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This is a California form that can be used for EAMS Forms within Workers Comp.
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In addition to the document cover sheet, forms filed with your local Workers’ Compensation Appeals Board (WCAB) district office need a “document separator sheet.” We need the separator sheet so information in the form that follows it can be read by our Electronic Adjudication Management System (EAMS). The separator sheet is required even if you are only filing one document. This means you will be submitting at least three documents, in the following order, with anything you file at the WCAB: 1. A document cover sheet 2. A document separator sheet 3. The form you need to file If you are filing supporting documents with your form you will need separator sheets to identify them. Keep in mind the separator sheet provides information about the document that follows it. American LegalNet, Inc. www.FormsWorkFlow.com