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socrateaser
socrateaser, Lawyer
Category: California Employment Law
Satisfied Customers: 33552
Experience:  Retired (mostly)
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I was hurt at work in 1997. My workers comp case settled by

Customer Question

I was hurt at work in 1997. My workers comp case settled by way of stips in 2001 (70% disability) with a monetary award and award for future medical. My case was re-opened in 2001 for new and further disability. My case is still unresolved. Since 2005, my former employer (a self-insured public entity) has ignored my requests for reimbursement for medical expenses (employer does not have MPN), and has not paid me my life pension payments which I have been owed since my monetary award was paid out in 2008. Since the law on penalties changed in 2005, what penalties is my former employer subject to? Is it just the 10% for each past due monthly pension payment? Any penalty for not reimbursing my medical expenses or providing medical treatment pursuant to the 2001 settlement?
Submitted: 2 years ago.
Category: California Employment Law
Expert:  socrateaser replied 2 years ago.
The WCAB may impose a penalty of 25% of the total award, or $10,000, whichever is less, where compensation benefits have been "unreasonably delayed or refused." Labor Code § 5814(a) The 25% penalty does not apply where the employer discovers a potential violation before the employee claims the 25% penalty and, within 90 days after discovery, pays the benefits due plus a self-imposed penalty of 10%; see Labor Code § 5814(b).

Where an employer or insurer knowingly violates Labor Code § 5814 "with a frequency that indicates a general business practice," the WCAB may impose administrative penalties of up to $400,000. Labor Code § 5814.6(a).

A "strict liability" penalty is imposed for late payment of benefits without any showing that the carrier acted "unreasonably." Labor Code § 4650 requires the carrier to pay an additional 10% if temporary disability benefits are not paid within 14 days after the insurer is notified of the injury. (This penalty does not apply, however, if the insurer denies liability or notifies the injured employee within the 14-day period what additional information is required to act on the claim.) Labor Code§ 4650.

A compensation award may be increased by 50% where the employee's injuries result from "serious and willful misconduct" by the employer. Labor Code § 4553.

Hope this helps.

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Customer: replied 2 years ago.

Your answer states that the 25% penalty is on the "total award" unreasonably delayed, up to $10,000. That is not correct. With the changes in the workers comp law in 2005 the penalty is no longer a percentage of the total award (previously known as the "species of benefit"), but is now, unfortunately, only a percentage of the delayed benefit itself up to $10,000.

 

(You took so long to answer, I did the research myself. Thanks anyway.)

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