March 2021 Newsletter by Clifford Weinberg

Mar 17, 2021

“Proposed legislation makes no sense”
To our Clients, Friends and Followers:
State Senate Bill 335 has been introduced on 3/12/21 to amend Labor Code Section 5402 regarding the time to reach a compensability decision. The time is presently 90 days from the date the claim form is served upon the employer. The amendment would seek to cut that time in half, to 45 days, and if not rejected within that time the claim would be presumed compensable. I find this to be ludicrous and denies an employer’s due process rights to properly investigate claims on both a factual and medical basis. For example, it would make the ability to obtain a panel QME pursuant to the compensability provisions of Labor Code section 4060 meaningless. This is because if a medical-legal opinion is deemed necessary, the strike process can take up to 15 days, and the remaining doctor identified as the QME has 60 days in which to set the exam. This would extend the examination date well beyond the 45 day limit, and require a rejection of the claim on that basis alone.
SB 335 doesn’t stop there. The bill also proposes the following:
  • During the proposed 45 day delay period, the bill would increase the employer’s medical liability from $10,000.00 to $17,000.00.
  • Faster decisions would also be required on presumption cases involving safety officers for heart trouble, hernia and pneumonia per Labor Code sections 3212, and the low back presumption for law enforcement per Section 3213.2. The decision date would be reduced to 30 days.
  • The bill would require a 10% increase on the full amount of the Award if payments/benefits are unreasonably delayed in cases involving these presumptions per Labor Code sections 3212 and 3213.2 (not just the amount that has been delayed).
The bill is still in committee in the Senate. It is arbitrary and punitive to California employers in most difficult economic times, and as stated, cutting the decision time in ½ to determine compensability is a denial of the employer’s due process rights. We will be closing monitoring its progress and continue to provide updates.
Stay tuned. Stay safe. Stay well.
Clifford Weinberg
Senior Partner

Related Articles

Fall 2021 Update

To our Clients and Friends:   Perhaps the most vexing and challenging part of workers’ compensation defense, is the handling of medical disputes through the intricate and difficult PQME system.  It is a very complicated affair, with tight time frames and all...

read more

Client Bulletin SB 335

  As reported by Work Comp Central, the California Senate has passed SB 335 (on a vote of 29 to 10), which if enacted, would cause a major disruption and attendant challenges in how claim administrators handle and conduct investigations, under Lab C 5412.   As...

read more

Our Newsletter