Managing Employee Injuries and Disability and Occupational Safety

payment made after the employer decides to accept liability will be subject to the ten percent penalty. Labor Code Section 4650(d).

2. A FTER 6-1-04 Late payments are subject to a 25% penalty with a $10,000 cap based on the actual benefit unreasonably delayed or denied rather than the entire specie of benefits. Late payments to a medical provider would not constitute a 5814 penalty unless it results in significant harm to the worker (i.e. he or she didn’t receive a necessary treatment). Employers will be allowed to pay a voluntary “penalty” consisting of the corrected payment, plus 10 percent, provided they act before a 5814 was filed. There is a new, up to $400,000, penalty for pattern and practice of unreasonable delay or denial. 5814 penalties are now subject to a 2-year statute of limitations, and are presumed resolved when cases are compromised and released. B. C IVIL P ENALTY L EGISLATION E FFECTIVE J ANUARY 1, 1990 Self-insured employers, insurance carriers and adjusting agents who fail to pay benefits may be assessed civil penalties. The penalty provisions are enforced by the Administrative Director of the Division of Workers’ Compensation. Penalties range from $100 for minor violations up to $5,000 for more serious violations. These penalties may be imposed, for example, if an audit shows that the employer has failed to give an employee adequate notice, has failed to send notification to the Division of Workers’ Compensation concerning an injury or has delayed in the payment of benefits.

C. L ATE P AYMENT OF M EDICAL F EES

Where an employer fails to pay medical fees upon billing by a physician, a 10% (prior to 1-1-04) or 15% (after 1-1-04) penalty may be applied plus interest.

D. S ERIOUS AND W ILLFUL M ISCONDUCT (50%)

Except where an injury results in death or a permanent disability of 70% or more, the compensation otherwise payable is increased by one-half, together with costs and expenses not to exceed $250, where an employee is injured by reason of the employer’s serious and willful misconduct. Labor Code Section 4553. 1. D EFINED Serious and willful misconduct is conduct that the employer, by actions of an executive, managing officer, general superintendent or a supervisor with discretionary powers of direction, knows or should know is likely to cause serious injury, or that evidences reckless disregard for the safety of others. Labor Code Section 4553. The act or omission must be more than negligent. It must be an affirmative and knowing disregard of the consequences. The issue is decided by the facts that existed at the time.

Managing Employee Injuries, Disability and Occupational Safety ©2019 (s) Liebert Cassidy Whitmore 51