or benefit may
be taken into account by the appeals board in fixing the amount of
the compensation to be paid.  The acceptance of any such payment,
allowance, or benefit shall not operate as a waiver of any right or
claim which the employee or his dependents has against the employer.




4909.1.  Authorized representatives of the Department of
Corrections, and the Department of the Youth Authority may request
the State Compensation Insurance Fund to provide any payment,
allowance, or benefit as described in Section 4909.  When requested
by an authorized representative, the State Compensation Insurance
Fund shall administer the benefits in a timely fashion.

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5000.  No contract, rule, or regulation shall exempt the employer
from liability for the compensation fixed by this division, but
nothing in this division shall:
   (a) Impair the right of the parties interested to compromise,
subject to the provisions herein contained, any liability which is
claimed to exist under this division on account of injury or death.
   (b) Confer upon the dependents of any injured employee any
interest which the employee may not release by compromise or for
which he, or his estate is in the event of such compromise by him
accountable to dependents.



5001.  Compensation is the measure of the responsibility which the
employer has assumed for injuries or deaths which occur to employees
in his employment when subject to this division.  No release of
liability or compromise agreement is valid unless it is approved by
the appeals board or referee.



5002.  A copy of the release or compromise agreement signed by both
parties shall forthwith be filed with the appeals board.  Upon filing
with and approval by the appeals board, it may, without notice, of
its own motion or on the application of either party, enter its award
based upon the release or compromise agreement.




5003.  Every release or compromise agreement shall be in writing and
duly executed, and the signature of the employee or other
beneficiary shall be attested by two disinterested witnesses or
acknowledged before a notary public.  The document shall specify:
   (a) The date of the accident.
   (b) The average weekly wages of the employee, determined according
to Chapter 1 of Part 2 of this division.
   (c) The nature of the disability, whether total or partial,
permanent or temporary.
   (d) The amount paid, or due and unpaid, to the employee up to the
date of the release or agreement or death, and the amount of the
payment or benefits then or thereafter to be made.
   (e) The length of time such payment or benefit is to continue.
   (f) In the event a claim of lien under subdivision (f) or (g) of
Section 4903 has been filed, the number of days and the amount of
temporary disability indemnity which should be allowed to the lien
claimant.



5004.  In case of death there shall also be stated in the release or
compromise agreement:
   (a) The date of death.
   (b) The name of the widow.
   (c) The names and ages of all children.
   (d) The names of all other dependents.
   (e) Whether the dependents are total or partial.
   (f) The amount paid or to be paid as a death benefit and to whom
payment is to be made.


5005.  In any case involving a claim of occupational disease or
cumulative injury, as set forth in Section 5500.5, the employee and
any employer, or any insurance carrier for any employer, may enter
into a compromise and release agreement settling either all or any
part of the employee's claim, including a part of his claim against
any employer.  Such compromise and release agreement, upon approval
by the appeals board or a referee, shall be a total release as to
such employer or insurance carrier for the portion or portions of the
claim released, but shall not constitute a bar to a recovery from
any one or all of the remaining employers or insurance carriers for
the periods of exposure not so released.
   In any case where a compromise and release agreement of a portion
of a claim has been made and approved, the employee may elect to
proceed as provided in Section 5500.5 against any one or more of the
remaining employers, or against an employer for that portion of his
exposure not so released; in any such proceeding after election
following compromise and release, that portion of liability
attributable to the portion or portions of the exposure so released
shall be assessed and deducted from the liability of the remaining
defendant or defendants, but any such defendant shall receive no
credit for any moneys paid by way of compromise and release in excess
of the liability actually assessed against the released employments
and the employee shall not receive any further benefits from the
released employments for any liability assessed to them above what
was paid by way of compromise and release.
   In approving a compromise and release agreement under this
section, the appeals board or referee shall determine the adequacy of
the compromise and release agreement as it shall then reflect the
potential liability of the released exposure after apportionment, but
need not make a final actual determination of the potential
liability of the employer or employers for that portion of the
exposure being released.



5006.  A determination of facts by the appeals board under this
chapter has no collateral estoppel effect on a subsequent criminal
prosecution and does not preclude litigation of those same facts in
the criminal proceeding.

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5100. At the time of making its award, or at any time thereafter,
the appeals board, on its own motion either upon notice, or upon
application of either party with due notice to the other, may commute
the compensation payable under this division to a lump sum and order
it to be paid forthwith or at some future time if any of the
following conditions appear:
   (a) That such commutation is necessary for the protection of the
person entitled thereto, or for the best interest of the applicant.
In determining what is in the best interest of the applicant, the
appeals board shall consider the general financial condition of the
applicant, including but not limited to, the applicant's ability to
live without periodic indemnity payments and to discharge debts
incurred prior to the date of injury.
   (b) That commutation will avoid inequity and will not cause undue
expense or hardship to the applicant.
   (c) That the employer has sold or otherwise disposed of the
greater part of his assets or is about to do so.
   (d) That the employer is not a resident of this state.



5100.5.  Notwithstanding the provisions of Section 5100, the appeals
board shall not commute the compensation payable under this division
to a lump sum when such compensation is payable under Section 4751
of the Labor Code.


5100.6.  Notwithstanding the provisions of Section 5100, the appeals
board shall not permit the commutation or settlement of prospective
compensation or indemnity payments or other benefits to which the
employee is entitled under vocational rehabilitation.



5101.  The amount of the lump sum shall be determined as follows:
   (a) If the injury causes temporary disability, the appeals board
shall estimate the probable duration thereof and the probable amount
of the temporary disability payments therefor, in accordance with
Chapter 2 of Part 2 of this division, and shall fix the lump sum at
the amount so determined.
   (b) If the injury causes permanent disability or death, the
appeals board shall fix the total amount of the permanent disability
payment or death benefit payable therefor in accordance with Chapter
2 of Part 2 of this division, and shall estimate the present value
thereof, assuming interest at the rate of 3 percent per annum and
disregarding the probability of the beneficiary's death in all cases
except where the percentage of permanent disability is such as to
entitle the beneficiary to a life pension, and then taking into
consideration the probability of the beneficiary's death only in
estimating the present value of such life pension.



5102.  The appeals board may order the lump sum paid directly to the
injured employee or his dependents, or deposited with any savings
bank or trust company authorized to transact business in this state,
which agrees to accept the same as a deposit bearing interest; or the
appeals board may order the lump sum deposited with the State
Compensation Insurance Fund.  Any lump sum so deposited, together
with all interest derived therefrom, shall thereafter be held in
trust for the injured employee, or in the event of his death, for his
dependents.  In the event of the employee's death, his dependents
shall have no further recourse against the employer under this
chapter.



5103.  Payments from the lump sum so deposited shall be made by the
trustee only in the amounts and at the time fixed by order of the
appeals board and until the lump sum and interest thereon are
exhausted.


5104.  In the appointment of the trustee, preference may be given to
the choice of the injured employee or his dependents.



5105.  Upon the payment of a lump sum, the employer shall present to
the appeals board a proper receipt evidencing the same, executed
either by the injured employee or his dependents, or by the trustee.
The appeals board shall thereupon issue its certificate in proper
form evidencing such payment.  Such certificate, upon filing with the
clerk of the superior court in which any judgment upon an award has
been entered, operates as a satisfaction of the award and fully
discharges the employer from any further liability on account
thereof.


5106.  The appeals board shall, upon the request of the Director of
Industrial Relations, where the employer is uninsured and the
installments of compensation awarded are to be paid in the future,
determine the present worth of the future payments, discounted at the
rate of 3 percent per annum, and order the present worth paid into
the Uninsured Employers Fund, which fund shall thereafter pay to the
beneficiaries of the award the future payments as they become due.

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5270.  This part shall not apply in cases where an injured employee
or dependent is involved unless the employee or dependent is
represented by an attorney.


5270.5.  (a) The presiding workers' compensation judge at each
district office  shall prepare a list of all eligible attorneys who
apply to be placed on the list of eligible arbitrators.  Attorneys
are eligible to become arbitrators if they are active members of the
California State Bar Association and are one of the following:
   (1) A certified specialist in workers' compensation, or eligible
to become certified.
   (2) A retired workers' compensation judge.
   (3) A retired appeals board member.
   (4) An attorney who has been certified to serve as a judge pro
tempore.
   (b) No attorney shall be included in a panel of arbitrators, if he
or she has served as a judge in any proceeding involving the same
case, or has represented, or whose firm has represented, any party in
the same case.



5271.  (a) The parties to a dispute submitted for arbitration may
select any eligible attorney from the list prepared by the presiding
workers' compensation judge to serve as arbitrator.  However, when
the disputed issue involves insurance coverage, the parties may
select any attorney as arbitrator upon agreement of the parties.
   (b) If the parties cannot select an arbitrator by agreement,
either party may  request the presiding workers' compensation judge
to assign a panel of five arbitrators selected at random from the
list of eligible attorneys.  No more than three arbitrators on a
five-member panel may be defense attorneys, no more than three may be
applicant's attorneys, and no more than two may be retired workers'
compensation judges or appeals board commissioners.
   (c) For each party in excess of one party in the capacity of
employer and one party in the capacity of injured employee or lien
claimant, the presiding judge shall randomly select two additional
arbitrators to add to the panel.  For each additional party in the
capacity of employer, the presiding judge shall assign a retired
workers' compensation judge or retired appeals board commissioner and
an applicant's attorney.  For each additional party in the capacity
of injured employee or lien claimant, the presiding judge shall
assign a retired workers' compensation judge or retired appeals board
commissioner and a defense attorney.  For each additional other
party, the presiding judge shall assign two arbitrators to the panel,
in order of rotation from case to case, as follows:  a retired
workers' compensation judge or retired appeals board commissioner, an
applicant's attorney, a defense attorney.
   (d) A party may petition the presiding workers' compensation judge
to remove a member from the panel pursuant to Section 170.1 of the
Code of Civil Procedure.  The presiding workers' compensation judge
shall assign another eligible attorney to replace any member removed
under this subdivision.
   (e) Each party or lien claimant shall strike two members from the
panel, and the remaining attorney shall serve as arbitrator.



5272.  Arbitrators shall have all of the statutory and regulatory
duties and responsibilities of a workers' compensation judge, as set
forth in Chapter 1 (commencing with Section 5300) of Part 4, except
for the following:
   (a) Arbitrators shall have no power to order the injured worker to
be examined by a qualified medical evaluator pursuant to Sections
5701 and 5703.5.
   (b) Arbitrators shall not have power of contempt.



5273.  (a) In disputes between an employee and an employer, the
employer shall pay all costs related to the arbitration proceeding,
including use of facilities, hearing reporter per diems and
transcript costs.
   (b) In all other disputes, the costs of the arbitration
proceedings, including the arbitrator's compensation, shall be paid
as follows:
   (1) By the parties equally in any dispute between an employer and
an insurer, or an employer and a lien claimant.
   (2) By the parties equally in proceedings subject to Section
5500.5.
   (3) By the dependents in accordance with their proportionate share
of death benefits, where there is no dispute as to the injury
causing death.
   (c) Disputes regarding the costs or fees for arbitration shall be
within the exclusive jurisdiction of the appeals board, and shall be
determined initially by the presiding judge of the district office.




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.


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.



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.



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.

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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.


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.


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.




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.



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.



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.



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.



5307.  (a) Except for those rules and regulations within the
authority of the court administrator regarding trial level
proceedings as defined in subdivision (c), the appeals board may by
an order signed by four members:
   (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.
   (c) The court administrator shall adopt reasonable, proper, and
uniform rules for district office procedure regarding trial level
proceedings of the workers' compensation appeals board.  These rules
shall include, but not be limited to, all of the following:
   (1) Rules regarding conferences, hearings, continuances, and other
matters deemed reasonable and necessary to expeditiously resolve
disputes.
   (2) The kind and character of forms to be used at all trial level
proceedings.
   All rules and regulations adopted by the court administrator
pursuant to this subdivision shall be subject to the requirements of
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).



5307.1.  (a) The administrative director, after public hearings,
shall adopt and revise periodically an official medical fee schedule
that shall establish reasonable maximum fees paid for medical
services other than physician services, drugs and pharmacy services,
health care facility fees, home health care, and all other treatment,
care, services, and goods described in Section 4600 and provided
pursuant to this section. Except for physician services, all fees
shall be in accordance with the fee-related structure and rules of
the relevant Medicare and Medi-Cal payment systems, provided that
employer liability for medical treatment, including issues of
reasonableness, necessity, frequency, and duration, shall be
determined in accordance with Section 4600. Commencing January 1,
2004, and continuing until the time the administrative director has
adopted an official medical fee schedule in accordance with the
fee-related structure and rules of the relevant Medicare payment
systems, except for the components listed in subdivision (j), maximum
reasonable fees shall be 120 percent of the estimated aggregate fees
prescribed in the relevant Medicare payment system for the same
class of services before application of the inflation factors
provided in subdivision (g), except that for pharmacy services and
drugs that are not otherwise covered by a Medicare fee schedule
payment for facility services, the maximum reasonable fees shall be
100 percent of fees prescribed in the relevant Medi-Cal payment
system. Upon adoption by the administrative director of an official
medical fee schedule pursuant to this section, the maximum reasonable
fees paid shall not exceed 120 percent of estimated aggregate fees
prescribed in the Medicare payment system for the same class of
services before application of the inflation factors provided in
subdivision (g). Pharmacy services and drugs shall be subject to the
requirements of this section, whether furnished through a pharmacy or
dispensed directly by the practitioner pursuant to subdivision (b)
of Section 4024 of the Business and Professions Code.
   (b) In order to comply with the standards specified in subdivision
(f), the administrative director may adopt different conversion
factors, diagnostic related group weights, and other factors
affecting payment amounts from those used in the Medicare payment
system, provided estimated aggregate fees do not exceed 120 percent
of the estimated aggregate fees paid for the same class of services
in the relevant Medicare payment system.
   (c) Notwithstanding subdivisions (a) and (d), the maximum facility
fee for services performed in an ambulatory surgical center, or in a
hospital outpatient department, may not exceed 120 percent of the
fee paid by Medicare for the same services performed in a hospital
outpatient department.
   (d) If the administrative director determines that a medical
treatment, facility use, product, or service is not covered by a
Medicare payment system, the administrative director shall establish
maximum fees for that item, provided that the maximum fee paid shall
not exceed 120 percent of the fees paid by Medicare for services that
require comparable resources. If the administrative director
determines that a pharmacy service or drug is not covered by a
Medi-Cal payment system, the administrative director shall establish
maximum fees for that item.  However, the maximum fee paid shall not
exceed 100 percent of the fees paid by Medi-Cal for pharmacy services
or drugs that require comparable resources.
   (e) Prior to the adoption by the administrative director of a
medical fee schedule pursuant to this section, for any treatment,
facility use, product, or service not covered by a Medicare payment
system, including acupuncture services, or, with regard to pharmacy
services and drugs, for a pharmacy service or drug that is not
covered by a Medi-Cal payment system, the maximum reasonable fee paid
shall not exceed the fee specified in the official medical fee
schedule in effect on December 31, 2003.
   (f) Within the limits provided by this section, the rates or fees
established shall be adequate to ensure a reasonable standard of
services and care for injured employees.
   (g) (1) (A) Notwithstanding any other provision of law, the
official medical fee schedule shall be adjusted to conform to any
relevant changes in the Medicare and Medi-Cal payment systems no
later than 60 days after the effective date of those changes,
provided that both of the following conditions are met:
   (i) The annual inflation adjustment for facility fees for
inpatient hospital services provided by acute care hospitals and for
hospital outpatient services shall be determined solely by the
estimated increase in the hospital market basket for the 12 months
beginning October 1 of the preceding calendar year.
   (ii) The annual update in the operating standardized amount and
capital standard rate for inpatient hospital services provided by
hospitals excluded from the Medicare prospective payment system for
acute care hospitals and the conversion factor for hospital
outpatient services shall be determined solely by the estimated
increase in the hospital market basket for excluded hospitals for the
12 months beginning October 1 of the preceding calendar year.
   (B) The update factors contained in clauses (i) and (ii) of
subparagraph (A) shall be applied beginning with the first update in
the Medicare fee schedule payment amounts after December 31, 2003.
   (2) The administrative director shall determine the effective date
of the changes, and shall issue 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 paragraph shall be published on the Internet Web
site of the Division of Workers' Compensation.
   (3) For the purposes of this subdivision, the following
definitions apply:
   (A) "Medicare Economic Index" means the input price index used by
the federal Centers for Medicare and Medicaid Services to measure
changes in the costs of a providing physician and other services paid
under the resource-based relative value scale.
   (B) "Hospital market basket" means the input price index used by
the federal Centers for Medicare and Medicaid Services to measure
changes in the costs of providing inpatient hospital services
provided by acute care hospitals that are included in the Medicare
prospective payment system.
   (C) "Hospital market basket for excluded hospitals" means the
input price index used by the federal Centers for Medicare and
Medicaid Services to measure changes in the costs of providing
inpatient services by hospitals that are excluded from the Medicare
prospective payment system.
   (h) Nothing in this section shall prohibit an employer or insurer
from contracting with a medical provider for reimbursement rates
different from those prescribed in the official medical fee schedule.

   (i) Except as provided in Section 4626, the official medical fee
schedule shall not apply to medical-legal expenses, as that term is
defined by Section 4620.
   (j) The following Medicare payment system components may not
become part of the official medical fee schedule until January 1,
2005:
   (1) Inpatient skilled nursing facility care.
   (2) Home health agency services.
   (3) Inpatient services furnished by hospitals that are exempt from
the prospective payment system for general acute care hospitals.
   (4) Outpatient renal dialysis services.
   (k) Notwithstanding subdivision (a), for the calendar years 2004
and 2005, the existing official medical fee schedule rates for
physician services shall remain in effect, but these rates shall be
reduced by 5 percent. The administrative director may reduce fees of
individual procedures by different amounts, but in no event shall the
administrative director reduce the fee for a procedure that is
currently reimbursed at a rate at or below the Medicare rate for the
same procedure.
   (l) Notwithstanding subdivision (a), the administrative director,
commencing January 1, 2006, shall have the authority, after public
hearings, to adopt and revise, no less frequently than biennially, an
official medical fee schedule for physician services. If the
administrative director fails to adopt an official medical fee
schedule for physician services by January 1, 2006, the existing
official medical fee schedule rates for physician services shall
remain in effect until a new schedule is adopted or the existing
schedule is revised.
   (m) (1) Notwithstanding subdivisions (a), (b), (f), and (g),
commencing January 1, 2008, the administrative director, after public
hearings, may adopt and revise, no less frequently than biennially,
an official medical fee schedule for inpatient facility fees for burn
cases in accordance with this subdivision. Until the date that the
administrative director adopts a fee schedule pursuant to this
subdivision, the inpatient fee schedule adopted and revised in
accordance with subdivisions (a) and (g) shall continue to apply to
inpatient facility fees for burn cases.
   (2) In order to establish inpatient facility fees for burn cases
that are adequate to ensure a reasonable standard of services and
care, the administrative director may do any of the following:
   (A) Adopt a fee schedule in accordance with the Medicare payment
system, or adopt different conversion factors, diagnostic related
group weights, and other factors affecting payment amounts from those
used in the Medicare payment system.
   (B) Adopt a fee schedule utilizing payment methodologies other
than those utilized by the Medicare payment system.
   (C) Adopt a fee schedule that utilizes both Medicare and
non-Medicare methodologies.
   (3) Inpatient facility fees for burn cases may exceed 120 percent,
but in no case shall exceed 180 percent, of the fees paid by
Medicare.  Inpatient facility fees for burn cases shall be excluded
from the calculation of estimated aggregate fees for purposes of
other subdivisions of this section.
   (4) The changes to this section made by this subdivision shall
remain in effect only until January 1, 2011.



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.



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 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, the
administrative director may make appropriate adjustments to medical
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 for the applicable services or products.



5307.27.  On or before December 1, 2004, 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.



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 or the court administrator.
   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.



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.



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.



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.




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.



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.



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, after
consideration of the recommendation of the court administrator, 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.



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.



5311.5.  The administrative director or the court administrator
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.



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.



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.



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.



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.



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.



5318.  (a) Implantable medical devices, hardware, and
instrumentation for Diagnostic Related Groups (DRGs) 004, 496, 497,
498, 519, and 520 shall be separately reimbursed at the provider's
documented paid cost, plus an additional 10 percent of the provider's
documented paid cost, not to exceed a maximum of two hundred fifty
dollars ($250), plus any sales tax and shipping and handling charges
actually paid.
   (b) This section shall be operative only until the administrative
director adopts a regulation specifying separate reimbursement, if
any, for implantable medical hardware or instrumentation for complex
spinal surgeries.

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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.



5401.  (a) Within one working day of receiving notice or knowledge
of injury under Section 5400 or 5402, which injury results in lost
time beyond the employee's work shift at the time of injury or which
results in medical treatment beyond first aid, the employer shall
provide, personally or by first-class mail, a claim form and a notice
of potential eligibility for benefits under this division to the
injured employee, or in the case of death, to his or her dependents.
As used in this subdivision, "first aid" means any one-time
treatment, and any followup visit for the purpose of observation of
minor scratches, cuts, burns, splinters, or other minor industrial
injury, which do not ordinarily require medical care.  This one-time
treatment, and followup visit for the purpose of observation, is
considered first aid even though provided by a physician or
registered professional personnel.  "Minor industrial injury" shall
not include serious exposure to a hazardous substance as defined in
subdivision (i) of Section 6302.  The claim form shall request the
injured employee's name and address, social security number, the time
and address where the injury occurred, and the nature of and part of
the body affected by the injury.  Claim forms shall be available at
district offices of the Employment Development Department and the
division.  Claim forms may be made available to the employee from any
other source.
   (b) Insofar as practicable, the notice of potential eligibility
for benefits required by this section and the claim form shall be a
single document and shall instruct the injured employee to fully read
the notice of potential eligibility.  The form and content of the
notice and claim form shall be prescribed by the administrative
director after consultation with the Commission on Health and Safety
and Workers' Compensation.  The notice shall be easily understandable
and available in both English and Spanish.  The content shall
include, but not be limited to, the following:
   (1) The procedure to be used to commence proceedings for the
collection of compensation for the purposes of this chapter.
   (2) A description of the different types of workers' compensation
benefits.
   (3) What happens to the claim form after it is filed.
   (4) From whom the employee can obtain medical care for the injury.

   (5) The role and function of the primary treating physician.
   (6) The rights of an employee to select and change the treating
physician pursuant to subdivision (e) of Section 3550 and Section
4600.
   (7) How to get medical care while the claim is pending.
   (8) The protections against discrimination provided pursuant to
Section 132a.
   (9) The following written statements:
   (A) You have a right to disagree with decisions affecting your
claim.
   (B) You can obtain free information from an information and
assistance officer of the state Division of Workers' Compensation, or
you can hear recorded information and a list of local offices by
calling (applicable information and assistance telephone number(s)).

   (C) You can consult an attorney.  Most attorneys offer one free
consultation.  If you decide to hire an attorney, his or her fee will
be taken out of some of your benefits. For names of workers'
compensation attorneys, call the State Bar of California at
(telephone number of the State Bar of California's legal
specialization program, or its equivalent).
   (c) The completed claim form shall be filed with the employer by
the injured employee, or, in the case of death, by a dependent of the
injured employee, or by an agent of the employee or dependent.
Except as provided in subdivision (d), a claim form is deemed filed
when it is personally delivered to the employer or received by the
employer by first-class or certified mail.  A dated copy of the
completed form shall be provided by the employer to the employer's
insurer and to the employee, dependent, or agent who filed the claim
form.
   (d) The claim form shall be filed with the employer prior to the
injured employee's entitlement to late payment supplements under
subdivision (d) of Section 4650, or prior to the injured employee's
request for a medical evaluation under Section 4060, 4061, or 4062.
Filing of the claim form with the employer shall toll, for injuries
occurring on or after January 1, 1994, the time limitations set forth
in Sections 5405 and 5406 until the claim is denied by the employer
or the injury becomes presumptively compensable pursuant to Section
5402.  For purposes of this subdivision, a claim form is deemed filed
when it is personally delivered to the employer or mailed to the
employer by first-class or certified mail.


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
Sections 1871.2 and 1879.2 of the Insurance Code may, but are not
required to, appear on the claim form.



5402.  (a) Knowledge of an injury, obtained from any source, on the
part of an employer, his or her 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) 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.
   (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 or the American College
of Occupational and Environmental Medicine's Occupational Medicine
Practice Guidelines, 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) shall not give rise
to a presumption of liability on the part of the employer.



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.



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.



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.



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.



5406.  Except as provided in Section 5406.5 or 5406.6, 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:
   (a) The date of death where death occurs within one year from date
of injury; or
   (b) The date of last furnishing of any benefits under Chapter 2
(commencing with Section 4550) of Part 2, where de