Section 10455 - ApplicationsA separate Application for Adjudication of Claim shall be filed for each separate injury for which benefits are claimed. All applications shall conform to the following requirements:
(a) Only one application shall be filed for each injury. Duplicative applications are subject to summary dismissal.(b) Upon filing an Application for Adjudication of Claim, the filing party shall concurrently serve a copy of the application and any accompanying documents on all other parties.(c) When filing an amended application, the applicant shall indicate on the box set forth on the application form that it is an amended application.(d) If the applicant is a minor or incompetent, the Application for Adjudication of Claim shall be accompanied by a Petition for Appointment of Guardian ad Litem and Trustee.(e) An applicant is not required to disclose their social security number. If an applicant discloses their Social Security number on the application, the Social Security number will be used solely for identification and verification purposes in order to administer the workers' compensation system except with the consent of the applicant, or as permitted or required by statute, regulation or judicial order.(f) Upon the filing of an initial application, the Workers' Compensation Appeals Board shall assign an adjudication case number and a venue. The case number and venue shall be indicated on a conformed copy of the application. (1) If the party filing the application is unrepresented, the Workers' Compensation Appeals Board shall serve a conformed copy of the application on all parties and lien claimants on the proof of service to the application.(2) If the party filing the application is represented, the Workers' Compensation Appeals Board shall serve a conformed copy of the application on the filing party or lien claimant. Upon receipt of the conformed copy of the application, the filing party shall forthwith serve a copy of the conformed application on all other parties and lien claimants.Cal. Code Regs. Tit. 8, § 10455
1. Renumbering of former section 10454 to new section 10455 filed 12-19-2002; operative 1-1-2003. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 2002, No. 51).
2. Renumbering of former section 10455 to section 10534 and new section 10455 filed 12-17-2019; operative 1-1-2020. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 2019, No. 51). Note: Authority cited: Sections 133, 5307, 5309 and 5708, Labor Code. Reference: Sections 126, 3208.2, 5307.5, 5316, 5500 and 5501, Labor Code.
1. Renumbering of former section 10454 to new section 10455 filed 12-19-2002; operative 1-1-2003. Submitted to OAL for printing only pursuant to Government Code section 11351(Register 2002, No. 51).
2. Renumbering of former section 10455 to section 10534 and new section 10455 filed 12-17-2019; operative 1/1/2020. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 2019, No. 51).