AB 2604, as introduced, Brown. Workers’ compensation: proceedings: payment delay.
Existing law establishes a workers’ compensation system, administered by the Administrative Director of the Division of Workers’ Compensation, to compensate an employee for injuries arising out of and in the course of his or her employment. Existing law requires that certain proceedings, including for the recovery of compensation, or concerning any right or liability arising out of or incidental thereto, be instituted before the Workers’ Compensation Appeals Board. The appeals board may fix and determine, in its award, the total amount of compensation to be paid and specify the manner of payment, or may fix and determine the weekly disability payment to be made and order payment during the continuance of disability. Existing law requires that when payment of compensation has been unreasonably delayed or refused, either prior to or subsequent to the issuance of an award, the amount of the unreasonably delayed or refused payment be increased up to 25% or up to $10,000, whichever is less, and the appeals board is required to use its discretion to accomplish a fair balance and substantial justice between the parties.
This bill would instead require that when payment of compensation has been unreasonably delayed or refused, either prior to or subsequent to the issuance of an award, the amount of the unreasonably delayed or refused payment be increased up to 25% or up to $10,000, whichever is more. In using its discretion to accomplish a fair balance and substantial justice between the parties, the appeals board would be required to consider the amount of the original award, the reason for and length of the delay, and whether there were prior violations.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.
The people of the State of California do enact as follows:
Section 5814 of the Labor Code is amended to
2read:
(a) When payment of compensation has been
4unreasonably delayed or refused, either prior to or subsequent to
5the issuance of an award, the amount of the payment unreasonably
6delayed or refused shall be increased up to 25 percent or up to ten
7thousand dollars ($10,000), whichever isbegin delete lessend deletebegin insert moreend insert. In any
8proceeding under this section, the appeals board shall use its
9discretionbegin insert, including, but not limited to, consideration of the
10amount of the original award, the reason for and length of the
11delay, and whether there are prior
violations of this section,end insert
to
12accomplish a fair balance and substantial justice between the
13parties.
14(b) If a potential violation of this section is discovered by the
15employer prior to an employee claiming a penalty under this
16section, the employer, within 90 days of the date of the discovery,
17may pay a self-imposed penalty in the amount of 10 percent of the
18amount of the payment unreasonably delayed or refused, along
19with the amount of the payment delayed or refused. This
20self-imposed penalty shall be in lieu of the penalty in subdivision
21(a).
22(c) Upon the approval of a compromise and release, findings
23and awards, or stipulations and orders by the appeals board, it shall
24be conclusively presumed that any accrued claims for penalty have
25been resolved, regardless of whether a petition for penalty has
26been filed, unless the claim for penalty is expressly excluded by
27the terms of the order or
award. Upon the submission of any issue
28for determination at a regular trial hearing, it shall be conclusively
29presumed that any accrued claim for penalty in connection with
P3 1the benefit at issue has been resolved, regardless of whether a
2petition for penalty has been filed, unless the issue of penalty is
3also submitted or is expressly excluded in the statement of issues
4being submitted.
5(d) The payment of any increased award pursuant to subdivision
6(a) shall be reduced by any amount paid under subdivision (d) of
7Section 4650 on the same unreasonably delayed or refused benefit
8payment.
9(e) No unreasonable delay in the provision of medical treatment
10shall be found when the treatment has been authorized by the
11employer in a timely manner and the only dispute concerns
12payment of a billing submitted by a physician or medical provider
13as provided in Section 4603.2.
14(f) Nothing in this section shall be construed to create a civil
15cause of action.
16(g) Notwithstanding any otherbegin delete provision ofend delete law, no action may
17be brought to recover penalties that may be awarded under this
18section more than two years from the date the payment of
19compensation was due.
20(h) This section shall apply to all injuries, without regard to
21whether the injury occurs before, on, or after the operative date of
22this section.
23(i) This section shall become operative on June 1, 2004.
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