California Bill Amendment Addresses Data Collection for Compensation Determination

A requirement that the California Division of Workers’ Compensation revise its existing data collection processes to capture the date an injured worker is notified of a fault determination would be dependent on a statutory appropriation, under a recently amended bill.

Senate Speaker Toni Atkins, D-San Diego, on Tuesday added appropriation language to SB1127, which would require employers to accept or deny liability within 75 days for certain alleged compensable injuries.

Employers currently have 90 days to determine liability for most claims. For example, claims for COVID-19 are presumed compensable for first responders if not denied within 30 days, while claims for other workers are presumed compensable when not denied within 45 days.

SB 1127 would also create a new penalty for the unreasonable denial of any claim identified in sections 3212 through 3213.2 of the Labor Code that would be equal to five times the amount of unreasonably delayed benefits and capped at $50,000.

The bill does not define an unreasonable denial and directs the Workers’ Compensation Appeal Board to assess the reasonableness of a denial of a claim based on the facts of the case.

Finally, the bill would allow firefighters and peace officers to receive up to 240 weeks of temporary disability benefits for suspected cancer claims, rather than the 104 weeks of TD available to other injured workers.

Ms Atkins said the bill creates an opportunity to make fair and positive changes to the workers’ compensation system in which injured workers continue to experience delays and denials that prevent their claims and access to medical care to advance in a timely manner.

California Professional Firefighters, which sponsors the bill, said the measure strikes a balance between providing a remedy for injured workers facing unreasonable refusals and employers facing additional costs to fill firefighter positions. wounded.

The California Workers’ Compensation Institute released an analysis in July indicating that the bill would likely have no effect on most claims and could lead to more conditional denials and litigation over complex claims. More than 90% of accepted claims have a liability decision within 75 days, CWCI said.

SB 1127 is up for a third and final vote in the Assembly. If passed, the measure will return to the Senate for approval of recent amendments.

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