Can I sign the form electronically?

Yes. Electronic signatures are generally valid under the federal ESIGN Act (15 U.S.C. ch. 96) and state laws such as UETA when accepted by the receiving agency; verify WCAB local e-filing rules before relying on e-signatures.

Is notarization required?

Most routine WCAB submissions do not require notarization, but certain declarations or affidavits may. Check the specific filing instructions or the district office for notarization requirements.

What if I discover an error after filing?

File an amended or corrected submission promptly and serve all parties. Include a clear explanation of the correction and reference the original filing to avoid confusion.

Where do I file the form?

File with the appropriate WCAB district office or via the Board's accepted electronic channels. If unsure, contact the WCAB clerk for the correct location and method.

How long until the Board processes it?

Processing times vary by district and workload; confirm with the district clerk. Timely and complete submissions are typically processed faster than incomplete packages.

Who must be served copies?

All parties listed in the WCAB case file must receive service per Board rules. Include a certificate of service documenting the method and date of service.

Electronic Signature
Templates
Other
WCAB CA Form 10214

WCAB CA Form 10214

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

SAVE PRINT CLEAR

STATE OF CALIFORNIA

DEPARTMENT OF INDUSTRIAL RELATIONS

DIVISION OF WORKERS' COMPENSATION

WORKERS' COMPENSATION APPEALS BOARD

Applicant

VS.

Defendants

Case No.

Petition for Appointment

of Guardian ad Litem

and Trustee

As a result of an alleged industrial injury on while employed by

to Injured Employee benefits are claimed by

the following minor(s)/incompetent(s): Employer

Strike inapplicable matter

Name

Date of Birth

The minor(s)/incompetent(s) require a Guardian ad Litem and Trustee to prosecute the claim and to receive

Strike inapplicable matter

and receipt for any benefits awarded or voluntarily furnished.

The Workers' Compensation Appeals Board is requested to appoint

as Guardian ad Litem and Trustee. Relationship if any

* who has legal custody of, and is legally responsible for the support of the minor(s).

(* Strike if not applicable.)

We hereby join in the above request. Date

Petitioner

Address

Attorney for Petitioner

Address and telephone number

NOTE:

Consent must be signed by all minors over 14 years of age and by all adults with sufficient capacity to form an intelligent preference.

WCAB-8

DIA WCAB FORM 8 (REV. 10-90)

What the WCAB CA Form 10214 Is and when it applies

The WCAB CA Form 10214 is a California Workers' Compensation Appeals Board form used in administrative workers' compensation matters. It records specific case data, party identification, and procedural requests that the Board needs to process or docket an action. The form is jurisdictional to California WCAB proceedings and typically accompanies evidence, declarations, or filing requests made to a claims adjudicator or clerk. Accurate completion helps ensure filings are accepted and routed to the correct WCAB district office for review and processing.

Why completing Form 10214 correctly matters

Accurate completion reduces processing delays, ensures correct case assignment, and preserves procedural rights before the WCAB. A complete form helps the Board locate the file, notify affected parties, and apply statutory timelines correctly.

Who commonly completes and files this form

The WCAB CA Form 10214 is completed by people and organizations directly involved in a California workers' compensation matter.

Claimants and representatives — injured workers or their attorneys preparing case filings.
Employers and insurers — claims administrators submitting responses or documentation.
Treating providers and vocational experts — supplying medical or vocational attachments where required.

Essential parts of a professional WCAB CA Form 10214 package

A complete submission includes clear identification, supporting exhibits, and declarative statements. Organize exhibits, label attachments, and include a concise cover sheet to help the clerk and opposing parties review quickly.

Claimant Info

Full legal name, birth date, and contact details exactly matching the case file and ID documents to avoid identity mismatches.

Case Identifiers

WCAB case number, employer name, insurer name, and any prior claim or claim number references for cross-referencing records.

Purpose Statement

Brief description of why the form is submitted (e.g., new evidence, procedural request, correction to record).

Attachments

Label and paginate exhibits (medical reports, bills, declarations) and include an attachments index for easy review.

Signatures

Signature blocks completed by the submitting party or authorized representative with printed name and date.

Certificate of Service

Proof that opposing parties received the submission, including method and date of service.

Step-by-step: prepare and submit Form 10214

Follow these sequential steps to minimize defects and reduce return cycles when filing with the WCAB.

01

Gather documents: Collect claimant ID, medical reports, and prior case documents.
02

Complete form: Enter all fields, use MM/DD/YYYY dates, and double-check names.
03

Attach exhibits: Label, paginate, and index attachments before combining into one package.
04

File and serve: Submit to the WCAB office and serve all parties per Board rules.

Filing flow in four clear actions

A concise submission flow improves acceptance rates and speeds administrative handling at the WCAB.

Prepare package: Assemble form and all supporting exhibits.
Verify details: Confirm names, case number, and dates for accuracy.
Submit to clerk: File at the appropriate WCAB district office or e-filing channel.
Confirm service: Provide proof of service to opposing parties and the Board.

Configuring a repeatable digital workflow for Form 10214

Standardize an electronic workflow to reduce manual errors, automate reminders, and keep a reproducible audit trail for each filing.

Field	Configuration
Document format	PDF/A recommended; include all exhibits in one file
Signer authentication	Email verification or SMS code to attribute signatures
Notifications	Auto-notify parties when the form is filed and served
Retention policy	Store signed package per retention timeline and access controls

Technical considerations for e-filing and e-signing

Choose a platform that supports secure PDF files, audit trails, and required signer authentication methods for legal submissions.

Integrations: Salesforce | NetSuite | Google Workspace
File types: PDF, DOCX, XLSX supported
Security: TLS in transit | AES-256 at rest

Typical eSignature pricing and feature comparison

Compare representative starting prices and core features for common eSignature vendors. signNow is listed first per platform comparison standards.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day trial	Varies by plan	Varies by plan	Yes, limited	Yes, limited
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

Security and compliance checklist for electronic filing

Encryption: TLS 1.2/1.3 in transit; AES-256 at rest

Certifications: SOC 2 Type II and ISO 27001 available

Privacy: GDPR and CCPA compliance supported

Healthcare: HIPAA-compliant with BAA available

Legal Acts: ESIGN and UETA legal alignment

Accessibility: WCAG 2.0 Level AA conformance

Consequences of incorrect or late filings

Case Delay: Missed dates can postpone hearings

Rejection: Incomplete forms may be rejected by clerk

Loss of Rights: Late filings can forfeit procedural remedies

Evidence Exclusion: Untimely exhibits may be excluded

Additional Costs: Correction orders increase legal expenses

Confidentiality Risk: Improper PHI handling can breach HIPAA

Common errors to avoid when preparing Form 10214

Leaving the WCAB case number blank or transposed, which prevents clerks from locating the correct file and delays processing.
Using inconsistent claimant or employer names across attachments, triggering identity checks and follow-up requests from the Board.
Failing to paginate and label exhibits, causing reviewers to miss key evidence and prompting requests for resubmission.
Not including a certificate of service or incorrect service method, resulting in procedural defects or returned filings.

Frequently asked questions about filing and signing Form 10214

Answers to common practical and technical questions about completing, signing, and submitting the form in California WCAB matters.

Need help? Contact support

Can I sign the form electronically?
Yes. Electronic signatures are generally valid under the federal ESIGN Act (15 U.S.C. ch. 96) and state laws such as UETA when accepted by the receiving agency; verify WCAB local e-filing rules before relying on e-signatures.
Is notarization required?
Most routine WCAB submissions do not require notarization, but certain declarations or affidavits may. Check the specific filing instructions or the district office for notarization requirements.
What if I discover an error after filing?
File an amended or corrected submission promptly and serve all parties. Include a clear explanation of the correction and reference the original filing to avoid confusion.
Where do I file the form?
File with the appropriate WCAB district office or via the Board's accepted electronic channels. If unsure, contact the WCAB clerk for the correct location and method.
How long until the Board processes it?
Processing times vary by district and workload; confirm with the district clerk. Timely and complete submissions are typically processed faster than incomplete packages.
Who must be served copies?
All parties listed in the WCAB case file must receive service per Board rules. Include a certificate of service documenting the method and date of service.

Explore Templates

Telemarketing Report Phone Log Book Escrow Form Secured Loan Form

be ready to get more

Join over 28 million airSlate SignNow users

Sign Now