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California Workers' Compensation Administrative Penalties for the 1994 (Part 3)

By Edited Oct 1, 2016 0 0

The following are the Workers Compensation Administrative Penalties for California for the year 1994.

§ 10111.1 Schedule of Administrative Penalties for Injuries on or After January 1, 1994

(6)  The penalty for each failure to notify an injured employee that his or her injury may have caused permanent disability and the procedures for evaluation the permanent disability, or of the employer's position that the injury may have caused permanent disability and the procedures for evaluating the permanent disability, or of the employer's position that the injury has caused no permanent disability and the employee's remedies, in the manner provided by Title 8, California Code of Regulations, Division 1, Chapter 4.5, Subchapter 1, Article 8, beginning with Section 9810; is $100 if the notice was issued up to 10 days late, and an additional $100 for each additional delay of not more than 10 days, to a maximum penalty of $500.

(7)  The penalty for each failure to notify a claimant of the denial of all death benefits claimed by that person (except a denial limited to all or any of: burial expense, benefits which were due to the injured worker before his or her death, or medical-legal expense), in the manner provided by Title 8, California Code of Regulations, Division 1 Chapter 4.5, Subchapter 1, Article 8, beginning with Section 9810, is $100 if the notice was issued up to 10 days late, and an additional $100 for each additional delay of not more than 10 days, to a maximum penalty of $500.

(8)  The penalty for each failure to send a notice denying liability for all workers' compensation benefits, in accordance with Title 8, California Code of Regulations, Division 4.5, Chapter 1, Article 8, beginning with Section 9810, is $100 if the notice was issued up to 10 days late, and an additional $100 for each additional delay of not more than 10 days, to a maximum penalty of $500.

(9)  The penalty for each notice denying liability for all workers' compensation benefits, which was materially misleading, is $500

(10)  The penalty for each failure to pay any uncontested penalty assessment in a Notice of Penalty Assessments within 15 days of receipt of the Notice of Penalty Assessment is:

$100 for each assessment paid more than 15 but not more than 30 days after receipt
$300 for each assessment paid more than 30 but nor more than 45 days after receipt
$500 for each assessment not paid within 45 days after receipt

(11)  The penalty for each failure to comply with Section 10104 of this Subchapter is:

$100 for each period of 1 to 14 days' delay in filing the Annual Report of Inventory, to a maximum penalty of $500 for each Annual Report of Inventory;

$500 for each Annual Report of Inventory that overstates or understates the number of claims by 10% or more.

(c)  The following Group C violations carry penalties of up to $1000;

(1)  The penalty for each failure to pay compensation as ordered in a Notice of Compensation Due within 15 days of receipt, if no timely Request for Review of Notice of Compensation Due was filed, is:

$250 if the compensation was paid more than 15 but not more than 30 days from receipt of notice;
$500 if the compensation was paid more than 30 but not more than 45 days from receipt of notice;
$1000 for failure to pay the compensation within 45 days of receipt of notice.

(2)  The penalty for each termination, interruption or deferral of vocational rehabilitation services other than as provided by Labor Code Sections 4637(b) is $1000.

(3) The penalty for each failure to pay or denial of rehabilitation maintenance allowance, temporary disability indemnity, or salary continuation in lieu of temporary disability indemnity, without a factual, medical or legal basis for the failure or denial, is:

$100 for the equivalent of 3 days or less of unpaid indemnity;
$200 for the equivalent of more than 3 but not more than 7 days of unpaid indemnity;
$300 for the equivalent of more than 7 but not more than 14 days of unpaid indemnity
$500 for the equivalent of more than 14 but not more than 21 days of unpaid indemnity;
$750 for the equivalent of more than 21 but not more than 28 days of unpaid indemnity;
$1000 for the equivalent of more than 28 days of unpaid indemnity.

(4)  The penalty for each failure to pay permanent disability indemnity based on a reasonable estimate of permanent disability, or denial of permanent disability indemnity, without a factual, medical or legal basis, is;

$200 for up to 6 weeks of unpaid indemnity;
$400 for more than 6 weeks but not more than 15 weeks of unpaid indemnity;
$750 for more than 15 but not more than 30 weeks of unpaid indemnity;
$1000 for more than 30 weeks of unpaid indemnity.

(5)  The penalty for each failure to pay or denial of death benefits to any claimant without a factual, medical or legal basis for the failure or denial, is;

$100 for the equivalent of 3 days or less of unpaid indemnity under Labor Code §4701(b), or for up to $300 of unpaid burial expenses;

$200 for the equivalent of more than 3 but not more than 7 days of unpaid indemnity under Labor Code §4701(b), or for more than $300 for the equivalent of more than 7 but not more than 14 days of unpaid indemnity under Labor Code §4701(b), or for more than $600, up to $900, of unpaid burial expenses;

$500 for the equivalent of more than 14 but not more than 21 days of unpaid indemnity under Labor Code §4701(b), or for more than $900, up to $1,500, of unpaid burial expenses;

$750 for the equivalent of more than 21 but not more than 28 days of unpaid indemnity under Labor Code §4701(b), or for more than $1,500, up to $2,250, of unpaid burial expenses;

$1,000 for the equivalent of more than 28 days of unpaid indemnity under Labor Code §4701(b), or for more than $2,250 of unpaid burial expenses.

The penalty for each failure to pay or denial of payment to any claimant of compensation which was accrued and unpaid to the injured worker at the time of the worker's death is the same penalty which would apply for failure to pay or denial of payment of that compensation to the injured worker.

The penalty under this subsection does not supersede the penalty under subsection 10111.1(d)(1).

(6) The penalty for each failure to investigate a claim as provided by Section 10109 of these Regulations is:

$250 if the failure to investigate involved a claim for medical treatment only, with no reasonable expectation of liability for indemnity payments;

$500 if the failure to investigate involved a claim or reasonable expectation of liability for temporary or permanent disability indemnity or vocational rehabilitation benefits;

$1000 if the failure to investigate involved a claim or reasonable expectation of liability for death benefits, or a combination of two or more of the following classes of benefits temporary or permanent disability indemnity or vocational rehabilitation.

This penalty does not supersede a penalty for denial of a claim without an investigation and documentation supporting a factual, medical, or legal basis for denial as set forth in Section 10111.1(d)(1) of this subchapter.

For more information on California Workers’ Compensation benefits, see the following articles:

California Workers' Compensation: What to Do If You are Injured at Work
California Workers' Compensation: Permanent Disability Benefits
California Workers' Compensation: Temporary Disability Benefits

 

 

 

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