2701. Disability benefits shall be paid by the department through
public employment offices or other agencies approved by the director.
2701.5. The department shall issue the initial payment for
unemployment compensation disability benefits to a monetarily
eligible claimant who is otherwise determined eligible by the
department under applicable law and regulation within 14 days of
receipt of his or her properly completed first disability claim.
2702. Minors who are eligible for disability benefits may be paid
and receive such benefits in their own right and a receipt signed by
a minor shall be valid and binding in all respects.
2703. The establishment of a disability benefit period for
unemployment compensation disability benefits shall not establish a
benefit year for unemployment compensation benefits and the filing of
a valid claim for one shall not establish a valid claim for the
other. Wages used to establish a valid claim for disability benefits
may be used to establish a subsequent claim for disability benefits
or unemployment compensation benefits provided such wages were paid
in the base period applicable to the subsequent claim.
2705. Where an individual who would be eligible to receive
disability benefits dies before making a claim therefor, the director
may in accordance with authorized regulations allow the filing of a
claim for such benefits by a person legally entitled thereto under
Section 1341.
2705.1. Where an individual who would be eligible to receive
disability benefits is mentally unable to make a claim therefor, the
director shall, in accordance with authorized regulations, allow the
filing of a claim for these benefits by the spouse or domestic
partner of the individual, in the absence of any other legally
authorized representative of the individual. A payment shall be made
upon affidavit executed by the spouse or domestic partner or person
or persons claiming to be entitled to the benefits and the receipt of
the affidavit or affidavits shall fully discharge the Director of
Employment Development from any further liability with reference to
the payments, without the necessity of inquiring into the truth of
any of the facts stated in the affidavit.
For the purposes of this section "mentally unable to make a claim"
shall be limited to those cases in which the individual is certified
by a healing arts practitioner specified in Sections 2708 and 2709
to be mentally unable to make a claim pursuant to this part.
2706. Claims for disability benefits shall be made in accordance
with authorized regulations of the Director of Employment
Development. Each employer shall post and maintain in places readily
accessible to individuals in his service printed statements
concerning such regulations and shall make available to each such
individual copies of such printed statements, regulations or matters
relating to claims for disability benefits as the Director of
Employment Development may prescribe. Such printed statements shall
be supplied to each employer by the Director of Employment
Development without cost to the employer.
2706.1. A first claim, accompanied by a certificate on a form
furnished by the department to the claimant, shall be filed not later
than the 41st consecutive day following the first compensable day of
unemployment and disability with respect to which the claim is made
for benefits, which time shall be extended by the department upon a
showing of good cause. If a first claim is not complete, the claim
form shall be returned to the claimant for completion and it shall be
completed and returned not later than the 10th consecutive day after
the date it was mailed by the department to the claimant, except
that such time shall be extended by the department upon a showing of
good cause.
2706.2. Any continued medical certification shall be submitted to
the department within 20 days of the date the claimant is issued a
notice of final payment or departmental request for additional
medical certification. The 20-day time limit shall be extended by the
department upon a showing of good cause.
2707. The department shall give a notice of the filing of a first
claim for each disability benefit period to the employing unit by
which the claimant was last employed immediately preceding the filing
of such claim.
2707.1. Within two working days after receipt of the notice
provided for in Section 2707, or if there has been a termination of
the claimant's service within five days after such termination,
whichever is the later, the last employer shall notify the department
of any information known to him which may bear upon the eligibility
of the claimant.
2707.2. The department shall consider the facts submitted by the
employer pursuant to Section 2707.1 and make a determination as to
the eligibility of the claimant for benefits. The department shall
promptly notify the claimant of the determination and the reasons
therefor. The claimant may appeal therefrom to an administrative law
judge within 20 days from mailing or personal service of the notice
of determination. The 20-day period may be extended for good cause.
The director shall be an interested party to any appeal.
"Good cause," as used in this section, shall include, but not be
limited to, mistake, inadvertence, surprise, or excusable neglect.
2707.3. (a) Except as provided in subdivision (b) of this section,
upon the filing of a claim for unemployment compensation disability
benefits, the Employment Development Department shall promptly make a
computation on the claim which shall set forth the maximum amount of
benefits potentially payable during the disability benefit period
and the weekly benefit amount. The Employment Development Department
shall promptly notify the claimant of the computation.
(b) No computation shall be made on a claim of an employee for
disability benefits under an approved self-insured plan if the
uninterrupted period of disability for such claim does not exceed the
waiting period prescribed for benefits from the Disability Fund
under subdivision (b) of Section 2627.
2707.4. The claimant may, within 20 days after the mailing or
personal service of the notice of computation or recomputation,
protest the accuracy of the computation or recomputation. The 20-day
period may be extended for good cause. The department shall consider
any such protest and shall promptly notify the claimant of the
recomputation or denial of recomputation. The claimant may appeal
from a notice of denial of recomputation in the manner prescribed in
Section 2707. 2. The director shall be an interested party to any
appeal.
"Good cause," as used in this section, shall include, but not be
limited to, mistake, inadvertence, surprise, or excusable neglect.
2707.5. (a) The department may for good cause reconsider any
determination provided for in this part prior to the filing of an
appeal therefrom, or within 30 days after an appeal to an
administrative law judge is filed. The department shall promptly
notify the claimant of any reconsidered determination, and the
claimant may appeal therefrom in the manner prescribed in Section
2707.2. The director shall be an interested party to any appeal.
(b) The department may for good cause reconsider any computation
or recomputation provided for in this part within one year from the
beginning date of the disability benefit period to which the notice
of computation or recomputation relates, except that no recomputation
may be considered with respect to any issue considered or under
consideration in an appeal taken from a denial of recomputation. The
department shall promptly notify the claimant of the recomputation.
The claimant may protest the accuracy of the recomputation as
prescribed in Section 2707.4.
2707.6. Notices, protests, and information required under this
article shall be submitted in accordance with authorized regulations.
2708. (a) (1) In accordance with the director's authorized
regulations, and except as provided in subdivision (c) and Sections
2708.1 and 2709, a claimant shall establish medical eligibility for
each uninterrupted period of disability by filing a first claim for
disability benefits supported by the certificate of a treating
physician or practitioner that establishes the sickness, injury, or
pregnancy of the employee, or the condition of the family member that
warrants the care of the employee. For subsequent periods of
uninterrupted disability after the period covered by the initial
certificate or any preceding continued claim, a claimant shall file a
continued claim for those benefits supported by the certificate of a
treating physician or practitioner. A certificate filed to establish
medical eligibility for the employee's own sickness, injury, or
pregnancy shall contain a diagnosis and diagnostic code prescribed in
the International Classification of Diseases, or, where no diagnosis
has yet been obtained, a detailed statement of symptoms.
(2) A certificate filed to establish medical eligibility of the
employee's own sickness, injury, or pregnancy shall also contain a
statement of medical facts including secondary diagnoses when
applicable, within the physician's or practitioner's knowledge, based
on a physical examination and a documented medical history of the
claimant by the physician or practitioner, indicating the physician's
or practitioner's conclusion as to the claimant's disability, and a
statement of the physician's or practitioner's opinion as to the
expected duration of the disability.
(b) An employee shall be required to file a certificate to
establish eligibility when taking leave to care for a family member
with a serious health condition. The certificate shall be developed
by the department. In order to establish medical eligibility of the
serious health condition of the family member that warrants the care
of the employee, the information shall be within the physician's or
practitioner's knowledge and shall be based on a physical examination
and documented medical history of the family member and shall
contain all of the following:
(1) A diagnosis and diagnostic code prescribed in the
International Classification of Diseases, or, where no diagnosis has
yet been obtained, a detailed statement of symptoms.
(2) The date, if known, on which the condition commenced.
(3) The probable duration of the condition.
(4) An estimate of the amount of time that the physician or
practitioner believes the employee is needed to care for the child,
parent, spouse, or domestic partner.
(5) (A) A statement that the serious health condition warrants the
participation of the employee to provide care for his or her child,
parent, spouse, or domestic partner.
(B) "Warrants the participation of the employee" includes, but is
not limited to, providing psychological comfort, and arranging "third
party" care for the child, parent, spouse, or domestic partner, as
well as directly providing, or participating in, the medical care.
(c) The department shall develop a certification form for bonding
that is separate and distinct from the certificate required in
subdivision (a) for an employee taking leave to bond with a minor
child within the first year of the child's birth or placement in
connection with foster care or adoption.
(d) The first and any continuing claim of an individual who
obtains care and treatment outside this state shall be supported by a
certificate of a treating physician or practitioner duly licensed or
certified by the state or foreign country in which the claimant is
receiving the care and treatment. If a physician or practitioner
licensed by and practicing in a foreign country is under
investigation by the department for filing false claims and the
department does not have legal remedies to conduct a criminal
investigation or prosecution in that country, the department may
suspend the processing of all further certifications until the
physician or practitioner fully cooperates, and continues to
cooperate with the investigation. A physician or practitioner
licensed by and practicing in a foreign country who has been
convicted of filing false claims with the department may not file a
certificate in support of a claim for disability benefits for a
period of five years.
(e) For purposes of this part:
(1) "Physician" has the same meaning as defined in Section 3209.3
of the Labor Code.
(2) "Practitioner" means a person duly licensed or certified in
California acting within the scope of his or her license or
certification who is a dentist, podiatrist, or a nurse practitioner,
and in the case of a nurse practitioner, after performance of a
physical examination by a nurse practitioner and collaboration with a
physician and surgeon, or as to normal pregnancy or childbirth, a
midwife or nurse midwife, or nurse practitioner.
(f) For a claimant who is hospitalized in or under the authority
of a county hospital in this state, a certificate of initial and
continuing medical disability, if any, shall satisfy the requirements
of this section if the disability is shown by the claimant's
hospital chart, and the certificate is signed by the hospital's
registrar. For a claimant hospitalized in or under the care of a
medical facility of the United States government, a certificate of
initial and continuing medical disability, if any, shall satisfy the
requirements of this section if the disability is shown by the
claimant's hospital chart, and the certificate is signed by a medical
officer of the facility duly authorized to do so.
(g) Nothing in this section shall be construed to preclude the
department from requesting additional medical evidence to supplement
the first or any continued claim if the additional evidence can be
procured without additional cost to the claimant. The department may
require that the additional evidence include any or all of the
following:
(1) Identification of diagnoses.
(2) Identification of symptoms.
(3) A statement setting forth the facts of the claimant's
disability. The statement shall be completed by any of the following
individuals:
(A) The physician or practitioner treating the claimant.
(B) The registrar, authorized medical officer, or other duly
authorized official of the hospital or health facility treating the
claimant.
(C) An examining physician or other representative of the
department.
2708.1. (a) Except as provided in subdivision (b), where an
individual is entitled to receive unemployment compensation
disability benefits reduced by the amount of temporary workers'
compensation received for any day under Section 2629, it shall not be
necessary that he or she obtain a certificate of a physician as
required by subdivision (a) of Section 2708 to receive the reduced
amount of disability benefits for that day, provided that the
claimant submits evidence to the department of receipt of temporary
disability benefits under a workers' compensation law for that day.
(b) This section does not apply to Chapter 7 (commencing with
Section 3300).
2709. If any individual in good faith adheres to the teachings of
any bona fide church, sect, denomination or organization and in
accordance with its principles depends for healing entirely upon
prayer or spiritual means, no medical examination shall be required,
but in lieu thereof the director may accept the certificate of a duly
authorized and accredited practitioner of that bona fide church,
sect, denomination or organization as to the disability of the
claimant, or the serious health condition of the family member that
warrants the care of the individual, for purposes of Chapter 7
(commencing with Section 3300) of Part 2, and the estimated duration
of such disability, and no authorized regulation prescribing the
manner of proof of illness, injury, or serious health condition shall
discriminate against that individual.
2712. Whenever an individual is entitled to benefits under this
part but there is a dispute whether such benefits are payable from
the Disability Fund or from one or another voluntary plan, benefits
shall be paid to the individual, pursuant to authorized regulations,
from the source against which his claim was first filed, at not less
than the Disability Fund rate, pending the determination of the
dispute. The appeals board may prescribe by regulation the time,
manner, method, and procedure through which such disputes may be
determined by administrative law judges and the appeals board. If it
is finally determined that the benefits should have been paid from
one of said sources other than the one which paid the benefits,
reimbursement shall be promptly made from the Disability Fund or the
voluntary plan, as the case may be, and the claimant shall be
promptly paid the accumulated excess, if any, to which he is
entitled. Reimbursement shall also be made to the extent of actual
liability for benefits from one to another of the above mentioned
sources when it is determined that benefits have been paid in error
from one source which should have been paid from another.
2712.5. (a) If, in a disputed coverage proceeding under Section
2712 a final decision of an administrative law judge or of the
appeals board finds that an employer or insurer shall reimburse the
Disability Fund and the employer or insurer fails to pay all or any
part of the reimbursement within 15 days after the decision of an
administrative law judge or of the appeals board becomes final, the
director shall assess the unpaid amount against the employer or the
insurer. The provisions of Article 8 (commencing with Section 1126)
of Chapter 4 of Part 1 with respect to the assessment of
contributions shall apply to the recovery of the unpaid amount. The
provisions of Chapter 7 (commencing with Section 1701) of Part 1 with
respect to the collection of contributions shall apply to the
recovery of unpaid amounts under this section. Amounts so collected
shall be deposited in the Disability Fund.
(b) The provisions of Article 9 (commencing with Section 1176) of
Chapter 4 of Part 1 shall apply to amounts collected under this
section and to amounts reimbursed to the Disability Fund after a
final decision by an administrative law judge or the appeals board in
a disputed coverage proceeding under Section 2712.
2713. In proceedings under this part the claimant, upon a showing
of good cause, may request a closed hearing except that the last
employer and each base period employer of the claimant shall be
entitled to participate in any such hearing.
2714. All medical records of the department obtained under this
part, except to the extent necessary for the proper administration of
this part, or as provided elsewhere in law shall be confidential and
shall not be published or be open to public inspection in any manner
revealing the identity of the claimant or family member, or the
nature or cause of his or her disability. Medical records that are
disclosed shall be disclosed only pursuant to Section 1095, and shall
remain confidential.
2701. Disability benefits shall be paid by the department through
public employment offices or other agencies approved by the director.
2701.5. The department shall issue the initial payment for
unemployment compensation disability benefits to a monetarily
eligible claimant who is otherwise determined eligible by the
department under applicable law and regulation within 14 days of
receipt of his or her properly completed first disability claim.
2702. Minors who are eligible for disability benefits may be paid
and receive such benefits in their own right and a receipt signed by
a minor shall be valid and binding in all respects.
2703. The establishment of a disability benefit period for
unemployment compensation disability benefits shall not establish a
benefit year for unemployment compensation benefits and the filing of
a valid claim for one shall not establish a valid claim for the
other. Wages used to establish a valid claim for disability benefits
may be used to establish a subsequent claim for disability benefits
or unemployment compensation benefits provided such wages were paid
in the base period applicable to the subsequent claim.
2705. Where an individual who would be eligible to receive
disability benefits dies before making a claim therefor, the director
may in accordance with authorized regulations allow the filing of a
claim for such benefits by a person legally entitled thereto under
Section 1341.
2705.1. Where an individual who would be eligible to receive
disability benefits is mentally unable to make a claim therefor, the
director shall, in accordance with authorized regulations, allow the
filing of a claim for these benefits by the spouse or domestic
partner of the individual, in the absence of any other legally
authorized representative of the individual. A payment shall be made
upon affidavit executed by the spouse or domestic partner or person
or persons claiming to be entitled to the benefits and the receipt of
the affidavit or affidavits shall fully discharge the Director of
Employment Development from any further liability with reference to
the payments, without the necessity of inquiring into the truth of
any of the facts stated in the affidavit.
For the purposes of this section "mentally unable to make a claim"
shall be limited to those cases in which the individual is certified
by a healing arts practitioner specified in Sections 2708 and 2709
to be mentally unable to make a claim pursuant to this part.
2706. Claims for disability benefits shall be made in accordance
with authorized regulations of the Director of Employment
Development. Each employer shall post and maintain in places readily
accessible to individuals in his service printed statements
concerning such regulations and shall make available to each such
individual copies of such printed statements, regulations or matters
relating to claims for disability benefits as the Director of
Employment Development may prescribe. Such printed statements shall
be supplied to each employer by the Director of Employment
Development without cost to the employer.
2706.1. A first claim, accompanied by a certificate on a form
furnished by the department to the claimant, shall be filed not later
than the 41st consecutive day following the first compensable day of
unemployment and disability with respect to which the claim is made
for benefits, which time shall be extended by the department upon a
showing of good cause. If a first claim is not complete, the claim
form shall be returned to the claimant for completion and it shall be
completed and returned not later than the 10th consecutive day after
the date it was mailed by the department to the claimant, except
that such time shall be extended by the department upon a showing of
good cause.
2706.2. Any continued medical certification shall be submitted to
the department within 20 days of the date the claimant is issued a
notice of final payment or departmental request for additional
medical certification. The 20-day time limit shall be extended by the
department upon a showing of good cause.
2707. The department shall give a notice of the filing of a first
claim for each disability benefit period to the employing unit by
which the claimant was last employed immediately preceding the filing
of such claim.
2707.1. Within two working days after receipt of the notice
provided for in Section 2707, or if there has been a termination of
the claimant's service within five days after such termination,
whichever is the later, the last employer shall notify the department
of any information known to him which may bear upon the eligibility
of the claimant.
2707.2. The department shall consider the facts submitted by the
employer pursuant to Section 2707.1 and make a determination as to
the eligibility of the claimant for benefits. The department shall
promptly notify the claimant of the determination and the reasons
therefor. The claimant may appeal therefrom to an administrative law
judge within 20 days from mailing or personal service of the notice
of determination. The 20-day period may be extended for good cause.
The director shall be an interested party to any appeal.
"Good cause," as used in this section, shall include, but not be
limited to, mistake, inadvertence, surprise, or excusable neglect.
2707.3. (a) Except as provided in subdivision (b) of this section,
upon the filing of a claim for unemployment compensation disability
benefits, the Employment Development Department shall promptly make a
computation on the claim which shall set forth the maximum amount of
benefits potentially payable during the disability benefit period
and the weekly benefit amount. The Employment Development Department
shall promptly notify the claimant of the computation.
(b) No computation shall be made on a claim of an employee for
disability benefits under an approved self-insured plan if the
uninterrupted period of disability for such claim does not exceed the
waiting period prescribed for benefits from the Disability Fund
under subdivision (b) of Section 2627.
2707.4. The claimant may, within 20 days after the mailing or
personal service of the notice of computation or recomputation,
protest the accuracy of the computation or recomputation. The 20-day
period may be extended for good cause. The department shall consider
any such protest and shall promptly notify the claimant of the
recomputation or denial of recomputation. The claimant may appeal
from a notice of denial of recomputation in the manner prescribed in
Section 2707. 2. The director shall be an interested party to any
appeal.
"Good cause," as used in this section, shall include, but not be
limited to, mistake, inadvertence, surprise, or excusable neglect.
2707.5. (a) The department may for good cause reconsider any
determination provided for in this part prior to the filing of an
appeal therefrom, or within 30 days after an appeal to an
administrative law judge is filed. The department shall promptly
notify the claimant of any reconsidered determination, and the
claimant may appeal therefrom in the manner prescribed in Section
2707.2. The director shall be an interested party to any appeal.
(b) The department may for good cause reconsider any computation
or recomputation provided for in this part within one year from the
beginning date of the disability benefit period to which the notice
of computation or recomputation relates, except that no recomputation
may be considered with respect to any issue considered or under
consideration in an appeal taken from a denial of recomputation. The
department shall promptly notify the claimant of the recomputation.
The claimant may protest the accuracy of the recomputation as
prescribed in Section 2707.4.
2707.6. Notices, protests, and information required under this
article shall be submitted in accordance with authorized regulations.
2708. (a) (1) In accordance with the director's authorized
regulations, and except as provided in subdivision (c) and Sections
2708.1 and 2709, a claimant shall establish medical eligibility for
each uninterrupted period of disability by filing a first claim for
disability benefits supported by the certificate of a treating
physician or practitioner that establishes the sickness, injury, or
pregnancy of the employee, or the condition of the family member that
warrants the care of the employee. For subsequent periods of
uninterrupted disability after the period covered by the initial
certificate or any preceding continued claim, a claimant shall file a
continued claim for those benefits supported by the certificate of a
treating physician or practitioner. A certificate filed to establish
medical eligibility for the employee's own sickness, injury, or
pregnancy shall contain a diagnosis and diagnostic code prescribed in
the International Classification of Diseases, or, where no diagnosis
has yet been obtained, a detailed statement of symptoms.
(2) A certificate filed to establish medical eligibility of the
employee's own sickness, injury, or pregnancy shall also contain a
statement of medical facts including secondary diagnoses when
applicable, within the physician's or practitioner's knowledge, based
on a physical examination and a documented medical history of the
claimant by the physician or practitioner, indicating the physician's
or practitioner's conclusion as to the claimant's disability, and a
statement of the physician's or practitioner's opinion as to the
expected duration of the disability.
(b) An employee shall be required to file a certificate to
establish eligibility when taking leave to care for a family member
with a serious health condition. The certificate shall be developed
by the department. In order to establish medical eligibility of the
serious health condition of the family member that warrants the care
of the employee, the information shall be within the physician's or
practitioner's knowledge and shall be based on a physical examination
and documented medical history of the family member and shall
contain all of the following:
(1) A diagnosis and diagnostic code prescribed in the
International Classification of Diseases, or, where no diagnosis has
yet been obtained, a detailed statement of symptoms.
(2) The date, if known, on which the condition commenced.
(3) The probable duration of the condition.
(4) An estimate of the amount of time that the physician or
practitioner believes the employee is needed to care for the child,
parent, spouse, or domestic partner.
(5) (A) A statement that the serious health condition warrants the
participation of the employee to provide care for his or her child,
parent, spouse, or domestic partner.
(B) "Warrants the participation of the employee" includes, but is
not limited to, providing psychological comfort, and arranging "third
party" care for the child, parent, spouse, or domestic partner, as
well as directly providing, or participating in, the medical care.
(c) The department shall develop a certification form for bonding
that is separate and distinct from the certificate required in
subdivision (a) for an employee taking leave to bond with a minor
child within the first year of the child's birth or placement in
connection with foster care or adoption.
(d) The first and any continuing claim of an individual who
obtains care and treatment outside this state shall be supported by a
certificate of a treating physician or practitioner duly licensed or
certified by the state or foreign country in which the claimant is
receiving the care and treatment. If a physician or practitioner
licensed by and practicing in a foreign country is under
investigation by the department for filing false claims and the
department does not have legal remedies to conduct a criminal
investigation or prosecution in that country, the department may
suspend the processing of all further certifications until the
physician or practitioner fully cooperates, and continues to
cooperate with the investigation. A physician or practitioner
licensed by and practicing in a foreign country who has been
convicted of filing false claims with the department may not file a
certificate in support of a claim for disability benefits for a
period of five years.
(e) For purposes of this part:
(1) "Physician" has the same meaning as defined in Section 3209.3
of the Labor Code.
(2) "Practitioner" means a person duly licensed or certified in
California acting within the scope of his or her license or
certification who is a dentist, podiatrist, or a nurse practitioner,
and in the case of a nurse practitioner, after performance of a
physical examination by a nurse practitioner and collaboration with a
physician and surgeon, or as to normal pregnancy or childbirth, a
midwife or nurse midwife, or nurse practitioner.
(f) For a claimant who is hospitalized in or under the authority
of a county hospital in this state, a certificate of initial and
continuing medical disability, if any, shall satisfy the requirements
of this section if the disability is shown by the claimant's
hospital chart, and the certificate is signed by the hospital's
registrar. For a claimant hospitalized in or under the care of a
medical facility of the United States government, a certificate of
initial and continuing medical disability, if any, shall satisfy the
requirements of this section if the disability is shown by the
claimant's hospital chart, and the certificate is signed by a medical
officer of the facility duly authorized to do so.
(g) Nothing in this section shall be construed to preclude the
department from requesting additional medical evidence to supplement
the first or any continued claim if the additional evidence can be
procured without additional cost to the claimant. The department may
require that the additional evidence include any or all of the
following:
(1) Identification of diagnoses.
(2) Identification of symptoms.
(3) A statement setting forth the facts of the claimant's
disability. The statement shall be completed by any of the following
individuals:
(A) The physician or practitioner treating the claimant.
(B) The registrar, authorized medical officer, or other duly
authorized official of the hospital or health facility treating the
claimant.
(C) An examining physician or other representative of the
department.
2708.1. (a) Except as provided in subdivision (b), where an
individual is entitled to receive unemployment compensation
disability benefits reduced by the amount of temporary workers'
compensation received for any day under Section 2629, it shall not be
necessary that he or she obtain a certificate of a physician as
required by subdivision (a) of Section 2708 to receive the reduced
amount of disability benefits for that day, provided that the
claimant submits evidence to the department of receipt of temporary
disability benefits under a workers' compensation law for that day.
(b) This section does not apply to Chapter 7 (commencing with
Section 3300).
2709. If any individual in good faith adheres to the teachings of
any bona fide church, sect, denomination or organization and in
accordance with its principles depends for healing entirely upon
prayer or spiritual means, no medical examination shall be required,
but in lieu thereof the director may accept the certificate of a duly
authorized and accredited practitioner of that bona fide church,
sect, denomination or organization as to the disability of the
claimant, or the serious health condition of the family member that
warrants the care of the individual, for purposes of Chapter 7
(commencing with Section 3300) of Part 2, and the estimated duration
of such disability, and no authorized regulation prescribing the
manner of proof of illness, injury, or serious health condition shall
discriminate against that individual.
2712. Whenever an individual is entitled to benefits under this
part but there is a dispute whether such benefits are payable from
the Disability Fund or from one or another voluntary plan, benefits
shall be paid to the individual, pursuant to authorized regulations,
from the source against which his claim was first filed, at not less
than the Disability Fund rate, pending the determination of the
dispute. The appeals board may prescribe by regulation the time,
manner, method, and procedure through which such disputes may be
determined by administrative law judges and the appeals board. If it
is finally determined that the benefits should have been paid from
one of said sources other than the one which paid the benefits,
reimbursement shall be promptly made from the Disability Fund or the
voluntary plan, as the case may be, and the claimant shall be
promptly paid the accumulated excess, if any, to which he is
entitled. Reimbursement shall also be made to the extent of actual
liability for benefits from one to another of the above mentioned
sources when it is determined that benefits have been paid in error
from one source which should have been paid from another.
2712.5. (a) If, in a disputed coverage proceeding under Section
2712 a final decision of an administrative law judge or of the
appeals board finds that an employer or insurer shall reimburse the
Disability Fund and the employer or insurer fails to pay all or any
part of the reimbursement within 15 days after the decision of an
administrative law judge or of the appeals board becomes final, the
director shall assess the unpaid amount against the employer or the
insurer. The provisions of Article 8 (commencing with Section 1126)
of Chapter 4 of Part 1 with respect to the assessment of
contributions shall apply to the recovery of the unpaid amount. The
provisions of Chapter 7 (commencing with Section 1701) of Part 1 with
respect to the collection of contributions shall apply to the
recovery of unpaid amounts under this section. Amounts so collected
shall be deposited in the Disability Fund.
(b) The provisions of Article 9 (commencing with Section 1176) of
Chapter 4 of Part 1 shall apply to amounts collected under this
section and to amounts reimbursed to the Disability Fund after a
final decision by an administrative law judge or the appeals board in
a disputed coverage proceeding under Section 2712.
2713. In proceedings under this part the claimant, upon a showing
of good cause, may request a closed hearing except that the last
employer and each base period employer of the claimant shall be
entitled to participate in any such hearing.
2714. All medical records of the department obtained under this
part, except to the extent necessary for the proper administration of
this part, or as provided elsewhere in law shall be confidential and
shall not be published or be open to public inspection in any manner
revealing the identity of the claimant or family member, or the
nature or cause of his or her disability. Medical records that are
disclosed shall be disclosed only pursuant to Section 1095, and shall
remain confidential.
2701. Disability benefits shall be paid by the department through
public employment offices or other agencies approved by the director.
2701.5. The department shall issue the initial payment for
unemployment compensation disability benefits to a monetarily
eligible claimant who is otherwise determined eligible by the
department under applicable law and regulation within 14 days of
receipt of his or her properly completed first disability claim.
2702. Minors who are eligible for disability benefits may be paid
and receive such benefits in their own right and a receipt signed by
a minor shall be valid and binding in all respects.
2703. The establishment of a disability benefit period for
unemployment compensation disability benefits shall not establish a
benefit year for unemployment compensation benefits and the filing of
a valid claim for one shall not establish a valid claim for the
other. Wages used to establish a valid claim for disability benefits
may be used to establish a subsequent claim for disability benefits
or unemployment compensation benefits provided such wages were paid
in the base period applicable to the subsequent claim.
2705. Where an individual who would be eligible to receive
disability benefits dies before making a claim therefor, the director
may in accordance with authorized regulations allow the filing of a
claim for such benefits by a person legally entitled thereto under
Section 1341.
2705.1. Where an individual who would be eligible to receive
disability benefits is mentally unable to make a claim therefor, the
director shall, in accordance with authorized regulations, allow the
filing of a claim for these benefits by the spouse or domestic
partner of the individual, in the absence of any other legally
authorized representative of the individual. A payment shall be made
upon affidavit executed by the spouse or domestic partner or person
or persons claiming to be entitled to the benefits and the receipt of
the affidavit or affidavits shall fully discharge the Director of
Employment Development from any further liability with reference to
the payments, without the necessity of inquiring into the truth of
any of the facts stated in the affidavit.
For the purposes of this section "mentally unable to make a claim"
shall be limited to those cases in which the individual is certified
by a healing arts practitioner specified in Sections 2708 and 2709
to be mentally unable to make a claim pursuant to this part.
2706. Claims for disability benefits shall be made in accordance
with authorized regulations of the Director of Employment
Development. Each employer shall post and maintain in places readily
accessible to individuals in his service printed statements
concerning such regulations and shall make available to each such
individual copies of such printed statements, regulations or matters
relating to claims for disability benefits as the Director of
Employment Development may prescribe. Such printed statements shall
be supplied to each employer by the Director of Employment
Development without cost to the employer.
2706.1. A first claim, accompanied by a certificate on a form
furnished by the department to the claimant, shall be filed not later
than the 41st consecutive day following the first compensable day of
unemployment and disability with respect to which the claim is made
for benefits, which time shall be extended by the department upon a
showing of good cause. If a first claim is not complete, the claim
form shall be returned to the claimant for completion and it shall be
completed and returned not later than the 10th consecutive day after
the date it was mailed by the department to the claimant, except
that such time shall be extended by the department upon a showing of
good cause.
2706.2. Any continued medical certification shall be submitted to
the department within 20 days of the date the claimant is issued a
notice of final payment or departmental request for additional
medical certification. The 20-day time limit shall be extended by the
department upon a showing of good cause.
2707. The department shall give a notice of the filing of a first
claim for each disability benefit period to the employing unit by
which the claimant was last employed immediately preceding the filing
of such claim.
2707.1. Within two working days after receipt of the notice
provided for in Section 2707, or if there has been a termination of
the claimant's service within five days after such termination,
whichever is the later, the last employer shall notify the department
of any information known to him which may bear upon the eligibility
of the claimant.
2707.2. The department shall consider the facts submitted by the
employer pursuant to Section 2707.1 and make a determination as to
the eligibility of the claimant for benefits. The department shall
promptly notify the claimant of the determination and the reasons
therefor. The claimant may appeal therefrom to an administrative law
judge within 20 days from mailing or personal service of the notice
of determination. The 20-day period may be extended for good cause.
The director shall be an interested party to any appeal.
"Good cause," as used in this section, shall include, but not be
limited to, mistake, inadvertence, surprise, or excusable neglect.
2707.3. (a) Except as provided in subdivision (b) of this section,
upon the filing of a claim for unemployment compensation disability
benefits, the Employment Development Department shall promptly make a
computation on the claim which shall set forth the maximum amount of
benefits potentially payable during the disability benefit period
and the weekly benefit amount. The Employment Development Department
shall promptly notify the claimant of the computation.
(b) No computation shall be made on a claim of an employee for
disability benefits under an approved self-insured plan if the
uninterrupted period of disability for such claim does not exceed the
waiting period prescribed for benefits from the Disability Fund
under subdivision (b) of Section 2627.
2707.4. The claimant may, within 20 days after the mailing or
personal service of the notice of computation or recomputation,
protest the accuracy of the computation or recomputation. The 20-day
period may be extended for good cause. The department shall consider
any such protest and shall promptly notify the claimant of the
recomputation or denial of recomputation. The claimant may appeal
from a notice of denial of recomputation in the manner prescribed in
Section 2707. 2. The director shall be an interested party to any
appeal.
"Good cause," as used in this section, shall include, but not be
limited to, mistake, inadvertence, surprise, or excusable neglect.
2707.5. (a) The department may for good cause reconsider any
determination provided for in this part prior to the filing of an
appeal therefrom, or within 30 days after an appeal to an
administrative law judge is filed. The department shall promptly
notify the claimant of any reconsidered determination, and the
claimant may appeal therefrom in the manner prescribed in Section
2707.2. The director shall be an interested party to any appeal.
(b) The department may for good cause reconsider any computation
or recomputation provided for in this part within one year from the
beginning date of the disability benefit period to which the notice
of computation or recomputation relates, except that no recomputation
may be considered with respect to any issue considered or under
consideration in an appeal taken from a denial of recomputation. The
department shall promptly notify the claimant of the recomputation.
The claimant may protest the accuracy of the recomputation as
prescribed in Section 2707.4.
2707.6. Notices, protests, and information required under this
article shall be submitted in accordance with authorized regulations.
2708. (a) (1) In accordance with the director's authorized
regulations, and except as provided in subdivision (c) and Sections
2708.1 and 2709, a claimant shall establish medical eligibility for
each uninterrupted period of disability by filing a first claim for
disability benefits supported by the certificate of a treating
physician or practitioner that establishes the sickness, injury, or
pregnancy of the employee, or the condition of the family member that
warrants the care of the employee. For subsequent periods of
uninterrupted disability after the period covered by the initial
certificate or any preceding continued claim, a claimant shall file a
continued claim for those benefits supported by the certificate of a
treating physician or practitioner. A certificate filed to establish
medical eligibility for the employee's own sickness, injury, or
pregnancy shall contain a diagnosis and diagnostic code prescribed in
the International Classification of Diseases, or, where no diagnosis
has yet been obtained, a detailed statement of symptoms.
(2) A certificate filed to establish medical eligibility of the
employee's own sickness, injury, or pregnancy shall also contain a
statement of medical facts including secondary diagnoses when
applicable, within the physician's or practitioner's knowledge, based
on a physical examination and a documented medical history of the
claimant by the physician or practitioner, indicating the physician's
or practitioner's conclusion as to the claimant's disability, and a
statement of the physician's or practitioner's opinion as to the
expected duration of the disability.
(b) An employee shall be required to file a certificate to
establish eligibility when taking leave to care for a family member
with a serious health condition. The certificate shall be developed
by the department. In order to establish medical eligibility of the
serious health condition of the family member that warrants the care
of the employee, the information shall be within the physician's or
practitioner's knowledge and shall be based on a physical examination
and documented medical history of the family member and shall
contain all of the following:
(1) A diagnosis and diagnostic code prescribed in the
International Classification of Diseases, or, where no diagnosis has
yet been obtained, a detailed statement of symptoms.
(2) The date, if known, on which the condition commenced.
(3) The probable duration of the condition.
(4) An estimate of the amount of time that the physician or
practitioner believes the employee is needed to care for the child,
parent, spouse, or domestic partner.
(5) (A) A statement that the serious health condition warrants the
participation of the employee to provide care for his or her child,
parent, spouse, or domestic partner.
(B) "Warrants the participation of the employee" includes, but is
not limited to, providing psychological comfort, and arranging "third
party" care for the child, parent, spouse, or domestic partner, as
well as directly providing, or participating in, the medical care.
(c) The department shall develop a certification form for bonding
that is separate and distinct from the certificate required in
subdivision (a) for an employee taking leave to bond with a minor
child within the first year of the child's birth or placement in
connection with foster care or adoption.
(d) The first and any continuing claim of an individual who
obtains care and treatment outside this state shall be supported by a
certificate of a treating physician or practitioner duly licensed or
certified by the state or foreign country in which the claimant is
receiving the care and treatment. If a physician or practitioner
licensed by and practicing in a foreign country is under
investigation by the department for filing false claims and the
department does not have legal remedies to conduct a criminal
investigation or prosecution in that country, the department may
suspend the processing of all further certifications until the
physician or practitioner fully cooperates, and continues to
cooperate with the investigation. A physician or practitioner
licensed by and practicing in a foreign country who has been
convicted of filing false claims with the department may not file a
certificate in support of a claim for disability benefits for a
period of five years.
(e) For purposes of this part:
(1) "Physician" has the same meaning as defined in Section 3209.3
of the Labor Code.
(2) "Practitioner" means a person duly licensed or certified in
California acting within the scope of his or her license or
certification who is a dentist, podiatrist, or a nurse practitioner,
and in the case of a nurse practitioner, after performance of a
physical examination by a nurse practitioner and collaboration with a
physician and surgeon, or as to normal pregnancy or childbirth, a
midwife or nurse midwife, or nurse practitioner.
(f) For a claimant who is hospitalized in or under the authority
of a county hospital in this state, a certificate of initial and
continuing medical disability, if any, shall satisfy the requirements
of this section if the disability is shown by the claimant's
hospital chart, and the certificate is signed by the hospital's
registrar. For a claimant hospitalized in or under the care of a
medical facility of the United States government, a certificate of
initial and continuing medical disability, if any, shall satisfy the
requirements of this section if the disability is shown by the
claimant's hospital chart, and the certificate is signed by a medical
officer of the facility duly authorized to do so.
(g) Nothing in this section shall be construed to preclude the
department from requesting additional medical evidence to supplement
the first or any continued claim if the additional evidence can be
procured without additional cost to the claimant. The department may
require that the additional evidence include any or all of the
following:
(1) Identification of diagnoses.
(2) Identification of symptoms.
(3) A statement setting forth the facts of the claimant's
disability. The statement shall be completed by any of the following
individuals:
(A) The physician or practitioner treating the claimant.
(B) The registrar, authorized medical officer, or other duly
authorized official of the hospital or health facility treating the
claimant.
(C) An examining physician or other representative of the
department.
2708.1. (a) Except as provided in subdivision (b), where an
individual is entitled to receive unemployment compensation
disability benefits reduced by the amount of temporary workers'
compensation received for any day under Section 2629, it shall not be
necessary that he or she obtain a certificate of a physician as
required by subdivision (a) of Section 2708 to receive the reduced
amount of disability benefits for that day, provided that the
claimant submits evidence to the department of receipt of temporary
disability benefits under a workers' compensation law for that day.
(b) This section does not apply to Chapter 7 (commencing with
Section 3300).
2709. If any individual in good faith adheres to the teachings of
any bona fide church, sect, denomination or organization and in
accordance with its principles depends for healing entirely upon
prayer or spiritual means, no medical examination shall be required,
but in lieu thereof the director may accept the certificate of a duly
authorized and accredited practitioner of that bona fide church,
sect, denomination or organization as to the disability of the
claimant, or the serious health condition of the family member that
warrants the care of the individual, for purposes of Chapter 7
(commencing with Section 3300) of Part 2, and the estimated duration
of such disability, and no authorized regulation prescribing the
manner of proof of illness, injury, or serious health condition shall
discriminate against that individual.
2712. Whenever an individual is entitled to benefits under this
part but there is a dispute whether such benefits are payable from
the Disability Fund or from one or another voluntary plan, benefits
shall be paid to the individual, pursuant to authorized regulations,
from the source against which his claim was first filed, at not less
than the Disability Fund rate, pending the determination of the
dispute. The appeals board may prescribe by regulation the time,
manner, method, and procedure through which such disputes may be
determined by administrative law judges and the appeals board. If it
is finally determined that the benefits should have been paid from
one of said sources other than the one which paid the benefits,
reimbursement shall be promptly made from the Disability Fund or the
voluntary plan, as the case may be, and the claimant shall be
promptly paid the accumulated excess, if any, to which he is
entitled. Reimbursement shall also be made to the extent of actual
liability for benefits from one to another of the above mentioned
sources when it is determined that benefits have been paid in error
from one source which should have been paid from another.
2712.5. (a) If, in a disputed coverage proceeding under Section
2712 a final decision of an administrative law judge or of the
appeals board finds that an employer or insurer shall reimburse the
Disability Fund and the employer or insurer fails to pay all or any
part of the reimbursement within 15 days after the decision of an
administrative law judge or of the appeals board becomes final, the
director shall assess the unpaid amount against the employer or the
insurer. The provisions of Article 8 (commencing with Section 1126)
of Chapter 4 of Part 1 with respect to the assessment of
contributions shall apply to the recovery of the unpaid amount. The
provisions of Chapter 7 (commencing with Section 1701) of Part 1 with
respect to the collection of contributions shall apply to the
recovery of unpaid amounts under this section. Amounts so collected
shall be deposited in the Disability Fund.
(b) The provisions of Article 9 (commencing with Section 1176) of
Chapter 4 of Part 1 shall apply to amounts collected under this
section and to amounts reimbursed to the Disability Fund after a
final decision by an administrative law judge or the appeals board in
a disputed coverage proceeding under Section 2712.
2713. In proceedings under this part the claimant, upon a showing
of good cause, may request a closed hearing except that the last
employer and each base period employer of the claimant shall be
entitled to participate in any such hearing.
2714. All medical records of the department obtained under this
part, except to the extent necessary for the proper administration of
this part, or as provided elsewhere in law shall be confidential and
shall not be published or be open to public inspection in any manner
revealing the identity of the claimant or family member, or the
nature or cause of his or her disability. Medical records that are
disclosed shall be disclosed only pursuant to Section 1095, and shall
remain confidential.
