Labor Code — Part 8 | LAB — United States — California law | Esheria

Labor Code

Part 8 of 13 · provisions 1,401–1,600

This section says the act is to be known as the Labor Code.

Jurisdiction
United States — California
Instrument
Code
Citation
LAB
Version
Undated source snapshot
Language
en
Official source
View official record ↗
Complete work
View statute overview
AI foundation models Administrative appeals Asbestos Workers’ Account COVID-19 impacts COVID-19 infection prevention COVID-19 leave COVID-19 sick leave Civil penalties Employer compliance Employer reporting Hazardous substances information Hearing procedure Inspections MSDS Medi-Cal Medicaid PPE inventory Permits Route lists Safety data sheets Uninsured Employers Fund Workplace safety Workplace safety reporting abatement +2,986 more

Statute overview

About this statute

This section points to other code provisions that govern preferred claims for work performed or personal services rendered. This section says the act is named the Promote Ownership by Workers for Economic Recovery Act and may be cited by that name. This section states legislative findings about worker cooperatives and says the Legislature wants to study whether a federated worker cooperative system could help advance the goals of the Future of Work Commission. This section defines two terms used in the division: “Association” and “Secretary.” A state panel must conduct a study on creating an Association of Cooperative Labor Contractors and publish it online by June 30, 2024.

Read the provisions Ask with citations

Legal text

Provisions of Labor Code

Showing 200 of 2,599

  1. 4203.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 1. General Provisions [4201 - 4209] ( Article 1 added by Stats. 1965, Ch. 1685. )

    Verify source ↗

    This section defines “enrollee” as any person enrolled in an economic opportunity program.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 1. General Provisions [4201 - 4209] ( Article 1 added by Stats. 1965, Ch. 1685. ) ## 4203. “Enrollee” means any person enrolled in an economic opportunity program. (Added by Stats. 1965, Ch. 1685.)
  2. 4204.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 1. General Provisions [4201 - 4209] ( Article 1 added by Stats. 1965, Ch. 1685. )

    Verify source ↗

    This section defines “sponsoring agency.”

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 1. General Provisions [4201 - 4209] ( Article 1 added by Stats. 1965, Ch. 1685. ) ## 4204. “Sponsoring agency” means any agency, entity, or institution, public or private, receiving grants or financial assistance, either directly or as a subcontractor, pursuant to Public Law 88-452. (Added by Stats. 1965, Ch. 1685.)
  3. 4205.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 1. General Provisions [4201 - 4209] ( Article 1 added by Stats. 1965, Ch. 1685. )

    Verify source ↗

    “Participating agency” means any public or private agency, entity, or institution that takes part in an economic opportunity program, except a sponsoring agency.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 1. General Provisions [4201 - 4209] ( Article 1 added by Stats. 1965, Ch. 1685. ) ## 4205. “Participating agency” means any agency, entity or institution, public or private, taking part in an economic opportunity program, other than a sponsoring agency. (Added by Stats. 1965, Ch. 1685.)
  4. 4206.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 1. General Provisions [4201 - 4209] ( Article 1 added by Stats. 1965, Ch. 1685. )

    Verify source ↗

    An enrollee in a covered economic opportunity program generally has no right to receive compensation from sponsoring or participating agencies, except as this chapter provides otherwise.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 1. General Provisions [4201 - 4209] ( Article 1 added by Stats. 1965, Ch. 1685. ) ## 4206. Except as provided in this chapter, an enrollee within a given economic opportunity program shall have no right to receive compensation from sponsoring or participating agencies, entities, and institutions, public or private. (Added by Stats. 1965, Ch. 1685.)
  5. 4207.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 1. General Provisions [4201 - 4209] ( Article 1 added by Stats. 1965, Ch. 1685. )

    Verify source ↗

    Compensation is provided to an enrollee, or to dependents if the injury causes death, for qualifying injuries connected to service in an economic opportunity program, subject to listed conditions.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 1. General Provisions [4201 - 4209] ( Article 1 added by Stats. 1965, Ch. 1685. ) ## 4207. Compensation shall be furnished an enrollee for injury or to dependents if injury causes death, suffered within or without the state occurring in the course of his duties for a sponsoring agency within an economic opportunity program if the following conditions occur: (a) Where, at the time of injury, the enrollee is performing services and is acting within the scope of his duties as a recipient of aid within an economic opportunity program. (b) Where injury is proximately caused by his service as an enrollee within an economic opportunity program either with or without negligence. (c) Where injury is not caused by the intoxication of the injured enrollee. (d) Where the injury is not intentionally self-inflicted. (Added by Stats. 1965, Ch. 1685.)
  6. 4208.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 1. General Provisions [4201 - 4209] ( Article 1 added by Stats. 1965, Ch. 1685. )

    Verify source ↗

    If compensation conditions exist, recovery under this chapter is the exclusive remedy for an enrollee’s injury or death claims against the sponsoring agency or participating agency.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 1. General Provisions [4201 - 4209] ( Article 1 added by Stats. 1965, Ch. 1685. ) ## 4208. Where the conditions of compensation exist, the right to recover such compensation pursuant to the provisions of this chapter is the exclusive remedy for injury or death of an enrollee against the sponsoring agency, or the participating agency. (Added by Stats. 1965, Ch. 1685.)
  7. 4209.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 1. General Provisions [4201 - 4209] ( Article 1 added by Stats. 1965, Ch. 1685. )

    Verify source ↗

    This section says the chapter’s provisions apply to enrollees and their dependents, as long as that application is not inconsistent with the chapter.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 1. General Provisions [4201 - 4209] ( Article 1 added by Stats. 1965, Ch. 1685. ) ## 4209. Insofar as not inconsistent with the provisions of this chapter, all of the provisions of this division shall pertain to enrollees and their dependents and the furnishing of compensation benefits thereto. (Added by Stats. 1965, Ch. 1685.)
  8. 4211.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 2. Benefits [4211 - 4214] ( Article 2 added by Stats. 1965, Ch. 1685. )

    Verify source ↗

    If liability for compensation exists, the compensation must be provided subject to the limits of this chapter.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 2. Benefits [4211 - 4214] ( Article 2 added by Stats. 1965, Ch. 1685. ) ## 4211. Where liability for compensation exists, such compensation shall be provided as limited by this chapter. (Added by Stats. 1965, Ch. 1685.)
  9. 4212.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 2. Benefits [4211 - 4214] ( Article 2 added by Stats. 1965, Ch. 1685. )

    Verify source ↗

    For an enrollee injured or killed while performing duties under an economic opportunity program, average weekly earnings for disability indemnity are set under Section 4453, and there is no statutory minimum average weekly earnings for temporary disability indemnity under this chapter.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 2. Benefits [4211 - 4214] ( Article 2 added by Stats. 1965, Ch. 1685. ) ## 4212. If an enrollee suffers injury or death in the performance of his duties under an economic opportunity program, then, irrespective of his remuneration from this or other employment, his average weekly earnings for the purpose of determining temporary and permanent disability indemnity shall be determined in accordance with Section 4453, provided that for the purpose of this chapter only, there shall be no statutory minimum average weekly earnings for temporary disability indemnity. If the injury sustained by an enrollee causes death, death benefits shall be determined in accordance with Sections 4701 and 4702 of this code. (Added by Stats. 1965, Ch. 1685.)
  10. 4213.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 2. Benefits [4211 - 4214] ( Article 2 added by Stats. 1965, Ch. 1685. )

    Verify source ↗

    If an enrollee’s injury causes permanent disability, the percentage of disability must be determined by using the appeals board’s adopted schedule for a laborer of like age.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 2. Benefits [4211 - 4214] ( Article 2 added by Stats. 1965, Ch. 1685. ) ## 4213. If the injury sustained by an enrollee causes permanent disability, the percentage of disability to total disability shall be determined for the occupation of a laborer of like age by applying the schedule for the determination of the percentage of permanent disabilities prepared and adopted by the appeals board. (Amended by Stats. 1967, Ch. 1364.)
  11. 4214.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 2. Benefits [4211 - 4214] ( Article 2 added by Stats. 1965, Ch. 1685. )

    Verify source ↗

    If a fatal injury occurs, the enrollee’s reasonable burial expenses must be paid, up to $600.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 2. Benefits [4211 - 4214] ( Article 2 added by Stats. 1965, Ch. 1685. ) ## 4214. In addition to death benefit in the event of fatal injury, the reasonable expenses of the enrollee’s burial shall be paid not to exceed six hundred dollars ($600). (Added by Stats. 1965, Ch. 1685.)
  12. 4226.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 3. Adjustment of Claims [4226 - 4229] ( Article 3 added by Stats. 1965, Ch. 1685. )

    Verify source ↗

    If the U.S. government or its agent provides benefits under an economic opportunity program, the indemnity payable under this chapter must be reduced by the amount of those monetary benefits.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 3. Adjustment of Claims [4226 - 4229] ( Article 3 added by Stats. 1965, Ch. 1685. ) ## 4226. Should the United States government or any agent thereof, pursuant to federal statute, rule or regulations furnish benefits to enrollees or dependents of enrollees under an economic opportunity program, then the amount of indemnity which an enrollee or his dependents are entitled to receive under this chapter shall be reduced by the amount of monetary benefits the enrollee or his dependents have and will receive from the above source as a result of injury. (Added by Stats. 1965, Ch. 1685.)
  13. 4227.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 3. Adjustment of Claims [4226 - 4229] ( Article 3 added by Stats. 1965, Ch. 1685. )

    Verify source ↗

    If the U.S. government or its agent already provides medical treatment to an injured enrollee, the enrollee has no right to the same or similar treatment under this chapter.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 3. Adjustment of Claims [4226 - 4229] ( Article 3 added by Stats. 1965, Ch. 1685. ) ## 4227. If the United States government or any agent thereof furnishes medical treatment to an injured enrollee, the enrollee will have no right to receive the same or similar treatment under this chapter. (Added by Stats. 1965, Ch. 1685.)
  14. 4228.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 3. Adjustment of Claims [4226 - 4229] ( Article 3 added by Stats. 1965, Ch. 1685. )

    Verify source ↗

    If the U.S. government or its agent reimburses an enrollee for medical treatment, the enrollee has no right to receive the same or similar treatment under this chapter.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 3. Adjustment of Claims [4226 - 4229] ( Article 3 added by Stats. 1965, Ch. 1685. ) ## 4228. If the furnishing of medical treatment by the United States government or its agent takes the form of reimbursement of the enrollee, he shall have no right to receive the same or similar treatment under this chapter. (Added by Stats. 1965, Ch. 1685.)
  15. 4229.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 3. Adjustment of Claims [4226 - 4229] ( Article 3 added by Stats. 1965, Ch. 1685. )

    Verify source ↗

    If compensation benefits here would stop an enrollee or dependents from getting federal benefits, they have no right to those chapter benefits and must not receive them.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 9. Economic Opportunity Programs [4201 - 4229] ( Chapter 9 added by Stats. 1965, Ch. 1685. ) ## ARTICLE 3. Adjustment of Claims [4226 - 4229] ( Article 3 added by Stats. 1965, Ch. 1685. ) ## 4229. If the furnishing of compensation benefits to an enrollee or his dependents under this chapter prevents such enrollee or his dependents from receiving benefits under the provisions of federal statute, rule or regulations, then the enrollee or his dependents shall have no right and shall not receive compensation benefits under this chapter. (Added by Stats. 1965, Ch. 1685.)
  16. 430.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Contracts and Applications for Employment [430 - 435] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    This section defines “applicant” as an applicant for employment.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Contracts and Applications for Employment [430 - 435] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 430. As used in this article “applicant” means an applicant for employment. (Enacted by Stats. 1937, Ch. 90.)
  17. 432.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Contracts and Applications for Employment [430 - 435] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    An employee or applicant who signs an employment-related instrument can request a copy of it.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Contracts and Applications for Employment [430 - 435] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 432. If an employee or applicant signs any instrument relating to the obtaining or holding of employment, he shall be given a copy of the instrument upon request. (Amended by Stats. 1969, Ch. 714.)
  18. 432.2.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Contracts and Applications for Employment [430 - 435] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Employers generally may not require, request, or administer polygraph or similar tests for applicants or employees, and must give written notice of the rights in this section before a test is administered.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Contracts and Applications for Employment [430 - 435] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 432.2. (a) No employer shall demand or require any applicant for employment or prospective employment or any employee to submit to or take a polygraph, lie detector or similar test or examination as a condition of employment or continued employment. The prohibition of this section does not apply to the federal government or any agency thereof or the state government or any agency or local subdivision thereof, including, but not limited to, counties, cities and counties, cities, districts, authorities, and agencies. (b) No employer shall request any person to take such a test, or administer such a test, without first advising the person in writing at the time the test is to be administered of the rights guaranteed by this section. (Amended by Stats. 1981, Ch. 316, Sec. 1.)
  19. 432.3.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Contracts and Applications for Employment [430 - 435] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Employers may not use or ask for an applicant’s salary history, and certain employers must provide and post pay scales.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Contracts and Applications for Employment [430 - 435] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 432.3. (a) An employer shall not rely on the salary history information of an applicant for employment as a factor in determining whether to offer employment to an applicant or what salary to offer an applicant. (b) An employer shall not, orally or in writing, personally or through an agent, seek salary history information, including compensation and benefits, about an applicant for employment. (c) (1) An employer, upon reasonable request, shall provide the pay scale for a position to an applicant applying for employment. (2) An employer, upon request, shall provide an employee the pay scale for the position in which the employee is currently employed. (3) An employer with 15 or more employees shall include the pay scale for a position in any job posting. (4) An employer shall maintain records of a job title and wage rate history for each employee for the duration of the employment plus three years after the end of the employment in order for the Labor Commissioner to determine if there is still a pattern of wage discrepancy. These records shall be open to inspection by the Labor Commissioner. (5) An employer with 15 or more employees that engages a third party to announce, post, publish, or otherwise make known a job posting shall provide the pay scale to the third party. The third party shall include the pay scale in the job posting. (d) (1) A person who claims to be aggrieved by a violation of this section may file a written complaint with the Labor Commissioner within one year after the date the person learned of the violation. The complaint shall state the name and address of the employer and shall provide a detailed account of the alleged violation, as may be required by the Labor Commissioner. (2) A person who claims to be aggrieved by a violation of this section may also bring a civil action for injunctive relief and any other relief that the court deems appropriate. (3) The Labor Commissioner shall promptly investigate complaints alleging violation of this section. (4) Upon finding that an employer has violated this section, the Labor Commissioner may order the employer to pay a civil penalty of no less than one hundred dollars ($100) and no more than ten thousand dollars ($10,000) per violation. The Labor Commissioner shall determine the amount of the penalty based on the totality of the circumstances, including, but not limited to, whether the employer has previously violated this section. For a first violation of subdivision (c), no penalty shall be assessed upon demonstration by the employer that all job postings for open positions have been updated to include the pay scale as required by this section. (5) If an employer fails to keep records in violation of this section, there shall be a rebuttable presumption in favor of the employee’s claim. (e) Section 433 does not apply to this section. (f) This section does not apply to salary history information disclosable to the public pursuant to federal or state law, including the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code) or the federal Freedom of Information Act (Section 552 of Title 5 of the United States Code). (g) This section applies to all employers, including state and local government employers and the Legislature. (h) Nothing in this section shall prohibit an applicant from voluntarily and without prompting disclosing salary history information to a prospective employer. (i) If an applicant voluntarily and without prompting discloses salary history information to a prospective employer, nothing in this section shall prohibit that employer from considering or relying on that voluntarily disclosed salary history information in determining the salary for that applicant. (j) Nothing in this section shall prohibit an employer from asking an applicant about the applicant’s salary expectation for the position being applied for. (k) Consistent with Section 1197.5, nothing in this section shall be construed to allow prior salary to justify any disparity in compensation. (l) All civil penalties collected pursuant to this section shall be deposited into the Labor Enforcement and Compliance Fund for distribution to the Division of Labor Standards Enforcement. Upon appropriation by the Legislature, these funds may be expended by the division to cover reasonable ongoing costs of administering and enforcing this section. (m) For purposes of this section, all of the following shall apply: (1) “Pay scale” means a good faith estimate of the salary or hourly wage range that the employer reasonably expects to pay for the position upon hire. (2) “Applicant” or “applicant for employment” means an individual who is seeking employment with the employer and is not currently employed with that employer in any capacity or position. (Amended by Stats. 2025, Ch. 468, Sec. 1. (SB 642) Effective January 1, 2026.)
  20. 432.5.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Contracts and Applications for Employment [430 - 435] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Employers and certain company representatives must not require workers or job applicants to sign a written agreement to any term they know is prohibited by law.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Contracts and Applications for Employment [430 - 435] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 432.5. No employer, or agent, manager, superintendent, or officer thereof, shall require any employee or applicant for employment to agree, in writing, to any term or condition which is known by such employer, or agent, manager, superintendent, or officer thereof to be prohibited by law. (Added by Stats. 1963, Ch. 559.)
  21. 432.6.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Contracts and Applications for Employment [430 - 435] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Employers and others may not require job applicants or employees to waive rights or protections as a condition of employment, and employers may not retaliate against someone for refusing such a waiver.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Contracts and Applications for Employment [430 - 435] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 432.6. (a) A person shall not, as a condition of employment, continued employment, or the receipt of any employment-related benefit, require any applicant for employment or any employee to waive any right, forum, or procedure for a violation of any provision of the California Fair Employment and Housing Act (Part 2.8 (commencing with Section 12900) of Division 3 of Title 2 of the Government Code) or this code, including the right to file and pursue a civil action or a complaint with, or otherwise notify, any state agency, other public prosecutor, law enforcement agency, or any court or other governmental entity of any alleged violation. (b) An employer shall not threaten, retaliate or discriminate against, or terminate any applicant for employment or any employee because of the refusal to consent to the waiver of any right, forum, or procedure for a violation of the California Fair Employment and Housing Act or this code, including the right to file and pursue a civil action or a complaint with, or otherwise notify, any state agency, other public prosecutor, law enforcement agency, or any court or other governmental entity of any alleged violation. (c) For purposes of this section, an agreement that requires an employee to opt out of a waiver or take any affirmative action in order to preserve their rights is deemed a condition of employment. (d) In addition to injunctive relief and any other remedies available, a court may award a prevailing plaintiff enforcing their rights under this section reasonable attorney’s fees. (e) This section does not apply to a person registered with a self-regulatory organization as defined by the Securities Exchange Act of 1934 (15 U.S.C. Sec. 78c) or regulations adopted under that act pertaining to any requirement of a self-regulatory organization that a person arbitrate disputes that arise between the person and their employer or any other person as specified by the rules of the self-regulatory organization. (f) Nothing in this section is intended to invalidate a written arbitration agreement that is otherwise enforceable under the Federal Arbitration Act (9 U.S.C. Sec. 1 et seq.). (g) This section does not apply to postdispute settlement agreements or negotiated severance agreements. (h) This section applies to contracts for employment entered into, modified, or extended on or after January 1, 2020. (i) The provisions of this section are severable. If any provision of this section or its application is held invalid, that invalidity shall not affect other provisions or applications that can be given effect without the invalid provision or application. (Added by Stats. 2019, Ch. 711, Sec. 3. (AB 51) Effective January 1, 2020.)
  22. 432.7.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Contracts and Applications for Employment [430 - 435] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Employers generally may not ask job applicants about certain non-conviction, sealed, dismissed, or juvenile-record arrest information, or use it in employment decisions.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Contracts and Applications for Employment [430 - 435] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 432.7. (a) (1) An employer, whether a public agency or private individual or corporation, shall not ask an applicant for employment to disclose, through any written form or verbally, information concerning an arrest or detention that did not result in conviction, or information concerning a referral to, and participation in, any pretrial or posttrial diversion program, or concerning a conviction that has been judicially dismissed or ordered sealed pursuant to law, including, but not limited to, Sections 1203.4, 1203.4a, 1203.425, 1203.45, and 1210.1 of the Penal Code. An employer also shall not seek from any source whatsoever, or utilize, as a factor in determining any condition of employment including hiring, promotion, termination, or any apprenticeship training program or any other training program leading to employment, any record of arrest or detention that did not result in conviction, or any record regarding a referral to, and participation in, any pretrial or posttrial diversion program, or concerning a conviction that has been judicially dismissed or ordered sealed pursuant to law, including, but not limited to, Sections 1203.4, 1203.4a, 1203.425, 1203.45, and 1210.1 of the Penal Code. This section shall not prevent an employer from asking an employee or applicant for employment about an arrest for which the employee or applicant is out on bail or on their own recognizance pending trial. (2) An employer, whether a public agency or private individual or corporation, shall not ask an applicant for employment to disclose, through any written form or verbally, information concerning or related to an arrest, detention, processing, diversion, supervision, adjudication, or court disposition that occurred while the person was subject to the process and jurisdiction of the juvenile court. An employer also shall not seek from any source whatsoever, or utilize, as a factor in determining any condition of employment including hiring, promotion, termination, or any apprenticeship training program or any other training program leading to employment, any record concerning or related to an arrest, detention, processing, diversion, supervision, adjudication, or court disposition that occurred while a person was subject to the process and jurisdiction of the juvenile court. (3) For purposes of this section: (A) “Conviction” includes a plea, verdict, or finding of guilt, regardless of whether a sentence is imposed by the court. (B) “Conviction” does not include, and shall not be construed to include, any adjudication by a juvenile court or any other court order or action taken with respect to a person who is under the process and jurisdiction of the juvenile court. (b) This section does not prohibit the disclosure of the information authorized for release under Sections 13203 and 13300 of the Penal Code, to a government agency employing a peace officer. However, the employer shall not determine any condition of employment other than paid administrative leave based solely on an arrest report. The information contained in an arrest report may be used as the starting point for an independent, internal investigation of a peace officer in accordance with Chapter 9.7 (commencing with Section 3300) of Division 4 of Title 1 of the Government Code. (c) If a person violates this section, or Article 6 (commencing with Section 11140) of Chapter 1 of Title 1 of Part 4 of the Penal Code, the applicant may bring an action to recover from that person actual damages or two hundred dollars ($200), whichever is greater, plus costs, and reasonable attorney’s fees. An intentional violation of this section shall entitle the applicant to treble actual damages, or five hundred dollars ($500), whichever is greater, plus costs, and reasonable attorney’s fees. An intentional violation of this section is a misdemeanor punishable by a fine not to exceed five hundred dollars ($500). (d) The remedies under this section shall be in addition to and not in derogation of all other rights and remedies that an applicant may have under any other law. (e) (1) Persons seeking employment or persons already employed as peace officers, or persons seeking employment in positions in the Department of Justice or other criminal justice agencies as defined in Section 13101 of the Penal Code are not covered by this section. (2) For persons already employed as nonsworn members of a criminal justice agency, as defined in Section 13101 of the Penal Code, but only for those positions for which the specific duties relate to the collection or analysis of evidence or property or directly relate to the activities described in subdivisions (a) and (b) of Section 13101 of the Penal Code, the offenses for which arrests or detentions shall be subject to disclosure shall be limited to violent felonies, as defined in subdivision (c) of Section 667.5 of the Penal Code, serious felonies, as defined in subdivision (c) of Section 1192.7 of the Penal Code, and crimes involving dishonesty or obstruction of legal processes, including, but not limited to, theft, embezzlement, fraud, extortion, falsifying evidence, falsifying or forging official documents, perjury, bribery, and influencing, intimidating, or threatening witnesses. (f) (1) Except as provided in paragraph (2), this section does not prohibit an employer at a health facility, as defined in Section 1250 of the Health and Safety Code, from asking an applicant for employment either of the following: (A) With regard to an applicant for a position with regular access to patients, to disclose an arrest under any section specified in Section 290 of the Penal Code. (B) With regard to an applicant for a position with access to drugs and medication, to disclose an arrest under any section specified in former Section 11590 of the Health and Safety Code, as it read on January 1, 2019. (2) (A) An employer specified in paragraph (1) shall not inquire into information concerning or related to an applicant’s arrest, detention, processing, diversion, supervision, adjudication, or court disposition that occurred while the person was subject to the process and jurisdiction of juvenile court law, unless the information concerns an adjudication by the juvenile court in which the applicant has been found by the court to have committed a felony or misdemeanor offense specified in paragraph (1) that occurred within five years preceding the application for employment. (B) Notwithstanding any other provision of this subdivision, an employer specified in paragraph (1) shall not inquire into information concerning or related to an applicant’s juvenile offense history that has been sealed by the juvenile court. (3) An employer seeking disclosure of offense history under paragraph (2) shall provide the applicant with a list describing the specific offenses under former Section 11590 of the Health and Safety Code, as it read on January 1, 2019, or Section 290 of the Penal Code for which disclosure is sought. (g) (1) A peace officer or employee of a law enforcement agency with access to criminal or juvenile offender record information maintained by a local law enforcement criminal or juvenile justice agency shall not knowingly disclose, with intent to affect a person’s employment, any information pertaining to an arrest or detention or proceeding that did not result in a conviction, including information pertaining to a referral to, and participation in, any pretrial or posttrial diversion program, to any person not authorized by law to receive that information. (2) Any other person authorized by law to receive criminal or juvenile offender record information maintained by a local law enforcement criminal or juvenile justice agency shall not knowingly disclose any information received pertaining to an arrest or detention or proceeding that did not result in a conviction, including information pertaining to a referral to, and participation in, any pretrial or posttrial diversion program, to any person not authorized by law to receive that information. (3) Except for those specifically referred to in Section 1070 of the Evidence Code, a person who is not authorized by law to receive or possess criminal or juvenile justice records information maintained by a local law enforcement criminal or juvenile justice agency, pertaining to an arrest or other proceeding that did not result in a conviction, including information pertaining to a referral to, and participation in, any pretrial or posttrial diversion program, shall not knowingly receive or possess that information. (h) “A person authorized by law to receive that information,” for purposes of this section, means any person or public agency authorized by a court, statute, or decisional law to receive information contained in criminal or juvenile offender records maintained by a local law enforcement criminal or juvenile justice agency, and includes, but is not limited to, those persons set forth in Section 11105 of the Penal Code, and any person employed by a law enforcement criminal or juvenile justice agency who is required by that employment to receive, analyze, or process criminal or juvenile offender record information. (i) This section does not require the Department of Justice to remove entries relating to an arrest or detention not resulting in conviction from summary criminal history records forwarded to an employer pursuant to law. (j) As used in this section, “pretrial or posttrial diversion program” means any program under Chapter 2.5 (commencing with Section 1000) or Chapter 2.7 (commencing with Section 1001) of Title 6 of Part 2 of the Penal Code, Section 13201 or 13352.5 of the Vehicle Code, Sections 626, 626.5, 654, or 725 of, or Article 20.5 (commencing with Section 790) of Chapter 2 of Part 1 of Division 2 of, the Welfare and Institutions Code, or any other program expressly authorized and described by statute as a diversion program. (k) (1) Subdivision (a) does not apply to any city, city and county, county, or district, or any officer or official thereof, in screening a prospective concessionaire, or the affiliates and associates of a prospective concessionaire for purposes of consenting to, or approving of, the prospective concessionaire’s application for, or acquisition of, any beneficial interest in a concession, lease, or other property interest. (2) For purposes of this subdivision the following terms apply: (A) “Screening” means a written request for criminal or juvenile history information made to a local law enforcement agency. (B) “Prospective concessionaire” means any individual, general or limited partnership, corporation, trust, association, or other entity that is applying for, or seeking to obtain, a public agency’s consent to, or approval of, the acquisition by that individual or entity of any beneficial ownership interest in any public agency’s concession, lease, or other property right whether directly or indirectly held. However, “prospective concessionaire” does not include any of the following: (i) A lender acquiring an interest solely as security for a bona fide loan made in the ordinary course of the lender’s business and not made for the purpose of acquisition. (ii) A lender upon foreclosure or assignment in lieu of foreclosure of the lender’s security. (C) “Affiliate” means any individual or entity that controls, or is controlled by, the prospective concessionaire, or who is under common control with the prospective concessionaire. (D) “Associate” means any individual or entity that shares a common business purpose with the prospective concessionaire with respect to the beneficial ownership interest that is subject to the consent or approval of the city, county, city and county, or district. (E) “Control” means the possession, direct or indirect, of the power to direct, or cause the direction of, the management or policies of the controlled individual or entity. (l) (1) Subdivision (a) does not prohibit a public agency, or any officer or official thereof, from denying consent to, or approval of, a prospective concessionaire’s application for, or acquisition of, any beneficial interest in a concession, lease, or other property interest based on the criminal history information of the prospective concessionaire or the affiliates or associates of the prospective concessionaire that show any criminal conviction for offenses involving moral turpitude. Criminal history information for purposes of this subdivision includes any criminal history information obtained pursuant to Section 11105 or 13300 of the Penal Code. (2) In considering criminal history information, a public agency shall consider the crime for which the prospective concessionaire or the affiliates or associates of the prospective concessionaire was convicted only if that crime relates to the specific business that is proposed to be conducted by the prospective concessionaire. (3) Any prospective concessionaire whose application for consent or approval to acquire a beneficial interest in a concession, lease, or other property interest is denied based on criminal history information shall be provided a written statement of the reason for the denial. (4) (A) If the prospective concessionaire submits a written request to the public agency within 10 days of the date of the notice of denial, the public agency shall review its decision with regard to any corrected record or other evidence presented by the prospective concessionaire as to the accuracy or incompleteness of the criminal history information utilized by the public agency in making its original decision. (B) The prospective concessionaire shall submit the copy or the corrected record of any other evidence to the public agency within 90 days of a request for review. The public agency shall render its decision within 20 days of the submission of evidence by the prospective concessionaire. (m) (1) Paragraph (1) of subdivision (a) does not prohibit an employer, whether a public agency or private individual or corporation, from asking an applicant about, or seeking from any source information regarding, a particular conviction of the applicant if, pursuant to Section 1829 of Title 12 of the United States Code or any other federal law, federal regulation, or state law, any of the following apply: (A) The employer is required by law to obtain information regarding the particular conviction of the applicant, regardless of whether that conviction has been expunged, judicially ordered sealed, statutorily eradicated, or judicially dismissed following probation. (B) The applicant would be required to possess or use a firearm in the course of their employment. (C) An individual with that particular conviction is prohibited by law from holding the position sought by the applicant, regardless of whether that conviction has been expunged, judicially ordered sealed, statutorily eradicated, or judicially dismissed following probation. (D) The employer is prohibited by law from hiring an applicant who has that particular conviction, regardless of whether that conviction has been expunged, judicially ordered sealed, statutorily eradicated, or judicially dismissed following probation. (2) For purposes of this subdivision, “particular conviction” means a conviction for specific criminal conduct or a category of criminal offenses prescribed by any federal law, federal regulation, or state law that contains requirements, exclusions, or both, expressly based on that specific criminal conduct or category of criminal offenses. (n) This section does not prohibit an employer, whether a public agency or private individual or corporation, required by state, federal, or local law to conduct criminal background checks for employment purposes or to restrict employment based on criminal history from complying with those requirements, or to prohibit the employer from seeking or receiving an applicant’s criminal history report that has been obtained pursuant to procedures otherwise provided for under federal, state, or local law. For purposes of this subdivision, federal law shall include rules or regulations promulgated by a self-regulatory organization, as defined in Section 3(a)(26) of the Securities Exchange Act of 1934, pursuant to the authority in Section 19(b) of the Securities Exchange Act of 1934, as amended by 124 Stat. 1652 (Public Law 11-203). (Amended by Stats. 2021, Ch. 158, Sec. 1. (AB 1480) Effective January 1, 2022.)
  23. 432.8.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Contracts and Applications for Employment [430 - 435] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    For certain marijuana-related convictions, the employer limitations and Section 432.7 penalties apply for two years from the conviction date.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Contracts and Applications for Employment [430 - 435] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 432.8. The limitations on employers and the penalties provided for in Section 432.7 shall apply to a conviction for violation of subdivision (b) or (c) of Section 11357 of the Health and Safety Code or a statutory predecessor thereof, or subdivision (c) of Section 11360 of the Health and Safety Code, or Section 11364, 11365, or 11550 of the Health and Safety Code as they related to marijuana prior to January 1, 1976, or a statutory predecessor thereof, two years from the date of such a conviction. (Added by Stats. 1976, Ch. 952.)
  24. 433.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Contracts and Applications for Employment [430 - 435] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Anyone who violates this article commits a misdemeanor.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Contracts and Applications for Employment [430 - 435] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 433. Any person violating this article is guilty of a misdemeanor. (Enacted by Stats. 1937, Ch. 90.)
  25. 434.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Contracts and Applications for Employment [430 - 435] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    This article does not apply to employment applications filed with railroad common carriers covered by the Railway Labor Act.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Contracts and Applications for Employment [430 - 435] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 434. The provisions of this article shall not apply to applications for employment filed with common carriers by railroad subject to the act of Congress known as the Railway Labor Act. (Enacted by Stats. 1937, Ch. 90.)
  26. 435.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Contracts and Applications for Employment [430 - 435] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Employers generally may not make audio or video recordings of employees in restrooms, locker rooms, or changing rooms unless a court order authorizes it.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Contracts and Applications for Employment [430 - 435] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 435. (a) No employer may cause an audio or video recording to be made of an employee in a restroom, locker room, or room designated by an employer for changing clothes, unless authorized by court order. (b) No recording made in violation of this section may be used by an employer for any purpose. This section applies to a private or public employer, except the federal government. (c) A violation of this section constitutes an infraction. (Added by Stats. 1998, Ch. 515, Sec. 1. Effective January 1, 1999.)
  27. 4350.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 10. Disaster Service Workers [4350 - 4355] ( Heading of Chapter 10 renumbered from Chapter 10.5 by Stats. 1951, Ch. 1440. )

    Verify source ↗

    The Office of Emergency Services must administer this chapter for volunteer disaster service workers.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 10. Disaster Service Workers [4350 - 4355] ( Heading of Chapter 10 renumbered from Chapter 10.5 by Stats. 1951, Ch. 1440. ) ## 4350. The Office of Emergency Services shall administer this chapter as it relates to volunteer disaster service workers. (Amended by Stats. 2013, Ch. 352, Sec. 401. (AB 1317) Effective September 26, 2013. Operative July 1, 2013, by Sec. 543 of Ch. 352.)
  28. 4351.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 10. Disaster Service Workers [4350 - 4355] ( Heading of Chapter 10 renumbered from Chapter 10.5 by Stats. 1951, Ch. 1440. )

    Verify source ↗

    Workers' compensation under this section is the exclusive remedy for a disaster service worker or the worker’s dependents for work-related injury or death.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 10. Disaster Service Workers [4350 - 4355] ( Heading of Chapter 10 renumbered from Chapter 10.5 by Stats. 1951, Ch. 1440. ) ## 4351. Compensation provided by this division is the exclusive remedy of a disaster service worker, or his or her dependents, for injury or death arising out of, and in the course of, his or her activities as a disaster service worker as against the state, the disaster council with which he or she is registered, and the county or city which has empowered the disaster council to register and direct his or her activities. Liability for compensation provided by this division is in lieu of any other liability whatsoever to a disaster service worker or his or her dependents or any other person on his or her behalf against the state, the disaster council with which the disaster service worker is registered, and the county or city which has empowered the disaster council to register and direct his or her activities, for any injury or death arising out of, and in the course of, his or her activities as a disaster service worker. (Repealed and added by Stats. 1986, Ch. 554, Sec. 3.)
  29. 4352.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 10. Disaster Service Workers [4350 - 4355] ( Heading of Chapter 10 renumbered from Chapter 10.5 by Stats. 1951, Ch. 1440. )

    Verify source ↗

    Compensation for disaster service workers cannot be paid without an initial appropriation, but the State Compensation Insurance Fund may advance compensation when funds are temporarily unavailable, and the California Emergency Management Agency must reimburse it within 30 days after funds become available.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 10. Disaster Service Workers [4350 - 4355] ( Heading of Chapter 10 renumbered from Chapter 10.5 by Stats. 1951, Ch. 1440. ) ## 4352. (a) No compensation shall be paid or furnished to a disaster service worker or a dependent of a disaster service worker pursuant to this division absent an initial appropriation of funds for the purpose of furnishing compensation to a disaster service worker or a dependent of a disaster service worker. Liability for the initial payment or furnishing of compensation is dependent upon and limited to the availability of money so appropriated. (b) Notwithstanding subdivision (a), when appropriated funds are temporarily unavailable for disbursement, the State Compensation Insurance Fund may provide compensation to an eligible claimant under this section whose injuries have previously either been accepted or found to be compensable by the Workers’ Compensation Appeals Board. (1) Compensation to, and benefits for, an eligible claimant provided for under this subdivision may include the issuance of checks by the State Compensation Insurance Fund. (2) Within 30 days of the date funds that had been temporarily unavailable are appropriated, and therefore become available, the California Emergency Management Agency shall reimburse the State Compensation Insurance Fund for compensation paid to, or benefits paid for, a claimant pursuant to paragraph (1), in addition to any applicable interest, service fees, or charges. (c) After all money appropriated as described in subdivision (a) is expended or set aside in bookkeeping reserves for the payment or furnishing of compensation and reimbursing the State Compensation Insurance Fund for its services, the payment or furnishing of compensation for an injury to a disaster service worker or his or her dependents is dependent upon there having been a reserve set up for the payment or furnishing of compensation to that disaster service worker or his or her dependents and for that injury, and liability is limited to the amount of the reserve. The excess in a reserve for the payment or furnishing of compensation or for reimbursing the State Compensation Insurance Fund for its compensation payments and services may be transferred to reserves of other disaster service workers for the payment or furnishing of compensation and reimbursing the State Compensation Insurance Fund, or may be used to set up reserves for other disaster service workers. (Amended by Stats. 2009, 4th Ex. Sess., Ch. 12, Sec. 25. Effective July 28, 2009.)
  30. 4353.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 10. Disaster Service Workers [4350 - 4355] ( Heading of Chapter 10 renumbered from Chapter 10.5 by Stats. 1951, Ch. 1440. )

    Verify source ↗

    If a disaster service worker is injured or dies while performing duties, average weekly earnings for disability indemnity are set at the maximum amount in Section 4453, regardless of other remuneration.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 10. Disaster Service Workers [4350 - 4355] ( Heading of Chapter 10 renumbered from Chapter 10.5 by Stats. 1951, Ch. 1440. ) ## 4353. If a disaster service worker suffers injury or death while in the performance of duties as a disaster service worker, then, irrespective of his or her remuneration from this or other employment or from both, the average weekly earnings for the purposes of determining temporary and permanent disability indemnity shall be taken at the maximum fixed for each, respectively, in Section 4453. (Repealed and added by Stats. 1986, Ch. 554, Sec. 3.)
  31. 4354.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 10. Disaster Service Workers [4350 - 4355] ( Heading of Chapter 10 renumbered from Chapter 10.5 by Stats. 1951, Ch. 1440. )

    Verify source ↗

    If a disaster service worker’s injury causes permanent disability, the disability percentage is determined using a schedule prepared and adopted by the administrative director, and the weekly permanent-disability payment equals the weekly temporary-total-disability benefit under Section 4353.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 10. Disaster Service Workers [4350 - 4355] ( Heading of Chapter 10 renumbered from Chapter 10.5 by Stats. 1951, Ch. 1440. ) ## 4354. If the injury sustained by a disaster service worker causes permanent disability, the percentage of disability to total disability shall be determined as for the occupation of a laborer of like age by applying the schedule for the determination of the percentages of permanent disabilities prepared and adopted by the administrative director. The amount of the weekly payment for permanent disability shall be the same as the weekly benefit which would be paid for temporary total disability pursuant to Section 4353. (Repealed and added by Stats. 1986, Ch. 554, Sec. 3.)
  32. 4355.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 10. Disaster Service Workers [4350 - 4355] ( Heading of Chapter 10 renumbered from Chapter 10.5 by Stats. 1951, Ch. 1440. )

    Verify source ↗

    Federal benefits can reduce state compensation for disaster service workers, and in some cases the worker has no right to duplicate medical treatment or state compensation.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 10. Disaster Service Workers [4350 - 4355] ( Heading of Chapter 10 renumbered from Chapter 10.5 by Stats. 1951, Ch. 1440. ) ## 4355. (a) Should the United States Government or any agent thereof, in accordance with any federal statute, rule, or regulation, furnish monetary assistance, benefits, or other temporary or permanent relief to disaster service workers or to disaster service workers and their dependents for injuries arising out of and occurring in the course of their activities as disaster service workers, the amount of compensation that any disaster service worker or his or her dependents are otherwise entitled to receive from the State of California under this division for any injury shall be reduced by the amount of monetary assistance, benefits, or other temporary or permanent relief the disaster service worker or his or her dependents have received and will receive from the United States or any agent thereof as a result of the injury. (b) If, in addition to monetary assistance, benefits, or other temporary or permanent relief, the United States Government or any agent thereof furnishes medical, surgical, or hospital treatment, or any combination thereof, to an injured disaster service worker, the disaster service worker has no right to receive similar medical, surgical, or hospital treatment under this division. (c) If, in addition to monetary assistance, benefits, or other temporary or permanent relief, the United States Government or any agent thereof will reimburse a disaster service worker or his or her dependents for medical, surgical, or hospital treatment, or any combination thereof, furnished to the injured disaster service worker, the disaster service worker has no right to receive similar medical, surgical, or hospital treatment under this division. (d) If the furnishing of compensation under this division to a disaster service worker or his or her dependents prevents the disaster service worker or his or her dependents from receiving assistance, benefits, or other temporary or permanent relief under a federal statute, rule, regulation, the disaster service worker and his or her dependents shall have no right to, and may not receive, any compensation from the State of California under this division for any injury for which the United States Government or any agent thereof will furnish assistance, benefits, or other temporary or permanent relief in the absence of the furnishing of compensation by the State of California. (Added by Stats. 2003, Ch. 228, Sec. 34. Effective August 11, 2003.)
  33. 4401.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 1. General Provisions [4401 - 4406] ( Article 1 added by Stats. 1980, Ch. 1041. )

    Verify source ↗

    The state declares that qualified injured workers with asbestosis from employment should receive workers’ compensation asbestos benefits promptly, without litigation delays to determine the responsible employer.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 1. General Provisions [4401 - 4406] ( Article 1 added by Stats. 1980, Ch. 1041. ) ## 4401. It is the declared policy of the state that qualified injured workers with asbestosis which arises out of and occurs in the course of employment shall receive workers’ compensation asbestos workers’ benefits promptly and not be subjected to delays of litigation to determine the responsible employer. (Amended by Stats. 1982, Ch. 1077, Sec. 1. Effective September 15, 1982. Provisions inoperative January 1, 1989, as prescribed in Section 4418.)
  34. 4402.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 1. General Provisions [4401 - 4406] ( Article 1 added by Stats. 1980, Ch. 1041. )

    Verify source ↗

    This section defines key terms used for asbestos workers’ compensation, including “asbestosis,” “asbestos worker,” “asbestos workers’ benefits,” and “dependents.”

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 1. General Provisions [4401 - 4406] ( Article 1 added by Stats. 1980, Ch. 1041. ) ## 4402. (a) “Asbestosis” means any pathology, whether or not combined with preexisting pathology, which results in disability or need for medical treatment from inhalation of asbestos fibers. (b) “Asbestos worker” means any person whose occupation subjected him or her to an exposure to asbestos fibers. (c) “Asbestos workers’ benefits” means temporary total disability benefits, permanent total disability benefits, death benefits, and medical benefits. (d) “Dependents” means, and is limited to, a surviving spouse who at the time of injury was dependent on the deceased asbestos worker for half or more of his or her support, and minor children of the deceased asbestos worker. (Amended by Stats. 1982, Ch. 1077, Sec. 1.5. Effective September 15, 1982. Provisions inoperative January 1, 1989, as prescribed in Section 4418.)
  35. 4403.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 1. General Provisions [4401 - 4406] ( Article 1 added by Stats. 1980, Ch. 1041. )

    Verify source ↗

    The Asbestos Workers’ Account is created in the Uninsured Employers Fund and is administered by the Director of Industrial Relations.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 1. General Provisions [4401 - 4406] ( Article 1 added by Stats. 1980, Ch. 1041. ) ## 4403. The Asbestos Workers’ Account is hereby created in the Uninsured Employers Fund in the State Treasury, and shall be administered by the Director of Industrial Relations. The money in the Asbestos Workers’ Account is hereby continuously appropriated for the purposes of this chapter, and to pay the expenses of the director in administering these provisions. (Added by Stats. 1980, Ch. 1041. Provisions inoperative January 1, 1989, as prescribed in Section 4418.)
  36. 4404.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 1. General Provisions [4401 - 4406] ( Article 1 added by Stats. 1980, Ch. 1041. )

    Verify source ↗

    This section says the division’s provisions apply to asbestos workers and their dependents for workers’ compensation asbestos workers’ benefits, unless that would conflict with the chapter.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 1. General Provisions [4401 - 4406] ( Article 1 added by Stats. 1980, Ch. 1041. ) ## 4404. Insofar as not inconsistent with the provisions of this chapter, all of the provisions of this division shall pertain to asbestos workers and their dependents for purposes of furnishing workers’ compensation asbestos workers’ benefits thereto. (Amended by Stats. 1982, Ch. 1077, Sec. 2. Effective September 15, 1982. Provisions inoperative January 1, 1989, as prescribed in Section 4418.)
  37. 4405.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 1. General Provisions [4401 - 4406] ( Article 1 added by Stats. 1980, Ch. 1041. )

    Verify source ↗

    An asbestos worker’s compensation claim is described as a temporary remedy, and the worker or dependents must make reasonable efforts to identify the employer responsible for payment.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 1. General Provisions [4401 - 4406] ( Article 1 added by Stats. 1980, Ch. 1041. ) ## 4405. Where the conditions of compensation exist under this division the right to recover workers’ compensation asbestos workers’ benefits pursuant to the provisions of this chapter is a temporary remedy for injury to an asbestos worker against the Asbestos Workers’ Account, and such asbestos worker or his or her dependents shall make all reasonable effort to establish the identity of the employer responsible for securing the payment of compensation. (Amended by Stats. 1982, Ch. 1077, Sec. 3. Effective September 15, 1982. Provisions inoperative January 1, 1989, as prescribed in Section 4418.)
  38. 4406.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 1. General Provisions [4401 - 4406] ( Article 1 added by Stats. 1980, Ch. 1041. )

    Verify source ↗

    Section 4406 requires the account to provide advance workers’ compensation asbestos benefits when the listed exposure and disease conditions are met, and generally requires an independent medical examination unless adequate medical evidence already exists.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 1. General Provisions [4401 - 4406] ( Article 1 added by Stats. 1980, Ch. 1041. ) ## 4406. (a) Payments as advances on workers’ compensation asbestos workers’ benefits shall be furnished an asbestos worker for injury resulting in asbestosis, or the dependents of the asbestos worker in the case of his or her death due to asbestosis, subject to the provisions of this division, if all of the following conditions occur: (1) The asbestos worker demonstrates to the account that at the time of exposure, the asbestos worker was performing services and was acting within the scope of his or her duties in an occupation that subjected the asbestos worker to the exposure to asbestos. (2) The asbestos worker demonstrates to the account that he or she is suffering from asbestosis. (3) The asbestos worker demonstrates to the account that he or she developed asbestosis from the employment. (4) The asbestos worker is entitled to compensation for asbestosis as otherwise provided for in this division. (b) The findings of the account with regard to the conditions in subdivision (a) shall not be evidence in any other proceeding. (c) The account shall require the asbestos worker to submit to an independent medical examination unless the information and assistance officer, in consultation with the medical director or his or her designee, determines that there exists adequate medical evidence that the worker developed asbestosis from the employment. (Amended by Stats. 1982, Ch. 1077, Sec. 4. Effective September 15, 1982. Provisions inoperative January 1, 1989, as prescribed in Section 4418.)
  39. 4407.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 2. Benefits [4407 - 4411] ( Article 2 added by Stats. 1980, Ch. 1041. )

    Verify source ↗

    If the account finds that the conditions in Section 4406 have occurred, advance payments of asbestos workers’ compensation benefits must be made under this chapter.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 2. Benefits [4407 - 4411] ( Article 2 added by Stats. 1980, Ch. 1041. ) ## 4407. When the account determines that the conditions in Section 4406 have occurred, payments as advances on workers’ compensation asbestos workers’ benefits shall be provided in accordance with this chapter, notwithstanding the right of the asbestos worker to secure compensation as otherwise provided for in this division. (Amended by Stats. 1982, Ch. 1077, Sec. 5. Effective September 15, 1982. Provisions inoperative January 1, 1989, as prescribed in Section 4418.)
  40. 4407.3.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 2. Benefits [4407 - 4411] ( Article 2 added by Stats. 1980, Ch. 1041. )

    Verify source ↗

    The death benefit under this chapter must be paid in installments, following the same manner and amounts as temporary disability indemnity.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 2. Benefits [4407 - 4411] ( Article 2 added by Stats. 1980, Ch. 1041. ) ## 4407.3. For purposes of this chapter, the death benefit shall be paid in installments in the same manner and amounts as temporary disability indemnity. (Added by Stats. 1982, Ch. 1077, Sec. 6. Effective September 15, 1982. Provisions inoperative January 1, 1989, as prescribed in Section 4418.)
  41. 4407.5.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 2. Benefits [4407 - 4411] ( Article 2 added by Stats. 1980, Ch. 1041. )

    Verify source ↗

    Benefits under this chapter must not be converted into a lump-sum payment.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 2. Benefits [4407 - 4411] ( Article 2 added by Stats. 1980, Ch. 1041. ) ## 4407.5. Benefits provided by this chapter shall not be commuted into a lump-sum payment. (Added by Stats. 1982, Ch. 1077, Sec. 7. Effective September 15, 1982. Provisions inoperative January 1, 1989, as prescribed in Section 4418.)
  42. 4408.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 2. Benefits [4407 - 4411] ( Article 2 added by Stats. 1980, Ch. 1041. )

    Verify source ↗

    An asbestos worker must first claim compensation from the employer or its workers’ compensation insurance carrier before seeking benefits under this chapter.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 2. Benefits [4407 - 4411] ( Article 2 added by Stats. 1980, Ch. 1041. ) ## 4408. Prior to seeking compensation benefits under this chapter, the asbestos worker shall first make claim on the employer or its workers’ compensation insurance carrier for payment of compensation under this division. If the asbestos worker is unable to locate the responsible employer or insurance carrier, or if the employer or insurance carrier fails to pay or denies liability for the compensation required by this division to the person entitled thereto, within a period of 30 days after the assertion of such a claim, the asbestos worker may seek payment of workers’ compensation asbestos workers’ benefits required by this division from the Asbestos Workers’ Account. (Amended by Stats. 1982, Ch. 1077, Sec. 8. Effective September 15, 1982. Provisions inoperative January 1, 1989, as prescribed in Section 4418.)
  43. 4409.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 2. Benefits [4407 - 4411] ( Article 2 added by Stats. 1980, Ch. 1041. )

    Verify source ↗

    The Director of Industrial Relations, or a representative, must assign investigative and claims adjustment services for Asbestos Workers’ Account cases.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 2. Benefits [4407 - 4411] ( Article 2 added by Stats. 1980, Ch. 1041. ) ## 4409. The Director of Industrial Relations, or his or her representative, shall assign investigative and claims adjustment services respecting matters concerning Asbestos Workers’ Account cases. Those assignments may be made within the department, including the Division of Workers’ Compensation, and excluding the State Compensation Insurance Fund. (Amended by Stats. 1994, Ch. 1097, Sec. 13. Effective January 1, 1995. Provisions inoperative January 1, 1989, as prescribed in Section 4418.)
  44. 4409.5.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 2. Benefits [4407 - 4411] ( Article 2 added by Stats. 1980, Ch. 1041. )

    Verify source ↗

    The administrative director must appoint workers’ compensation judges and support staff, and those staff must prioritize asbestos workers’ claims.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 2. Benefits [4407 - 4411] ( Article 2 added by Stats. 1980, Ch. 1041. ) ## 4409.5. The administrative director shall appoint workers’ compensation judges and support staff who shall give priority to the processing of the claims of asbestos workers. (Amended by Stats. 1985, Ch. 326, Sec. 12. Provisions inoperative January 1, 1989, as prescribed in Section 4418.)
  45. 4410.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 2. Benefits [4407 - 4411] ( Article 2 added by Stats. 1980, Ch. 1041. )

    Verify source ↗

    The administrative director must appoint at least two information and assistance officers, and those officers must prioritize and assist asbestos workers seeking benefits.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 2. Benefits [4407 - 4411] ( Article 2 added by Stats. 1980, Ch. 1041. ) ## 4410. The administrative director shall appoint at least two information and assistance officers who shall give priority to assisting asbestos workers pursuant to the provisions of this chapter. The information and assistance officer shall assist to the fullest extent possible any asbestos worker seeking benefits under this chapter. In assisting the asbestos worker, the information and assistance officer shall conduct necessary investigation and procure those records, reports, and information which are necessary to the early identification of responsible employers and insurance carriers, and to facilitate in the expediting of payments of benefits that may be due under this division. (Added by Stats. 1980, Ch. 1041. Provisions inoperative January 1, 1989, as prescribed in Section 4418.)
  46. 4411.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 2. Benefits [4407 - 4411] ( Article 2 added by Stats. 1980, Ch. 1041. )

    Verify source ↗

    This section requires the asbestos workers’ account and the appeals board to handle asbestos claims, join the account in related cases, and shift payment responsibility once a final responsible-employer decision is made.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 2. Benefits [4407 - 4411] ( Article 2 added by Stats. 1980, Ch. 1041. ) ## 4411. (a) When a claim is made against the Asbestos Workers’ Account, the account shall secure appropriate information, adjust the claim, and pay benefits provided by this chapter in accordance with the provisions of this division. (b) The asbestos worker shall, prior to the first payment of benefits by the Asbestos Workers’ Account, file an application before the Workers’ Compensation Appeals Board to determine the responsible employer for payment of compensation under this division. (c) In every case before the Workers’ Compensation Appeals Board in which a claim of injury from exposure to asbestos is alleged, the appeals board shall join the Asbestos Workers’ Account as a party to the proceeding and serve the fund with copies of all decisions and orders, including findings and awards, and order approving compromise and release. (d) Once a decision establishing the responsible employer or insurance carrier is agreed upon between the parties, or is issued by the Workers’ Compensation Appeals Board, and becomes final, the Asbestos Workers’ Account shall terminate payment of compensation benefits, notify all interested parties accordingly, and seek collection as provided for under this chapter. Responsibility for payment of all future compensation benefits shall be in accordance with such agreement, order, or decision. (e) The account shall terminate the payment of benefits to any employee who fails to cooperate fully in determining the responsible employer or insurance carrier. (f) The Asbestos Workers’ Account may, at any time, commence or join in proceedings before the Workers’ Compensation Appeals Board by filing an application on its own behalf. In any case in which the Asbestos Workers’ Account has been joined as a party or has filed an application on its own behalf, the Asbestos Workers’ Account shall have all of the rights and privileges of a party applicant. (Added by Stats. 1980, Ch. 1041. Provisions inoperative January 1, 1989, as prescribed in Section 4418.)
  47. 4412.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 3. Collections [4412 - 4418] ( Article 3 added by Stats. 1980, Ch. 1041. )

    Verify source ↗

    The Asbestos Workers’ Account must use reasonable and appropriate action to recover money it has paid as compensation benefits and costs. If the responsible employer is uninsured, the account is not entitled to reimbursement from the Uninsured Employers Fund.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 3. Collections [4412 - 4418] ( Article 3 added by Stats. 1980, Ch. 1041. ) ## 4412. The Asbestos Workers’ Account shall take all reasonable and appropriate action to insure that recovery is made by the account for all moneys paid as compensation benefits and as costs. In the event that the responsible employer is uninsured, the account shall not be entitled to reimbursement from the Uninsured Employers Fund. (Added by Stats. 1980, Ch. 1041. Provisions inoperative January 1, 1989, as prescribed in Section 4418.)
  48. 4413.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 3. Collections [4412 - 4418] ( Article 3 added by Stats. 1980, Ch. 1041. )

    Verify source ↗

    The Asbestos Workers’ Account is exempt from any time limit in this division for starting proceedings before the Workers’ Compensation Appeals Board, if the account has made payments, incurred service costs, or taken on liabilities.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 3. Collections [4412 - 4418] ( Article 3 added by Stats. 1980, Ch. 1041. ) ## 4413. No limitation of time provided by this division shall run against the Asbestos Workers’ Account to initiate proceedings before the Workers’ Compensation Appeals Board when the account has made any payment of moneys, incurred any costs for services, or encumbered any liability of the account. (Amended by Stats. 1982, Ch. 454, Sec. 138. Provisions inoperative January 1, 1989, as prescribed in Section 4418.)
  49. 4414.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 3. Collections [4412 - 4418] ( Article 3 added by Stats. 1980, Ch. 1041. )

    Verify source ↗

    The Asbestos Workers’ Account must file a lien right after it learns that proceedings have begun before the Workers’ Compensation Appeals Board or another benefits jurisdiction for the same injury. It may also use other available remedies to recover compensation benefits it has paid.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 3. Collections [4412 - 4418] ( Article 3 added by Stats. 1980, Ch. 1041. ) ## 4414. Immediately following the receipt of knowledge of initiation of proceedings before the Workers’ Compensation Appeals Board, or any other jurisdiction providing benefits for the same injury, the Asbestos Workers’ Account shall file a lien and may invoke such other remedies as are available to recover moneys expended for compensation benefits. (Added by Stats. 1980, Ch. 1041. Provisions inoperative January 1, 1989, as prescribed in Section 4418.)
  50. 4415.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 3. Collections [4412 - 4418] ( Article 3 added by Stats. 1980, Ch. 1041. )

    Verify source ↗

    The Director of Industrial Relations may use department attorneys or the Attorney General to represent the director and the state in any hearing or proceeding.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 3. Collections [4412 - 4418] ( Article 3 added by Stats. 1980, Ch. 1041. ) ## 4415. In any hearing or proceeding, the Director of Industrial Relations may use attorneys from within the department, or the Attorney General, to represent the director and the state. (Added by Stats. 1980, Ch. 1041. Provisions inoperative January 1, 1989, as prescribed in Section 4418.)
  51. 4416.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 3. Collections [4412 - 4418] ( Article 3 added by Stats. 1980, Ch. 1041. )

    Verify source ↗

    The Asbestos Workers’ Account must notify the responsible employer or insurance carrier of the amount needed to satisfy the lien, and full payment must be made within 30 days unless the account grants a reasonable extension.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 3. Collections [4412 - 4418] ( Article 3 added by Stats. 1980, Ch. 1041. ) ## 4416. Once an agreement as to the responsible employer is reached, or a decision is issued by the Workers’ Compensation Appeals Board and becomes final, the Asbestos Workers’ Account shall notify the responsible employer or insurance carrier of the amount of payment necessary to satisfy the lien in full. Full payment of the lien shall be made by the responsible employer or insurance carrier within 30 days of the issue of such notification. The account may grant a reasonable extension of time for payment of the lien beyond 30 days. This payment shall be for all moneys expended for compensation benefits, and for all recoverable costs including the cost of independent medical examination and all costs reasonably incidental thereto, including, but not limited to, costs of transportation, hospitalization, consultative evaluation, X-rays, laboratory tests, and other diagnostic procedures. The payment shall bear interest, as provided in Section 5800, from the date of the agreement or decision through the date of payment. The lien of the Asbestos Workers’ Account shall be allowed as a first lien against compensation, and shall have priority over all other liens. The lien of the Asbestos Workers’ Account may not be reduced by the Workers’ Compensation Appeals Board or by the parties unless express written consent to the proposed reduction of the lien is given by the Asbestos Workers’ Account and is filed in the record of proceedings before the Workers’ Compensation Appeals Board. (Added by Stats. 1980, Ch. 1041. Provisions inoperative January 1, 1989, as prescribed in Section 4418.)
  52. 4417.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 3. Collections [4412 - 4418] ( Article 3 added by Stats. 1980, Ch. 1041. )

    Verify source ↗

    An asbestos worker may still sue other people, and the Asbestos Workers’ Account may recover paid benefits by claim and first lien from certain settlement or judgment amounts.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 3. Collections [4412 - 4418] ( Article 3 added by Stats. 1980, Ch. 1041. ) ## 4417. Nothing in this chapter shall be construed to preclude the filing by an asbestos worker of a claim or suit for damages or indemnity against any person other than his or her employer. The Asbestos Workers’ Account shall be entitled to recover from, and shall have a first lien against, any amount which is recoverable by the injured employee pursuant to civil judgment or settlement in relation to a claim for damages or indemnity for the effect of exposure to asbestos, for all compensation benefits paid to the injured employee by the Asbestos Workers’ Account which have not previously been recovered from the responsible employer or employers by the Asbestos Workers’ Account. Recovery by the Asbestos Workers’ Account pursuant to the provisions of this section shall not have the effect of extinguishing or diminishing the liability of the responsible employer or employers to the injured employee for compensation payable under the provisions of this division. (Added by Stats. 1980, Ch. 1041. Provisions inoperative January 1, 1989, as prescribed in Section 4418.)
  53. 4418.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 3. Collections [4412 - 4418] ( Article 3 added by Stats. 1980, Ch. 1041. )

    Verify source ↗

    These chapter provisions for paying asbestos workers’ benefits from the Asbestos Workers’ Account stop being operative on January 1, 1989, unless a later statute changes that date.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 1. SCOPE AND OPERATION [3200 - 4418] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 11. Asbestos Workers’ Account [4401 - 4418] ( Chapter 11 added by Stats. 1980, Ch. 1041. ) ## ARTICLE 3. Collections [4412 - 4418] ( Article 3 added by Stats. 1980, Ch. 1041. ) ## 4418. The provisions of this chapter providing for the payment of workers’ compensation asbestos workers’ benefits from the Asbestos Workers’ Account shall be operative only until January 1, 1989, and as of that date all payments from the fund shall be terminated, and the state shall have no further obligation to pay asbestos workers’ benefits, unless a later enacted statute which is chaptered before January 1, 1989, deletes or extends that date. However, if no statute is enacted to delete or extend that date prior to January 1, 1989, the authority of the Asbestos Workers’ Account under this chapter to recover the benefits and costs paid to asbestos workers prior to that date shall continue until the benefits and costs have been recovered. (Amended by Stats. 1985, Ch. 1156, Sec. 4. Note: Termination provisions apply to Chapter 11, commencing with Section 4401.)
  54. 4451.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Average annual earnings are calculated as 52 times the average weekly earnings in this chapter.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. ) ## 4451. Average annual earnings shall be taken as fifty-two times the average weekly earnings referred to in this chapter. (Enacted by Stats. 1937, Ch. 90.)
  55. 4452.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    In disability cases, average annual earnings are treated as four times earnings, subject to a minimum of $4,800.64 and a maximum of $15,200.64. In death cases, the minimum and maximum limits are the ones set in Section 4702.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. ) ## 4452. Four times the average annual earnings shall be taken at not less than four thousand eight hundred dollars and sixty-four cents ($4,800.64) nor more than fifteen thousand two hundred dollars and sixty-four cents ($15,200.64) in disability cases, and in death cases shall be taken at not less than the minimum nor more than the maximum limits as provided in Section 4702 of this code. (Amended by Stats. 1957, Ch. 1996.)
  56. 4452.5.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    This section defines “permanent total disability” and “permanent partial disability” for this division.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. ) ## 4452.5. As used in this division: (a) “Permanent total disability” means a permanent disability with a rating of 100 percent permanent disability only. (b) “Permanent partial disability” means a permanent disability with a rating of less than 100 percent permanent disability. (Added by Stats. 1973, Ch. 1023.)
  57. 4453.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    This section sets minimum and maximum average weekly earnings used to calculate workers’ compensation disability indemnity, with different limits depending on injury date and disability category.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. ) ## 4453. (a) In computing average annual earnings for the purposes of temporary disability indemnity and permanent total disability indemnity only, the average weekly earnings shall be taken at: (1) Not less than one hundred twenty-six dollars ($126) nor more than two hundred ninety-four dollars ($294), for injuries occurring on or after January 1, 1983. (2) Not less than one hundred sixty-eight dollars ($168) nor more than three hundred thirty-six dollars ($336), for injuries occurring on or after January 1, 1984. (3) Not less than one hundred sixty-eight dollars ($168) for permanent total disability, and, for temporary disability, not less than the lesser of one hundred sixty-eight dollars ($168) or 1.5 times the employee’s average weekly earnings from all employers, but in no event less than one hundred forty-seven dollars ($147), nor more than three hundred ninety-nine dollars ($399), for injuries occurring on or after January 1, 1990. (4) Not less than one hundred sixty-eight dollars ($168) for permanent total disability, and for temporary disability, not less than the lesser of one hundred eighty-nine dollars ($189) or 1.5 times the employee’s average weekly earnings from all employers, nor more than five hundred four dollars ($504), for injuries occurring on or after January 1, 1991. (5) Not less than one hundred sixty-eight dollars ($168) for permanent total disability, and for temporary disability, not less than the lesser of one hundred eighty-nine dollars ($189) or 1.5 times the employee’s average weekly earnings from all employers, nor more than six hundred nine dollars ($609), for injuries occurring on or after July 1, 1994. (6) Not less than one hundred sixty-eight dollars ($168) for permanent total disability, and for temporary disability, not less than the lesser of one hundred eighty-nine dollars ($189) or 1.5 times the employee’s average weekly earnings from all employers, nor more than six hundred seventy-two dollars ($672), for injuries occurring on or after July 1, 1995. (7) Not less than one hundred sixty-eight dollars ($168) for permanent total disability, and for temporary disability, not less than the lesser of one hundred eighty-nine dollars ($189) or 1.5 times the employee’s average weekly earnings from all employers, nor more than seven hundred thirty-five dollars ($735), for injuries occurring on or after July 1, 1996. (8) Not less than one hundred eighty-nine dollars ($189), nor more than nine hundred three dollars ($903), for injuries occurring on or after January 1, 2003. (9) Not less than one hundred eighty-nine dollars ($189), nor more than one thousand ninety-two dollars ($1,092), for injuries occurring on or after January 1, 2004. (10) Not less than one hundred eighty-nine dollars ($189), nor more than one thousand two hundred sixty dollars ($1,260), for injuries occurring on or after January 1, 2005. For injuries occurring on or after January 1, 2006, average weekly earnings shall be taken at not less than one hundred eighty-nine dollars ($189), nor more than one thousand two hundred sixty dollars ($1,260) or 1.5 times the state average weekly wage, whichever is greater. Commencing on January 1, 2007, and each January 1 thereafter, the limits specified in this paragraph shall be increased by an amount equal to the percentage increase in the state average weekly wage as compared to the prior year. For purposes of this paragraph, “state average weekly wage” means the average weekly wage paid by employers to employees covered by unemployment insurance as reported by the United States Department of Labor for California for the 12 months ending March 31 of the calendar year preceding the year in which the injury occurred. (b) In computing average annual earnings for purposes of permanent partial disability indemnity, except as provided in Section 4659, the average weekly earnings shall be taken at: (1) Not less than seventy-five dollars ($75), nor more than one hundred ninety-five dollars ($195), for injuries occurring on or after January 1, 1983. (2) Not less than one hundred five dollars ($105), nor more than two hundred ten dollars ($210), for injuries occurring on or after January 1, 1984. (3) When the final adjusted permanent disability rating of the injured employee is 15 percent or greater, but not more than 24.75 percent: (A) not less than one hundred five dollars ($105), nor more than two hundred twenty-two dollars ($222), for injuries occurring on or after July 1, 1994; (B) not less than one hundred five dollars ($105), nor more than two hundred thirty-one dollars ($231), for injuries occurring on or after July 1, 1995; (C) not less than one hundred five dollars ($105), nor more than two hundred forty dollars ($240), for injuries occurring on or after July 1, 1996. (4) When the final adjusted permanent disability rating of the injured employee is 25 percent or greater, not less than one hundred five dollars ($105), nor more than two hundred twenty-two dollars ($222), for injuries occurring on or after January 1, 1991. (5) When the final adjusted permanent disability rating of the injured employee is 25 percent or greater but not more than 69.75 percent: (A) not less than one hundred five dollars ($105), nor more than two hundred thirty-seven dollars ($237), for injuries occurring on or after July 1, 1994; (B) not less than one hundred five dollars ($105), nor more than two hundred forty-six dollars ($246), for injuries occurring on or after July 1, 1995; and (C) not less than one hundred five dollars ($105), nor more than two hundred fifty-five dollars ($255), for injuries occurring on or after July 1, 1996. (6) When the final adjusted permanent disability rating of the injured employee is less than 70 percent: (A) not less than one hundred fifty dollars ($150), nor more than two hundred seventy-seven dollars and fifty cents ($277.50), for injuries occurring on or after January 1, 2003; (B) not less than one hundred fifty-seven dollars and fifty cents ($157.50), nor more than three hundred dollars ($300), for injuries occurring on or after January 1, 2004; (C) not less than one hundred fifty-seven dollars and fifty cents ($157.50), nor more than three hundred thirty dollars ($330), for injuries occurring on or after January 1, 2005; and (D) not less than one hundred ninety-five dollars ($195), nor more than three hundred forty-five dollars ($345), for injuries occurring on or after January 1, 2006. (7) When the final adjusted permanent disability rating of the injured employee is 70 percent or greater, but less than 100 percent: (A) not less than one hundred five dollars ($105), nor more than two hundred fifty-two dollars ($252), for injuries occurring on or after July 1, 1994; (B) not less than one hundred five dollars ($105), nor more than two hundred ninety-seven dollars ($297), for injuries occurring on or after July 1, 1995; (C) not less than one hundred five dollars ($105), nor more than three hundred forty-five dollars ($345), for injuries occurring on or after July 1, 1996; (D) not less than one hundred fifty dollars ($150), nor more than three hundred forty-five dollars ($345), for injuries occurring on or after January 1, 2003; (E) not less than one hundred fifty-seven dollars and fifty cents ($157.50), nor more than three hundred seventy-five dollars ($375), for injuries occurring on or after January 1, 2004; (F) not less than one hundred fifty-seven dollars and fifty cents ($157.50), nor more than four hundred five dollars ($405), for injuries occurring on or after January 1, 2005; and (G) not less than one hundred ninety-five dollars ($195), nor more than four hundred five dollars ($405), for injuries occurring on or after January 1, 2006. (8) For injuries occurring on or after January 1, 2013: (A) When the final adjusted permanent disability rating is less than 55 percent, not less than two hundred forty dollars ($240) nor more than three hundred forty-five dollars ($345). (B) When the final adjusted permanent disability rating is 55 percent or greater but less than 70 percent, not less than two hundred forty dollars ($240) nor more than four hundred five dollars ($405). (C) When the final adjusted permanent disability rating is 70 percent or greater but less than 100 percent, not less than two hundred forty dollars ($240) nor more than four hundred thirty-five dollars ($435). (9) For injuries occurring on or after January 1, 2014, not less than two hundred forty dollars ($240) nor more than four hundred thirty-five dollars ($435). (c) Between the limits specified in subdivisions (a) and (b), the average weekly earnings, except as provided in Sections 4456 to 4459, shall be arrived at as follows: (1) Where the employment is for 30 or more hours a week and for five or more working days a week, the average weekly earnings shall be the number of working days a week times the daily earnings at the time of the injury. (2) Where the employee is working for two or more employers at or about the time of the injury, the average weekly earnings shall be taken as the aggregate of these earnings from all employments computed in terms of one week; but the earnings from employments other than the employment in which the injury occurred shall not be taken at a higher rate than the hourly rate paid at the time of the injury. (3) If the earnings are at an irregular rate, such as piecework, or on a commission basis, or are specified to be by week, month, or other period, then the average weekly earnings mentioned in subdivision (a) shall be taken as the actual weekly earnings averaged for this period of time, not exceeding one year, as may conveniently be taken to determine an average weekly rate of pay. (4) Where the employment is for less than 30 hours per week, or where for any reason the foregoing methods of arriving at the average weekly earnings cannot reasonably and fairly be applied, the average weekly earnings shall be taken at 100 percent of the sum which reasonably represents the average weekly earning capacity of the injured employee at the time of his or her injury, due consideration being given to his or her actual earnings from all sources and employments. (d) Every computation made pursuant to this section beginning January 1, 1990, shall be made only with reference to temporary disability or the permanent disability resulting from an original injury sustained after January 1, 1990. However, all rights existing under this section on January 1, 1990, shall be continued in force. Except as provided in Section 4661.5, disability indemnity benefits shall be calculated according to the limits in this section in effect on the date of injury and shall remain in effect for the duration of any disability resulting from the injury. (Amended by Stats. 2012, Ch. 363, Sec. 34. (SB 863) Effective January 1, 2013.)
  58. 4453.5.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Benefits for an injury are not changed by later statutory changes in indemnity amounts.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. ) ## 4453.5. Benefits payable on account of an injury shall not be affected by a subsequent statutory change in amounts of indemnity payable under this division, and shall be continued as authorized, and in the amounts provided for, by the law in effect at the time the injury giving rise to the right to such benefits occurred. (Added by Stats. 1972, Ch. 460.)
  59. 4454.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Average weekly earnings must include overtime and certain employee remuneration benefits, but must exclude special-expense reimbursements and specified employer-paid programs for others.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. ) ## 4454. In determining average weekly earnings within the limits fixed in Section 4453, there shall be included overtime and the market value of board, lodging, fuel, and other advantages received by the injured employee as part of his remuneration, which can be estimated in money, but such average weekly earnings shall not include any sum which the employer pays to or for the injured employee to cover any special expenses entailed on the employee by the nature of his employment, nor shall there be included either the cost or the market value of any savings, wage continuation, wage replacement, or stock acquisition program or of any employee benefit programs for which the employer pays or contributes to persons other than the employee or his family. (Amended by Stats. 1968, 1st Ex. Sess., Ch. 4.)
  60. 4455.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    For injured employees under 18 with permanent incapacity, average weekly earnings are set using the earnings they would probably have at age 18, within Section 4453 limits.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. ) ## 4455. If the injured employee is under 18 years of age, and his or her incapacity is permanent, his or her average weekly earnings shall be deemed, within the limits fixed in Section 4453, to be the weekly sum that under ordinary circumstances he or she would probably be able to earn at the age of 18 years, in the occupation in which he or she was employed at the time of the injury or in any occupation to which he or she would reasonably have been promoted if he or she had not been injured. If the probable earnings at the age of 18 years cannot reasonably be determined, his or her average weekly earnings shall be taken at the maximum limit established in Section 4453. (Amended by Stats. 2002, Ch. 6, Sec. 58. Effective January 1, 2003.)
  61. 4456.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    If an employee is injured while working on a state or government unemployment work relief program, disability payments are calculated only from that person’s monthly earnings or expected earnings from the program, and must stay within the limits in section 4453.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. ) ## 4456. Where any employee is injured while engaged on any unemployment work relief program conducted by the State, or a political subdivision, or any State or governmental agency, the disability payments due under this division shall be determined solely on the monthly earnings or anticipated earnings of such person from such program, such payments to be within the minimum and maximum limits set forth in section 4453. (Enacted by Stats. 1937, Ch. 90.)
  62. 4457.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    If certain workmen’s average weekly earnings cannot otherwise be determined, they are deemed to be $40.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. ) ## 4457. In the event the average weekly earnings of workmen associating themselves under a partnership agreement, the principal purpose of which is the performance of labor on a particular piece of work, are not otherwise ascertainable, they shall be deemed to be forty dollars ($40). (Amended by Stats. 1961, Ch. 903.)
  63. 4458.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    For covered firefighting or fire-suppression injuries or deaths, average weekly earnings and annual earnings are set at specified statutory maximums for compensation purposes.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. ) ## 4458. If a member registered as an active firefighting member of any regularly organized volunteer fire department as described in Section 3361 suffers injury or death while in the performance of his duty as fireman, or if a person engaged in fire suppression as described in Section 3365 suffers injury or death while so engaged, then, irrespective of his remuneration from this or other employment or from both, his average weekly earnings for the purposes of determining temporary disability indemnity and permanent disability indemnity shall be taken at the maximum fixed for each, respectively, in Section 4453. Four times his average annual earnings in disability cases and in death cases shall be taken at the maximum limits provided in Sections 4452 and 4702 respectively. (Amended (as amended by Stats. 1973, Ch. 953) by Stats. 1976, Ch. 1347.)
  64. 4458.2.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    For certain peace officers and related law enforcement personnel who are injured or killed in the line of duty, compensation is calculated using specified maximum earnings limits.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. ) ## 4458.2. If an active peace officer of any department as described in Section 3362 suffers injury or death while in the performance of his or her duties as a peace officer, or if a person engaged in the performance of active law enforcement service as described in Section 3366 suffers injury or death while in the performance of that active law enforcement service, or if a person registered as a reserve peace officer of any regularly organized police or sheriff’s department as described in Section 3362.5 suffers injury or death while in the performance of his or her duties as a peace officer, then, irrespective of his or her remuneration from this or other employment or from both, his or her average weekly earnings for the purposes of determining temporary disability indemnity and permanent disability indemnity shall be taken at the maximum fixed for each, respectively, in Section 4453. Four times his or her average annual earnings in disability cases and in death cases shall be taken at the maximum limits provided in Sections 4452 and 4702 respectively. (Amended by Stats. 1989, Ch. 892, Sec. 30.5.)
  65. 4458.5.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    For certain injuries after active service ends, average weekly earnings are set at the maximum amount fixed in Section 4453 for the relevant disability, regardless of post-service pay.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. ) ## 4458.5. If a member suffers “an injury” following termination of active service, and within the time prescribed in Section 3212, 3212.2, 3212.3, 3212.4, 3212.5, 3212.6, 3212.7, or 3213, then, irrespective of his remuneration from any postactive service employment, his average weekly earnings for the purposes of determining temporary disability indemnity, permanent total disability indemnity, and permanent partial disability indemnity, shall be taken at the maximum fixed for each such disability, respectively, in Section 4453. (Added by renumbering Section 4458 (as added by Stats. 1976, Ch. 446) by Stats. 1978, Ch. 380.)
  66. 4459.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    A prior disability or earlier compensation does not bar compensation for a later injury, and dependents may receive death compensation; the employee’s average weekly earnings for that later claim must be set to a sum that reasonably reflects earning capacity at the time of the later injury.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 1. Average Earnings [4451 - 4459] ( Chapter 1 enacted by Stats. 1937, Ch. 90. ) ## 4459. The fact that an employee has suffered a previous disability, or received compensation therefor, does not preclude him from compensation for a later injury, or his dependents from compensation for death resulting therefrom, but in determining compensation for the later injury, or death resulting therefrom, his average weekly earnings shall be fixed at the sum which reasonably represents his earning capacity at the time of the later injury. (Enacted by Stats. 1937, Ch. 90.)
  67. 450.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Purchases [450 - 452] ( Article 4 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Employers, their agents or officers, and other persons must not force or pressure employees or job applicants to buy from them or anyone else.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Purchases [450 - 452] ( Article 4 enacted by Stats. 1937, Ch. 90. ) ## 450. (a) No employer, or agent or officer thereof, or other person, may compel or coerce any employee, or applicant for employment, to patronize his or her employer, or any other person, in the purchase of any thing of value. (b) For purposes of this section, to compel or coerce the purchase of any thing of value includes, but is not limited to, instances where an employer requires the payment of a fee or consideration of any type from an applicant for employment for any of the following purposes: (1) For an individual to apply for employment orally or in writing. (2) For an individual to receive, obtain, complete, or submit an application for employment. (3) For an employer to provide, accept, or process an application for employment. (Amended by Stats. 1998, Ch. 442, Sec. 1. Effective January 1, 1999.)
  68. 451.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Purchases [450 - 452] ( Article 4 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Anyone, including an agent or officer, who violates this article commits a misdemeanor.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Purchases [450 - 452] ( Article 4 enacted by Stats. 1937, Ch. 90. ) ## 451. Any person, or agent or officer thereof, who violates this article is guilty of a misdemeanor. (Enacted by Stats. 1937, Ch. 90.)
  69. 452.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Purchases [450 - 452] ( Article 4 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    An employer is not barred from setting the weight, color, quality, texture, style, form, and make of uniforms employees must wear.

    ## Labor Code - LAB ## DIVISION 2. EMPLOYMENT REGULATION AND SUPERVISION [200 - 2699.8] ( Division 2 enacted by Stats. 1937, Ch. 90. ) ## PART 1. COMPENSATION [200 - 452] ( Part 1 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 3. Privileges and Perquisites [350 - 452] ( Chapter 3 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Purchases [450 - 452] ( Article 4 enacted by Stats. 1937, Ch. 90. ) ## 452. Nothing in this article shall prohibit an employer from prescribing the weight, color, quality, texture, style, form and make of uniforms required to be worn by his employees. (Enacted by Stats. 1937, Ch. 90.)
  70. 4550.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 1. General Provisions [4550 - 4558] ( Article 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    If compensation liability exists under this division, the employer must furnish or pay the compensation as provided in this chapter.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 1. General Provisions [4550 - 4558] ( Article 1 enacted by Stats. 1937, Ch. 90. ) ## 4550. Where liability for compensation exists under this division, such compensation shall be furnished or paid by the employer and shall be as provided in this chapter. (Enacted by Stats. 1937, Ch. 90.)
  71. 4551.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 1. General Provisions [4550 - 4558] ( Article 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    If an employee’s injury was caused by the employee’s serious and willful misconduct, compensation is reduced by half, unless one of four listed exceptions applies.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 1. General Provisions [4550 - 4558] ( Article 1 enacted by Stats. 1937, Ch. 90. ) ## 4551. Where the injury is caused by the serious and willful misconduct of the injured employee, the compensation otherwise recoverable therefor shall be reduced one-half, except: (a) Where the injury results in death. (b) Where the injury results in a permanent disability of 70 percent or over. (c) Where the injury is caused by the failure of the employer to comply with any provision of law, or any safety order of the Division of Occupational Safety and Health, with reference to the safety of places of employment. (d) Where the injured employee is under 16 years of age at the time of injury. (Amended by Stats. 1980, Ch. 676.)
  72. 4552.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 1. General Provisions [4550 - 4558] ( Article 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    A reduction in compensation for an employee’s serious and willful misconduct is not enforceable, valid, or binding until the appeals board determines it by findings and award.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 1. General Provisions [4550 - 4558] ( Article 1 enacted by Stats. 1937, Ch. 90. ) ## 4552. The reduction of compensation because of the serious and willful misconduct of an employee is not enforceable, valid, or binding in any respect until the appeals board has so determined by its findings and award as provided in Chapter 6 of Part 4 of this division. (Amended by Stats. 1965, Ch. 1513.)
  73. 4553.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 1. General Provisions [4550 - 4558] ( Article 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    If an employee is injured because of serious and willful misconduct by the employer or specified managerial persons, the compensation otherwise recoverable is increased by one-half, and costs and expenses may be added up to $250.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 1. General Provisions [4550 - 4558] ( Article 1 enacted by Stats. 1937, Ch. 90. ) ## 4553. The amount of compensation otherwise recoverable shall be increased one-half, together with costs and expenses not to exceed two hundred fifty dollars ($250), where the employee is injured by reason of the serious and willful misconduct of any of the following: (a) The employer, or his managing representative. (b) If the employer is a partnership, on the part of one of the partners or a managing representative or general superintendent thereof. (c) If the employer is a corporation, on the part of an executive, managing officer, or general superintendent thereof. (Amended by Stats. 1982, Ch. 922, Sec. 10.)
  74. 4553.1.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 1. General Provisions [4550 - 4558] ( Article 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    The appeals board must make specific findings before serious and willful misconduct by an employer can be supported based on a safety-order violation.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 1. General Provisions [4550 - 4558] ( Article 1 enacted by Stats. 1937, Ch. 90. ) ## 4553.1. In order to support a holding of serious and willful misconduct by an employer based upon violation of a safety order, the appeals board must specifically find all of the following: (1) The specific manner in which the order was violated. (2) That the violation of the safety order did proximately cause the injury or death, and the specific manner in which the violation constituted the proximate cause. (3) That the safety order, and the conditions making the safety order applicable, were known to, and violated by, a particular named person, either the employer, or a representative designated by Section 4553, or that the condition making the safety order applicable was obvious, created a probability of serious injury, and that the failure of the employer, or a representative designated by Section 4553, to correct the condition constituted a reckless disregard for the probable consequences. (Amended by Stats. 1982, Ch. 922, Sec. 11.)
  75. 4554.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 1. General Provisions [4550 - 4558] ( Article 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    If an employer willfully fails to secure payment of compensation, the recoverable compensation for injury or death is increased by 10 percent.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 1. General Provisions [4550 - 4558] ( Article 1 enacted by Stats. 1937, Ch. 90. ) ## 4554. In case of the willful failure by an employer to secure the payment of compensation, the amount of compensation otherwise recoverable for injury or death as provided in this division shall be increased 10 percent. Failure of the employer to secure the payment of compensation as provided in Article 1 (commencing at Section 3700) of Chapter 4 of Part 1 of this division is prima facie evidence of willfulness on his part. (Amended by Stats. 1959, Ch. 1189.)
  76. 4555.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 1. General Provisions [4550 - 4558] ( Article 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    If an employer fails to secure compensation payments, the appeals board may award a reasonable attorney’s fee, in addition to compensation recoverable.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 1. General Provisions [4550 - 4558] ( Article 1 enacted by Stats. 1937, Ch. 90. ) ## 4555. In case of failure by an employer to secure the payment of compensation, the appeals board may award a reasonable attorney’s fee in addition to the amount of compensation recoverable. When a fee is awarded under this section no further fee shall be allowed under Section 4903 but the provisions of Section 4903 shall be applicable to secure the payment of any fee awarded under this section. (Amended by Stats. 1965, Ch. 1513.)
  77. 4555.5.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 1. General Provisions [4550 - 4558] ( Article 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    If a petition to reduce an award is denied, the appeals board may order the petitioner to pay certain employee costs.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 1. General Provisions [4550 - 4558] ( Article 1 enacted by Stats. 1937, Ch. 90. ) ## 4555.5. Whenever a petition to reduce an award, based upon a permanent disability rating which has become final, is denied, the appeals board may order the petitioner to pay to the injured employee all costs incident to the furnishing of X-rays, laboratory services, medical reports, and medical testimony incurred by such employee in connection with the proceeding on such petition. (Amended by Stats. 1965, Ch. 1513.)
  78. 4556.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 1. General Provisions [4550 - 4558] ( Article 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Increases under this article are not capped by the chapter’s maximum-amount rules for average earnings calculations.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 1. General Provisions [4550 - 4558] ( Article 1 enacted by Stats. 1937, Ch. 90. ) ## 4556. The increases provided for by this article shall not be limited by the provisions of Chapter 1 of this part relating to maximum amounts in the computation of average earnings. (Added by Stats. 1945, Ch. 520.)
  79. 4557.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 1. General Provisions [4550 - 4558] ( Article 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    If a worker under 16 was illegally employed and is injured, the compensation is increased by 50%, and the employer must pay that extra amount with the normal benefits.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 1. General Provisions [4550 - 4558] ( Article 1 enacted by Stats. 1937, Ch. 90. ) ## 4557. Where the injury is to an employee under 16 years of age and illegally employed at the time of injury, the entire compensation otherwise recoverable shall be increased fifty percent (50%), and such additional sum shall be paid by the employer at the same time and in the same manner as the normal compensation benefits. An employer shall not be held liable for the additional compensation provided by this section if such an employee is hired pursuant to a birth certificate, automobile driver’s license, or other reasonable evidence of the fact the employee is over the age of 15 years, even though such evidence of age were falsely obtained by the employee. The additional compensation provided by this section shall not exceed the maximum sum specified by Section 4553 for additional compensation payable for serious and willful misconduct on the part of an employer. This section shall not apply to the State or any of its political subdivisions or districts. (Amended by Stats. 1961, Ch. 1621.)
  80. 4558.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 1. General Provisions [4550 - 4558] ( Article 1 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    This section lets an employee, or the employee’s dependents after death, sue the employer for damages in limited power-press guard cases.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 1. General Provisions [4550 - 4558] ( Article 1 enacted by Stats. 1937, Ch. 90. ) ## 4558. (a) As used in this section: (1) “Employer” means a named identifiable person who is, prior to the time of the employee’s injury or death, an owner or supervisor having managerial authority to direct and control the acts of employees. (2) “Failure to install” means omitting to attach a point of operation guard either provided or required by the manufacturer, when the attachment is required by the manufacturer and made known by him or her to the employer at the time of acquisition, installation, or manufacturer-required modification of the power press. (3) “Manufacturer” means the designer, fabricator, or assembler of a power press. (4) “Power press” means any material-forming machine that utilizes a die which is designed for use in the manufacture of other products. (5) “Removal” means physical removal of a point of operation guard which is either installed by the manufacturer or installed by the employer pursuant to the requirements or instructions of the manufacturer. (6) “Specifically authorized” means an affirmative instruction issued by the employer prior to the time of the employee’s physical injury or death, but shall not mean any subsequent acquiescence in, or ratification of, removal of a point of operation safety guard. (b) An employee, or his or her dependents in the event of the employee’s death, may bring an action at law for damages against the employer where the employee’s injury or death is proximately caused by the employer’s knowing removal of, or knowing failure to install, a point of operation guard on a power press, and this removal or failure to install is specifically authorized by the employer under conditions known by the employer to create a probability of serious injury or death. (c) No liability shall arise under this section absent proof that the manufacturer designed, installed, required, or otherwise provided by specification for the attachment of the guards and conveyed knowledge of the same to the employer. Proof of conveyance of this information to the employer by the manufacturer may come from any source. (d) No right of action for contribution or indemnity by any defendant shall exist against the employer; however, a defendant may seek contribution after the employee secures a judgment against the employer pursuant to the provisions of this section if the employer fails to discharge his or her comparative share of the judgment. (Added by Stats. 1982, Ch. 922, Sec. 12.)
  81. 4600.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    This section requires employers to provide reasonably necessary medical treatment for injured workers and sets rules for doctor choice, interpreters, travel expenses, and home health care.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4600. (a) Medical, surgical, chiropractic, acupuncture, licensed clinical social worker, and hospital treatment, including nursing, medicines, medical and surgical supplies, crutches, and apparatuses, including orthotic and prosthetic devices and services, that is reasonably required to cure or relieve the injured worker from the effects of the worker’s injury shall be provided by the employer. In the case of the employer’s neglect or refusal reasonably to do so, the employer is liable for the reasonable expense incurred by or on behalf of the employee in providing treatment. (b) As used in this division and notwithstanding any other law, medical treatment that is reasonably required to cure or relieve the injured worker from the effects of the worker’s injury means treatment that is based upon the guidelines adopted by the administrative director pursuant to Section 5307.27. (c) Unless the employer or the employer’s insurer has established or contracted with a medical provider network as provided for in Section 4616, after 30 days from the date the injury is reported, the employee may be treated by a physician of the employee’s own choice or at a facility of the employee’s own choice within a reasonable geographic area. A chiropractor shall not be a treating physician after the employee has received the maximum number of chiropractic visits allowed by subdivision (c) of Section 4604.5. (d) (1) If an employee has notified the employee’s employer in writing prior to the date of injury that the employee has a personal physician, the employee shall have the right to be treated by that physician from the date of injury if the employee has health care coverage for nonoccupational injuries or illnesses on the date of injury in a plan, policy, or fund as described in subdivisions (b), (c), and (d) of Section 4616.7. (2) For purposes of paragraph (1), a personal physician shall meet all of the following conditions: (A) Be the employee’s regular physician and surgeon, licensed pursuant to Chapter 5 (commencing with Section 2000) of Division 2 of the Business and Professions Code. (B) Be the employee’s primary care physician and has previously directed the medical treatment of the employee, and who retains the employee’s medical records, including the employee’s medical history. “Personal physician” includes a medical group, if the medical group is a single corporation or partnership composed of licensed doctors of medicine or osteopathy, which operates an integrated multispecialty medical group providing comprehensive medical services predominantly for nonoccupational illnesses and injuries. (C) The physician agrees to be predesignated. (3) If the employee has health care coverage for nonoccupational injuries or illnesses on the date of injury in a health care service plan licensed pursuant to Chapter 2.2 (commencing with Section 1340) of Division 2 of the Health and Safety Code, and the employer is notified pursuant to paragraph (1), all medical treatment, utilization review of medical treatment, access to medical treatment, and other medical treatment issues shall be governed by Chapter 2.2 (commencing with Section 1340) of Division 2 of the Health and Safety Code. Disputes regarding the provision of medical treatment shall be resolved pursuant to Article 5.55 (commencing with Section 1374.30) of Chapter 2.2 of Division 2 of the Health and Safety Code. (4) If the employee has health care coverage for nonoccupational injuries or illnesses on the date of injury in a group health insurance policy as described in Section 4616.7, all medical treatment, utilization review of medical treatment, access to medical treatment, and other medical treatment issues shall be governed by the applicable provisions of the Insurance Code. (5) The insurer may require prior authorization of any nonemergency treatment or diagnostic service and may conduct reasonably necessary utilization review pursuant to Section 4610. (6) An employee is entitled to all medically appropriate referrals by the personal physician to other physicians or medical providers within the nonoccupational health care plan. An employee is entitled to treatment by physicians or other medical providers outside of the nonoccupational health care plan pursuant to standards established in Article 5 (commencing with Section 1367) of Chapter 2.2 of Division 2 of the Health and Safety Code. (e) (1) When at the request of the employer, the employer’s insurer, the administrative director, the appeals board, or a workers’ compensation administrative law judge, the employee submits to examination by a physician, the employee is entitled to receive, in addition to all other benefits herein provided, all reasonable expenses of transportation, meals, and lodging incident to reporting for the examination, together with one day of temporary disability indemnity for each day of wages lost in submitting to the examination. (2) Regardless of the date of injury, “reasonable expenses of transportation” includes mileage fees from the employee’s home to the place of the examination and back at the rate of twenty-one cents ($0.21) a mile or the mileage rate adopted by the Director of Human Resources pursuant to Section 19820 of the Government Code, whichever is higher, plus any bridge tolls. The mileage and tolls shall be paid to the employee at the time the employee is given notification of the time and place of the examination. (f) When at the request of the employer, the employer’s insurer, the administrative director, the appeals board, or a workers’ compensation administrative law judge, an employee submits to examination by a physician and the employee does not proficiently speak or understand the English language, the employee shall be entitled to the services of a qualified interpreter in accordance with conditions and a fee schedule prescribed by the administrative director. These services shall be provided by the employer. For purposes of this section, “qualified interpreter” means a language interpreter certified, or deemed certified, pursuant to Article 8 (commencing with Section 11435.05) of Chapter 4.5 of Part 1 of Division 3 of Title 2 of, or Section 68566 of, the Government Code. (g) If the injured employee cannot effectively communicate with the employee’s treating physician because the employee cannot proficiently speak or understand the English language, the injured employee is entitled to the services of a qualified interpreter during medical treatment appointments. To be a qualified interpreter for purposes of medical treatment appointments, an interpreter is not required to meet the requirements of subdivision (f), but shall meet any requirements established by rule by the administrative director that are substantially similar to the requirements set forth in Section 1367.04 of the Health and Safety Code. The administrative director shall adopt a fee schedule for qualified interpreter fees in accordance with this section. Upon request of the injured employee, the employer or insurance carrier shall pay for interpreter services. An employer shall not be required to pay for the services of an interpreter who is not certified or is provisionally certified by the person conducting the medical treatment or examination unless either the employer consents in advance to the selection of the individual who provides the interpreting service or the injured worker requires interpreting service in a language other than the languages designated pursuant to Section 11435.40 of the Government Code. (h) Home health care services shall be provided as medical treatment only if reasonably required to cure or relieve the injured employee from the effects of the employee’s injury and prescribed by a physician and surgeon licensed pursuant to Chapter 5 (commencing with Section 2000) of Division 2 of the Business and Professions Code, and subject to Section 5307.1 or 5307.8. The employer is not liable for home health care services that are provided more than 14 days prior to the date of the employer’s receipt of the physician’s prescription. (Amended by Stats. 2022, Ch. 609, Sec. 4. (SB 1002) Effective January 1, 2023.)
  82. 4600.05.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Employers must provide immediate nurse case manager support and give claimants a notice within three days in covered domestic terrorism-related workers' compensation claims; the administrative director must adopt implementing regulations.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4600.05. (a) An employer, as defined in Section 3300, shall provide immediate support from a nurse case manager for employees injured by an act of domestic terrorism, as defined in Section 2331 of Title 18 of the United States Code, whose injuries arise out of and in the course of employment, to assist injured employees in obtaining medically necessary medical treatment, as defined by the medical treatment utilization schedule adopted pursuant to Section 5307.27, and to assist providers of medical services in seeking authorization of medical treatment. (b) (1) This section shall apply only if the Governor has declared a state of emergency pursuant to subdivision (b) of Section 8558 of the Government Code in connection with the act of domestic terrorism. (2) Upon the issuance of a declaration pursuant to paragraph (1), an employer that has been notified of a claim for compensation arising out of the acts that resulted in the declaration shall provide a notice within three days to the claimant advising the claimant of medically necessary services provided pursuant to subdivision (a). In the case of a claim for compensation subject to this section that is filed after the declaration, the employer shall provide the notice to the claimant within three days. The notice shall be in the form adopted by the administrative director pursuant to subdivision (d). (c) This section shall not alter the conditions for compensability of an injury, as described in Sections 3208.3 and 3600. (d) The administrative director shall adopt regulations to implement this section, including, but not limited to, the definition of a nurse case manager’s qualifications, the scope and timing of immediate support from a nurse case manager, and the contents of the notice that employers shall provide to claimants. (Added by Stats. 2017, Ch. 736, Sec. 2. (AB 44) Effective January 1, 2018.)
  83. 4600.1.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    People or entities dispensing medicines and medical supplies must dispense the generic drug equivalent, unless one of the stated exceptions applies.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4600.1. (a) Subject to subdivision (b), any person or entity that dispenses medicines and medical supplies, as required by Section 4600, shall dispense the generic drug equivalent. (b) A person or entity is not required to dispense a generic drug equivalent under either of the following circumstances: (1) When a generic drug equivalent is unavailable. (2) When the prescribing physician specifically provides in writing that a nongeneric drug must be dispensed. (c) For purposes of this section, “dispense” has the same meaning as the definition contained in Section 4024 of the Business and Professions Code. (d) Nothing in this section shall be construed to preclude a prescribing physician, who is also the dispensing physician, from dispensing a generic drug equivalent. (e) This section shall only apply to medicines dispensed prior to the operative date of the drug formulary adopted pursuant to Section 5307.27. (Amended by Stats. 2015, Ch. 525, Sec. 2. (AB 1124) Effective January 1, 2016.)
  84. 4600.2.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Certain workers’ compensation pharmacy contracts must provide medicines and medical supplies as required, follow the adopted drug formulary, and avoid limiting medication availability based on network location.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4600.2. (a) Notwithstanding Section 4600, if a self-insured employer, group of self-insured employers, insurer of an employer, or group of insurers contracts with a pharmacy, group of pharmacies, or pharmacy benefit network to provide medicines and medical supplies required by this article to be provided to injured employees, those injured employees that are subject to the contract shall be provided medicines and medical supplies in the manner prescribed in the contract for as long as medicines or medical supplies are reasonably required to cure or relieve the injured employee from the effects of the injury. Medicines provided pursuant to the contract shall be subject to the drug formulary adopted by the administrative director pursuant to Section 5307.27, and such contracts may not limit the availability of medications otherwise prescribed pursuant to the formulary based on whether the pharmacy services are provided within or outside a medical provider network. (b) Nothing in this section shall affect the ability of employee-selected physicians to continue to prescribe and have the employer provide medicines subject to the drug formulary and medical supplies that the physicians deem reasonably required to cure or relieve the injured employee from the effects of the injury. (c) Each contract described in subdivision (a) shall comply with standards adopted by the administrative director. In adopting those standards, the administrative director shall seek to reduce pharmaceutical costs and may consult any relevant studies or practices in other states. The standards shall provide for access to a pharmacy within a reasonable geographic distance from an injured employee’s residence. (Amended by Stats. 2015, Ch. 525, Sec. 3. (AB 1124) Effective January 1, 2016.)
  85. 4600.3.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    This section lets certain injured employees receive care through a contracted health care organization, but it also preserves several employee choices and sets notice, timing, and physician-change rules.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4600.3. (a) (1) Notwithstanding Section 4600, when a self-insured employer, group of self-insured employers, or the insurer of an employer contracts with a health care organization certified pursuant to Section 4600.5 for health care services required by this article to be provided to injured employees, those employees who are subject to the contract shall receive medical services in the manner prescribed in the contract, providing that the employee may choose to be treated by a personal physician, personal chiropractor, or personal acupuncturist that they have designated prior to the injury, in which case the employee shall not be treated by the health care organization. Every employee shall be given an affirmative choice at the time of employment and at least annually thereafter to designate or change the designation of a health care organization or a personal physician, personal chiropractor, or personal acupuncturist. The choice shall be memorialized in writing and maintained in the employee’s personnel records. The employee who has designated a personal physician, personal chiropractor, or personal acupuncturist may change their designated caregiver at any time prior to the injury. Any employee who fails to designate a personal physician, personal chiropractor, or personal acupuncturist shall be treated by the health care organization selected by the employer. If the health care organization offered by the employer is the workers’ compensation insurer that covers the employee or is an entity that controls or is controlled by that insurer, as defined by Section 1215 of the Insurance Code, this information shall be included in the notice of contract with a health care organization. (2) Each contract described in paragraph (1) shall comply with the certification standards provided in Section 4600.5, and shall provide all medical, surgical, chiropractic, acupuncture, licensed clinical social worker, and hospital treatment, including nursing, medicines, medical and surgical supplies, crutches, and apparatus, including artificial members, that is reasonably required to cure or relieve the effects of the injury, as required by this division, without any payment by the employee of deductibles, copayments, or any share of the premium. However, an employee may receive immediate emergency medical treatment that is compensable from a medical service or health care provider who is not a member of the health care organization. (3) Insured employers, a group of self-insured employers, or self-insured employers who contract with a health care organization for medical services shall give notice to employees of eligible medical service providers and any other information regarding the contract and manner of receiving medical services as the administrative director may prescribe. Employees shall be duly notified that if they choose to receive care from the health care organization they must receive treatment for all occupational injuries and illnesses as prescribed by this section. (b) Notwithstanding subdivision (a), no employer which is required to bargain with an exclusive or certified bargaining agent which represents employees of the employer in accordance with state or federal employer-employee relations law shall contract with a health care organization for purposes of Section 4600.5 with regard to employees whom the bargaining agent is recognized or certified to represent for collective bargaining purposes pursuant to state or federal employer-employee relations law unless authorized to do so by mutual agreement between the bargaining agent and the employer. If the collective bargaining agreement is subject to the National Labor Relations Act, the employer may contract with a health care organization for purposes of Section 4600.5 at any time when the employer and bargaining agent have bargained to impasse to the extent required by federal law. (c) (1) When an employee is not receiving or is not eligible to receive health care coverage for nonoccupational injuries or illnesses provided by the employer, if 90 days from the date the injury is reported the employee who has been receiving treatment from a health care organization or their physician, chiropractor, acupuncturist, or other agent notifies their employer in writing that the employee desires to stop treatment by the health care organization, they shall have the right to be treated by a physician, chiropractor, or acupuncturist or at a facility of their own choosing within a reasonable geographic area. (2) When an employee is receiving or is eligible to receive health care coverage for nonoccupational injuries or illnesses provided by the employer, and has agreed to receive care for occupational injuries and illnesses from a health care organization provided by the employer, the employee may be treated for occupational injuries and diseases by a physician, chiropractor, or acupuncturist of their own choice or at a facility of their own choice within a reasonable geographic area if the employee or their physician, chiropractor, acupuncturist, or other agent notifies their employer in writing only after 180 days from the date the injury was reported, or upon the date of contract renewal or open enrollment of the health care organization, whichever occurs first, but in no case until 90 days from the date the injury was reported. (3) For purposes of this subdivision, an employer shall be deemed to provide health care coverage for nonoccupational injuries and illnesses if the employer pays more than one-half the costs of the coverage, or if the plan is established pursuant to collective bargaining. (d) An employee and employer may agree to other forms of therapy pursuant to Section 3209.7. (e) An employee enrolled in a health care organization shall have the right to no less than one change of physician on request, and shall be given a choice of physicians affiliated with the health care organization. The health care organization shall provide the employee a choice of participating physicians within five days of receiving a request. In addition, the employee shall have the right to a second opinion from a participating physician on a matter pertaining to diagnosis or treatment from a participating physician. (f) Nothing in this section or Section 4600.5 shall be construed to prohibit a self-insured employer, a group of self-insured employers, or insurer from engaging in any activities permitted by Section 4600. (g) Notwithstanding subdivision (c), in the event that the employer, group of employers, or the employer’s workers’ compensation insurer no longer contracts with the health care organization that has been treating an injured employee, the employee may continue treatment provided or arranged by the health care organization. If the employee does not choose to continue treatment by the health care organization, the employer may control the employee’s treatment for 30 days from the date the injury was reported. After that period, the employee may be treated by a physician of their own choice or at a facility of their own choice within a reasonable geographic area. (Amended by Stats. 2022, Ch. 609, Sec. 5. (SB 1002) Effective January 1, 2023.)
  86. 4600.35.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    An entity that wants to reimburse health care providers for treating injured workers on a capitated or per-person-per-month basis must be licensed under the Knox-Keene Health Care Service Plan Act of 1975.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4600.35. Any entity seeking to reimburse health care providers for health care services rendered to injured workers on a capitated, or per person per month basis, shall be licensed pursuant to the Knox-Keene Health Care Service Plan Act of 1975 (Chapter 2.2 (commencing with Section 1340) of Division 2 of the Health and Safety Code). (Added by Stats. 2002, Ch. 6, Sec. 61.5. Effective January 1, 2003.)
  87. 4600.4.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Certain workers’ compensation insurers, third-party administrators, and similar entities must keep utilization review or prior authorization services available during set business hours.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4600.4. (a) A workers’ compensation insurer, third-party administrator, or other entity that requires, or pursuant to regulation requires, a treating physician to obtain either utilization review or prior authorization in order to diagnose or treat injuries or diseases compensable under this article, shall ensure the availability of those services from 9 a.m. to 5:30 p.m. Pacific standard time of each normal business day. (b) For purposes of this article, “normal business day” does not include Saturday, Sunday, or any day that is declared by the Governor to be an official state holiday or a holiday listed on the Department of Human Resources internet website. (Amended by Stats. 2019, Ch. 647, Sec. 4. (SB 537) Effective January 1, 2020.)
  88. 4600.5.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    This section lets certain health plans, insurers, and other approved entities apply for certification as health care organizations, and sets conditions for certification, care access, and oversight.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4600.5. (a) Any health care service plan licensed pursuant to the Knox-Keene Health Care Service Plan Act, a disability insurer licensed by the Department of Insurance, or any entity, including, but not limited to, workers’ compensation insurers and third-party administrators authorized by the administrative director under subdivision (e), may make written application to the administrative director to become certified as a health care organization to provide health care to injured employees for injuries and diseases compensable under this article. (b) Each application for certification shall be accompanied by a reasonable fee prescribed by the administrative director, sufficient to cover the actual cost of processing the application. A certificate is valid for the period that the director may prescribe unless sooner revoked or suspended. (c) If the health care organization is a health care service plan licensed pursuant to the Knox-Keene Health Care Service Plan Act, and has provided the Managed Care Unit of the Division of Workers’ Compensation with the necessary documentation to comply with this subdivision, that organization shall be deemed to be a health care organization able to provide health care pursuant to Section 4600.3, without further application duplicating the documentation already filed with the Department of Managed Health Care. These plans shall be required to remain in good standing with the Department of Managed Health Care, and shall meet the following additional requirements: (1) Proposes to provide all medical and health care services that may be required by this article. (2) Provides a program involving cooperative efforts by the employees, the employer, and the health plan to promote workplace health and safety, consultative and other services, and early return to work for injured employees. (3) Proposes a timely and accurate method to meet the requirements set forth by the administrative director for all carriers of workers’ compensation coverage to report necessary information regarding medical and health care service cost and utilization, rates of return to work, average time in medical treatment, and other measures as determined by the administrative director to enable the director to determine the effectiveness of the plan. (4) Agrees to provide the administrative director with information, reports, and records prepared and submitted to the Department of Managed Health Care in compliance with the Knox-Keene Health Care Service Plan Act, relating to financial solvency, provider accessibility, peer review, utilization review, and quality assurance, upon request, if the administrative director determines the information is necessary to verify that the plan is providing medical treatment to injured employees in compliance with the requirements of this code. Disclosure of peer review proceedings and records to the administrative director shall not alter the status of the proceedings or records as privileged and confidential communications pursuant to Sections 1370 and 1370.1 of the Health and Safety Code. (5) Demonstrates the capability to provide occupational medicine and related disciplines. (6) Complies with any other requirement the administrative director determines is necessary to provide medical services to injured employees consistent with the intent of this article, including, but not limited to, a written patient grievance policy. (d) If the health care organization is a disability insurer licensed by the Department of Insurance, and is in compliance with subdivision (d) of Sections 10133 and 10133.5 of the Insurance Code, the administrative director shall certify the organization to provide health care pursuant to Section 4600.3 if the director finds that the plan is in good standing with the Department of Insurance and meets the following additional requirements: (1) Proposes to provide all medical and health care services that may be required by this article. (2) Provides a program involving cooperative efforts by the employees, the employer, and the health plan to promote workplace health and safety, consultative and other services, and early return to work for injured employees. (3) Proposes a timely and accurate method to meet the requirements set forth by the administrative director for all carriers of workers’ compensation coverage to report necessary information regarding medical and health care service cost and utilization, rates of return to work, average time in medical treatment, and other measures as determined by the administrative director to enable the director to determine the effectiveness of the plan. (4) Agrees to provide the administrative director with information, reports, and records prepared and submitted to the Department of Insurance in compliance with the Insurance Code relating to financial solvency, provider accessibility, peer review, utilization review, and quality assurance, upon request, if the administrative director determines the information is necessary to verify that the plan is providing medical treatment to injured employees consistent with the intent of this article. Disclosure of peer review proceedings and records to the administrative director shall not alter the status of the proceedings or records as privileged and confidential communications pursuant to subdivision (d) of Section 10133 of the Insurance Code. (5) Demonstrates the capability to provide occupational medicine and related disciplines. (6) Complies with any other requirement the administrative director determines is necessary to provide medical services to injured employees consistent with the intent of this article, including, but not limited to, a written patient grievance policy. (e) If the health care organization is a workers’ compensation insurer, third-party administrator, or any other entity that the administrative director determines meets the requirements of Section 4600.6, the administrative director shall certify the organization to provide health care pursuant to Section 4600.3 if the director finds that it meets the following additional requirements: (1) Proposes to provide all medical and health care services that may be required by this article. (2) Provides a program involving cooperative efforts by the employees, the employer, and the health plan to promote workplace health and safety, consultative and other services, and early return to work for injured employees. (3) Proposes a timely and accurate method to meet the requirements set forth by the administrative director for all carriers of workers’ compensation coverage to report necessary information regarding medical and health care service cost and utilization, rates of return to work, average time in medical treatment, and other measures as determined by the administrative director to enable the director to determine the effectiveness of the plan. (4) Agrees to provide the administrative director with information, reports, and records relating to provider accessibility, peer review, utilization review, quality assurance, advertising, disclosure, medical and financial audits, and grievance systems, upon request, if the administrative director determines the information is necessary to verify that the plan is providing medical treatment to injured employees consistent with the intent of this article. Disclosure of peer review proceedings and records to the administrative director shall not alter the status of the proceedings or records as privileged and confidential communications pursuant to subdivision (d) of Section 10133 of the Insurance Code. (5) Demonstrates the capability to provide occupational medicine and related disciplines. (6) Complies with any other requirement the administrative director determines is necessary to provide medical services to injured employees consistent with the intent of this article, including, but not limited to, a written patient grievance policy. (7) Complies with the following requirements: (A) An organization certified by the administrative director under this subdivision may not provide or undertake to arrange for the provision of health care to employees, or to pay for or to reimburse any part of the cost of that health care in return for a prepaid or periodic charge paid by or on behalf of those employees. (B) Every organization certified under this subdivision shall operate on a fee-for-service basis. As used in this section, fee for service refers to the situation where the amount of reimbursement paid by the employer to the organization or providers of health care is determined by the amount and type of health care rendered by the organization or provider of health care. (C) An organization certified under this subdivision is prohibited from assuming risk. (f) (1) A workers’ compensation health care provider organization authorized by the Department of Financial Protection and Innovation on December 31, 1997, shall be eligible for certification as a health care organization under subdivision (e). (2) An entity that had, on December 31, 1997, submitted an application with the Commissioner of Financial Protection and Innovation under Part 3.2 (commencing with Section 5150) shall be considered an applicant for certification under subdivision (e) and shall be entitled to priority in consideration of its application. The Commissioner of Financial Protection and Innovation shall provide complete files for all pending applications to the administrative director on or before January 31, 1998. (g) The provisions of this section shall not affect the confidentiality or admission in evidence of a claimant’s medical treatment records. (h) Charges for services arranged for or provided by health care service plans certified by this section and that are paid on a per-enrollee-periodic-charge basis shall not be subject to the schedules adopted by the administrative director pursuant to Section 5307.1. (i) Nothing in this section shall be construed to expand or constrict any requirements imposed by law on a health care service plan or insurer when operating as other than a health care organization pursuant to this section. (j) In consultation with interested parties, including the Department of Financial Protection and Innovation and the Department of Insurance, the administrative director shall adopt rules necessary to carry out this section. (k) The administrative director shall refuse to certify or may revoke or suspend the certification of any health care organization under this section if the director finds that: (1) The plan for providing medical treatment fails to meet the requirements of this section. (2) A health care service plan licensed by the Department of Managed Health Care, a workers’ compensation health care provider organization authorized by the Department of Financial Protection and Innovation, or a carrier licensed by the Department of Insurance is not in good standing with its licensing agency. (3) Services under the plan are not being provided in accordance with the terms of a certified plan. (l) (1) When an injured employee requests chiropractic treatment for work-related injuries, the health care organization shall provide the injured worker with access to the services of a chiropractor pursuant to guidelines for chiropractic care established by paragraph (2). Within five working days of the employee’s request to see a chiropractor, the health care organization and any person or entity who directs the kind or manner of health care services for the plan shall refer an injured employee to an affiliated chiropractor for work-related injuries that are within the guidelines for chiropractic care established by paragraph (2). Chiropractic care rendered in accordance with guidelines for chiropractic care established pursuant to paragraph (2) shall be provided by duly licensed chiropractors affiliated with the plan. (2) The health care organization shall establish guidelines for chiropractic care in consultation with affiliated chiropractors who are participants in the health care organization’s utilization review process for chiropractic care, which may include qualified medical evaluators knowledgeable in the treatment of chiropractic conditions. The guidelines for chiropractic care shall, at a minimum, explicitly require the referral of any injured employee who so requests to an affiliated chiropractor for the evaluation or treatment, or both, of neuromusculoskeletal conditions. (3) Whenever a dispute concerning the appropriateness or necessity of chiropractic care for work-related injuries arises, the dispute shall be resolved by the health care organization’s utilization review process for chiropractic care in accordance with the health care organization’s guidelines for chiropractic care established by paragraph (2). Chiropractic utilization review for work-related injuries shall be conducted in accordance with the health care organization’s approved quality assurance standards and utilization review process for chiropractic care. Chiropractors affiliated with the plan shall have access to the health care organization’s provider appeals process and, in the case of chiropractic care for work-related injuries, the review shall include review by a chiropractor affiliated with the health care organization, as determined by the health care organization. (4) The health care organization shall inform employees of the procedures for processing and resolving grievances, including those related to chiropractic care, including the location and telephone number where grievances may be submitted. (5) All guidelines for chiropractic care and utilization review shall be consistent with the standards of this code that require care to cure or relieve the effects of the industrial injury. (m) Individually identifiable medical information on patients submitted to the division shall not be subject to the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code). (n) (1) When an injured employee requests acupuncture treatment for work-related injuries, the health care organization shall provide the injured worker with access to the services of an acupuncturist pursuant to guidelines for acupuncture care established by paragraph (2). Within five working days of the employee’s request to see an acupuncturist, the health care organization and any person or entity who directs the kind or manner of health care services for the plan shall refer an injured employee to an affiliated acupuncturist for work-related injuries that are within the guidelines for acupuncture care established by paragraph (2). Acupuncture care rendered in accordance with guidelines for acupuncture care established pursuant to paragraph (2) shall be provided by duly licensed acupuncturists affiliated with the plan. (2) The health care organization shall establish guidelines for acupuncture care in consultation with affiliated acupuncturists who are participants in the health care organization’s utilization review process for acupuncture care, which may include qualified medical evaluators. The guidelines for acupuncture care shall, at a minimum, explicitly require the referral of any injured employee who so requests to an affiliated acupuncturist for the evaluation or treatment, or both, of neuromusculoskeletal conditions. (3) Whenever a dispute concerning the appropriateness or necessity of acupuncture care for work-related injuries arises, the dispute shall be resolved by the health care organization’s utilization review process for acupuncture care in accordance with the health care organization’s guidelines for acupuncture care established by paragraph (2). Acupuncture utilization review for work-related injuries shall be conducted in accordance with the health care organization’s approved quality assurance standards and utilization review process for acupuncture care. Acupuncturists affiliated with the plan shall have access to the health care organization’s provider appeals process and, in the case of acupuncture care for work-related injuries, the review shall include review by an acupuncturist affiliated with the health care organization, as determined by the health care organization. (4) The health care organization shall inform employees of the procedures for processing and resolving grievances, including those related to acupuncture care, including the location and telephone number where grievances may be submitted. (5) All guidelines for acupuncture care and utilization review shall be consistent with the standards of this code that require care to cure or relieve the effects of the industrial injury. (Amended (as amended by Stats. 2021, Ch. 615, Sec. 323) by Stats. 2022, Ch. 452, Sec. 202. (SB 1498) Effective January 1, 2023.)
  89. 4600.6.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Organizations seeking certification must file required materials, provide disclosures, avoid deceptive advertising, and follow grievance, recordkeeping, and care-quality rules.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4600.6. Any workers’ compensation insurer, third-party administrator, or other entity seeking certification as a health care organization under subdivision (e) of Section 4600.5 shall be subject to the following rules and procedures: (a) Each application for authorization as an organization under subdivision (e) of Section 4600.5 shall be verified by an authorized representative of the applicant and shall be in a form prescribed by the administrative director. The application shall be accompanied by the prescribed fee and shall set forth or be accompanied by each and all of the following: (1) The basic organizational documents of the applicant, such as the articles of incorporation, articles of association, partnership agreement, trust agreement, or other applicable documents and all amendments thereto. (2) A copy of the bylaws, rules, and regulations, or similar documents regulating the conduct of the internal affairs of the applicant. (3) A list of the names, addresses, and official positions of the persons who are to be responsible for the conduct of the affairs of the applicant, which shall include, among others, all members of the board of directors, board of trustees, executive committee, or other governing board or committee, the principal officers, each shareholder with over 5 percent interest in the case of a corporation, and all partners or members in the case of a partnership or association, and each person who has loaned funds to the applicant for the operation of its business. (4) A copy of any contract made, or to be made, between the applicant and any provider of health care, or persons listed in paragraph (3), or any other person or organization agreeing to perform an administrative function or service for the plan. The administrative director by rule may identify contracts excluded from this requirement and make provision for the submission of form contracts. The payment rendered or to be rendered to the provider of health care services shall be deemed confidential information that shall not be divulged by the administrative director, except that the payment may be disclosed and become a public record in any legislative, administrative, or judicial proceeding or inquiry. The organization shall also submit the name and address of each provider employed by, or contracting with, the organization, together with his or her license number. (5) A statement describing the organization, its method of providing for health services, and its physical facilities. If applicable, this statement shall include the health care delivery capabilities of the organization, including the number of full-time and part-time physicians under Section 3209.3, the numbers and types of licensed or state-certified health care support staff, the number of hospital beds contracted for, and the arrangements and the methods by which health care will be provided, as defined by the administrative director under Sections 4600.3 and 4600.5. (6) A copy of the disclosure forms or materials that are to be issued to employees. (7) A copy of the form of the contract that is to be issued to any employer, insurer of an employer, or a group of self-insured employers. (8) Financial statements accompanied by a report, certificate, or opinion of an independent certified public accountant. However, the financial statements from public entities or political subdivisions of the state need not include a report, certificate, or opinion by an independent certified public accountant if the financial statement complies with any requirements that may be established by regulation of the administrative director. (9) A description of the proposed method of marketing the organization and a copy of any contract made with any person to solicit on behalf of the organization or a copy of the form of agreement used and a list of the contracting parties. (10) A statement describing the service area or areas to be served, including the service location for each provider rendering professional services on behalf of the organization and the location of any other organization facilities where required by the administrative director. (11) A description of organization grievance procedures to be utilized as required by this part, and a copy of the form specified by paragraph (3) of subdivision (j). (12) A description of the procedures and programs for internal review of the quality of health care pursuant to the requirements set forth in this part. (13) Evidence of adequate insurance coverage or self-insurance to respond to claims for damages arising out of the furnishing of workers’ compensation health care. (14) Evidence of adequate insurance coverage or self-insurance to protect against losses of facilities where required by the administrative director. (15) Evidence of adequate workers’ compensation coverage to protect against claims arising out of work-related injuries that might be brought by the employees and staff of an organization against the organization. (16) Evidence of fidelity bonds in such amount as the administrative director prescribes by regulation. (17) Other information that the administrative director may reasonably require. (b) (1) An organization, solicitor, solicitor firm, or representative may not use or permit the use of any advertising or solicitation that is untrue or misleading, or any form of disclosure that is deceptive. For purposes of this chapter: (A) A written or printed statement or item of information shall be deemed untrue if it does not conform to fact in any respect that is or may be significant to an employer or employee, or potential employer or employee. (B) A written or printed statement or item of information shall be deemed misleading whether or not it may be literally true, if, in the total context in which the statement is made or the item of information is communicated, the statement or item of information may be understood by a person not possessing special knowledge regarding health care coverage, as indicating any benefit or advantage, or the absence of any exclusion, limitation, or disadvantage of possible significance to an employer or employee, or potential employer or employee. (C) A disclosure form shall be deemed to be deceptive if the disclosure form taken as a whole and with consideration given to typography and format, as well as language, shall be such as to cause a reasonable person, not possessing special knowledge of workers’ compensation health care, and the disclosure form therefor, to expect benefits, service charges, or other advantages that the disclosure form does not provide or that the organization issuing that disclosure form does not regularly make available to employees. (2) An organization, solicitor, or representative may not use or permit the use of any verbal statement that is untrue, misleading, or deceptive or make any representations about health care offered by the organization or its cost that does not conform to fact. All verbal statements are to be held to the same standards as those for printed matter provided in paragraph (1). (c) It is unlawful for any person, including an organization, subject to this part, to represent or imply in any manner that the person or organization has been sponsored, recommended, or approved, or that the person’s or organization’s abilities or qualifications have in any respect been passed upon, by the administrative director. (d) (1) An organization may not publish or distribute, or allow to be published or distributed on its behalf, any advertisement unless (A) a true copy thereof has first been filed with the administrative director, at least 30 days prior to any such use, or any shorter period as the administrative director by rule or order may allow, and (B) the administrative director by notice has not found the advertisement, wholly or in part, to be untrue, misleading, deceptive, or otherwise not in compliance with this part or the rules thereunder, and specified the deficiencies, within the 30 days or any shorter time as the administrative director by rule or order may allow. (2) If the administrative director finds that any advertisement of an organization has materially failed to comply with this part or the rules thereunder, the administrative director may, by order, require the organization to publish in the same or similar medium, an approved correction or retraction of any untrue, misleading, or deceptive statement contained in the advertising. (3) The administrative director by rule or order may classify organizations and advertisements and exempt certain classes, wholly or in part, either unconditionally or upon specified terms and conditions or for specified periods, from the application of subdivision (a). (e) (1) The administrative director shall require the use by each organization of disclosure forms or materials containing any information regarding the health care and terms of the workers’ compensation health care contract that the administrative director may require, so as to afford the public, employers, and employees with a full and fair disclosure of the provisions of the contract in readily understood language and in a clearly organized manner. The administrative director may require that the materials be presented in a reasonably uniform manner so as to facilitate comparisons between contracts of the same or other types of organizations. The disclosure form shall describe the health care that is required by the administrative director under Sections 4600.3 and 4600.5, and shall provide that all information be in concise and specific terms, relative to the contract, together with any additional information as may be required by the administrative director, in connection with the organization or contract. (2) All organizations, solicitors, and representatives of a workers’ compensation health care provider organization shall, when presenting any contract for examination or sale to a prospective employee, provide the employee with a properly completed disclosure form, as prescribed by the administrative director pursuant to this section for each contract so examined or sold. (3) In addition to the other disclosures required by this section, every organization and any agent or employee of the organization shall, when representing an organization for examination or sale to any individual purchaser or the representative of a group consisting of 25 or fewer individuals, disclose in writing the ratio of premium cost to health care paid for contracts with individuals and with groups of the same or similar size for the organization’s preceding fiscal year. An organization may report that information by geographic area, provided the organization identifies the geographic area and reports information applicable to that geographic area. (4) Where the administrative director finds it necessary in the interest of full and fair disclosure, all advertising and other consumer information disseminated by an organization for the purpose of influencing persons to become members of an organization shall contain any supplemental disclosure information that the administrative director may require. (f) When the administrative director finds it necessary in the interest of full and fair disclosure, all advertising and other consumer information disseminated by an organization for the purpose of influencing persons to become members of an organization shall contain any supplemental disclosure information that the administrative director may require. (g) (1) An organization may not refuse to enter into any contract, or may not cancel or decline to renew or reinstate any contract, because of the age or any characteristic listed or defined in subdivision (b) or (e) of Section 51 of the Civil Code of any contracting party, prospective contracting party, or person reasonably expected to benefit from that contract as an employee or otherwise. (2) The terms of any contract shall not be modified, and the benefits or coverage of any contract shall not be subject to any limitations, exceptions, exclusions, reductions, copayments, coinsurance, deductibles, reservations, or premium, price, or charge differentials, or other modifications because of the age or any characteristic listed or defined in subdivision (b) or (e) of Section 51 of the Civil Code of any contracting party, potential contracting party, or person reasonably expected to benefit from that contract as an employee or otherwise; except that premium, price, or charge differentials because of the sex or age of any individual when based on objective, valid, and up-to-date statistical and actuarial data are not prohibited. Nothing in this section shall be construed to permit an organization to charge different rates to individual employees within the same group solely on the basis of the employee’s sex. (3) It shall be deemed a violation of subdivision (a) for any organization to utilize marital status, living arrangements, occupation, gender, beneficiary designation, ZIP Codes or other territorial classification, or any combination thereof for the purpose of establishing sexual orientation. Nothing in this section shall be construed to alter in any manner the existing law prohibiting organizations from conducting tests for the presence of human immunodeficiency virus or evidence thereof. (4) This section shall not be construed to limit the authority of the administrative director to adopt or enforce regulations prohibiting discrimination because of sex, marital status, or sexual orientation. (h) (1) An organization may not use in its name any of the words “insurance,” “casualty,” “health care service plan,” “health plan,” “surety,” “mutual,” or any other words descriptive of the health plan, insurance, casualty, or surety business or use any name similar to the name or description of any health care service plan, insurance, or surety corporation doing business in this state unless that organization controls or is controlled by an entity licensed as a health care service plan or insurer pursuant to the Health and Safety Code or the Insurance Code and the organization employs a name related to that of the controlled or controlling entity. (2) Section 2415 of the Business and Professions Code, pertaining to fictitious names, does not apply to organizations certified under this section. (3) An organization or solicitor firm may not adopt a name style that is deceptive, or one that could cause the public to believe the organization is affiliated with or recommended by any governmental or private entity unless this affiliation or endorsement exists. (i) Each organization shall meet the following requirements: (1) All facilities located in this state, including, but not limited to, clinics, hospitals, and skilled nursing facilities, to be utilized by the organization shall be licensed by the State Department of Health Services, if that licensure is required by law. Facilities not located in this state shall conform to all licensing and other requirements of the jurisdiction in which they are located. (2) All personnel employed by or under contract to the organization shall be licensed or certified by their respective board or agency, where that licensure or certification is required by law. (3) All equipment required to be licensed or registered by law shall be so licensed or registered and the operating personnel for that equipment shall be licensed or certified as required by law. (4) The organization shall furnish services in a manner providing continuity of care and ready referral of patients to other providers at any time as may be appropriate and consistent with good professional practice. (5) All health care shall be readily available at reasonable times to all employees. To the extent feasible, the organization shall make all health care readily accessible to all employees. (6) The organization shall employ and utilize allied health manpower for the furnishing of health care to the extent permitted by law and consistent with good health care practice. (7) The organization shall have the organizational and administrative capacity to provide services to employees. The organization shall be able to demonstrate to the department that health care decisions are rendered by qualified providers, unhindered by fiscal and administrative management. (8) All contracts with employers, insurers of employers, and self-insured employers and all contracts with providers, and other persons furnishing services, equipment, or facilities to or in connection with the workers’ compensation health care organization, shall be fair, reasonable, and consistent with the objectives of this part. (9) Each organization shall provide to employees all workers’ compensation health care required by this code. The administrative director shall not determine the scope of workers’ compensation health care to be offered by an organization. (j) (1) Every organization shall establish and maintain a grievance system approved by the administrative director under which employees may submit their grievances to the organization. Each system shall provide reasonable procedures in accordance with regulations adopted by the administrative director that shall ensure adequate consideration of employee grievances and rectification when appropriate. (2) Every organization shall inform employees upon enrollment and annually thereafter of the procedures for processing and resolving grievances. The information shall include the location and telephone number where grievances may be submitted. (3) Every organization shall provide forms for complaints to be given to employees who wish to register written complaints. The forms used by organizations shall be approved by the administrative director in advance as to format. (4) The organization shall keep in its files all copies of complaints, and the responses thereto, for a period of five years. (k) Every organization shall establish procedures in accordance with regulations of the administrative director for continuously reviewing the quality of care, performance of medical personnel, utilization of services and facilities, and costs. Notwithstanding any other provision of law, there shall be no monetary liability on the part of, and no cause of action for damages shall arise against, any person who participates in quality of care or utilization reviews by peer review committees that are composed chiefly of physicians, as defined by Section 3209.3, for any act performed during the reviews if the person acts without malice, has made a reasonable effort to obtain the facts of the matter, and believes that the action taken is warranted by the facts, and neither the proceedings nor the records of the reviews shall be subject to discovery, nor shall any person in attendance at the reviews be required to testify as to what transpired thereat. Disclosure of the proceedings or records to the governing body of an organization or to any person or entity designated by the organization to review activities of the committees shall not alter the status of the records or of the proceedings as privileged communications. The above prohibition relating to discovery or testimony does not apply to the statements made by any person in attendance at a review who is a party to an action or proceeding the subject matter of which was reviewed, or to any person requesting hospital staff privileges, or in any action against an insurance carrier alleging bad faith by the carrier in refusing to accept a settlement offer within the policy limits, or to the administrative director in conducting surveys pursuant to subdivision (o). This section shall not be construed to confer immunity from liability on any workers’ compensation health care organization. In any case in which, but for the enactment of the preceding provisions of this section, a cause of action would arise against an organization, the cause of action shall exist notwithstanding the provisions of this section. (l) Nothing in this chapter shall be construed to prevent an organization from utilizing subcommittees to participate in peer review activities, nor to prevent an organization from delegating the responsibilities required by subdivision (i) as it determines to be appropriate, to subcommittees including subcommittees composed of a majority of nonphysician health care providers licensed pursuant to the Business and Professions Code, as long as the organization controls the scope of authority delegated and may revoke all or part of this authority at any time. Persons who participate in the subcommittees shall be entitled to the same immunity from monetary liability and actions for civil damages as persons who participate in organization or provider peer review committees pursuant to subdivision (i). (m) Every organization shall have and shall demonstrate to the administrative director that it has all of the following: (1) Adequate provision for continuity of care. (2) A procedure for prompt payment and denial of provider claims. (n) Every contract between an organization and an employer or insurer of an employer, and every contract between any organization and a provider of health care, shall be in writing. (o) (1) The administrative director shall conduct periodically an onsite medical survey of the health care delivery system of each organization. The survey shall include a review of the procedures for obtaining health care, the procedures for regulating utilization, peer review mechanisms, internal procedures for assuring quality of care, and the overall performance of the organization in providing health care and meeting the health needs of employees. (2) The survey shall be conducted by a panel of qualified health professionals experienced in evaluating the delivery of workers’ compensation health care. The administrative director shall be authorized to contract with professional organizations or outside personnel to conduct medical surveys. These organizations or personnel shall have demonstrated the ability to objectively evaluate the delivery of this health care. (3) Surveys performed pursuant to this section shall be conducted as often as deemed necessary by the administrative director to assure the protection of employees, but not less frequently than once every three years. Nothing in this section shall be construed to require the survey team to visit each clinic, hospital, office, or facility of the organization. (4) Nothing in this section shall be construed to require the medical survey team to review peer review proceedings and records conducted and compiled under this section or in medical records. However, the administrative director shall be authorized to require onsite review of these peer review proceedings and records or medical records where necessary to determine that quality health care is being delivered to employees. Where medical record review is authorized, the survey team shall ensure that the confidentiality of the physician-patient relationship is safeguarded in accordance with existing law and neither the survey team nor the administrative director or the administrative director’s staff may be compelled to disclose this information except in accordance with the physician-patient relationship. The administrative director shall ensure that the confidentiality of the peer review proceedings and records is maintained. The disclosure of the peer review proceedings and records to the administrative director or the medical survey team shall not alter the status of the proceedings or records as privileged and confidential communications. (5) The procedures and standards utilized by the survey team shall be made available to the organizations prior to the conducting of medical surveys. (6) During the survey, the members of the survey team shall offer such advice and assistance to the organization as deemed appropriate. (7) The administrative director shall notify the organization of deficiencies found by the survey team. The administrative director shall give the organization a reasonable time to correct the deficiencies, and failure on the part of the organization to comply to the administrative director’s satisfaction shall constitute cause for disciplinary action against the organization. (8) Reports of all surveys, deficiencies, and correction plans shall be open to public inspection, except that no surveys, deficiencies or correction plans shall be made public unless the organization has had an opportunity to review the survey and file a statement of response within 30 days, to be attached to the report. (p) (1) All records, books, and papers of an organization, management company, solicitor, solicitor firm, and any provider or subcontractor providing medical or other services to an organization, management company, solicitor, or solicitor firm shall be open to inspection during normal business hours by the administrative director. (2) To the extent feasible, all the records, books, and papers described in paragraph (1) shall be located in this state. In examining those records outside this state, the administrative director shall consider the cost to the organization, consistent with the effectiveness of the administrative director’s examination, and may upon reasonable notice require that these records, books, and papers, or a specified portion thereof, be made available for examination in this state, or that a true and accurate copy of these records, books, and papers, or a specified portion thereof, be furnished to the administrative director. (q) (1) The administrative director shall conduct an examination of the administrative affairs of any organization, and each person with whom the organization has made arrangements for administrative, or management services, as often as deemed necessary to protect the interest of employees, but not less frequently than once every five years. (2) The expense of conducting any additional or nonroutine examinations pursuant to this section, and the expense of conducting any additional or nonroutine medical surveys pursuant to subdivision (o) shall be charged against the organization being examined or surveyed. The amount shall include the actual salaries or compensation paid to the persons making the examination or survey, the expenses incurred in the course thereof, and overhead costs in connection therewith as fixed by the administrative director. In determining the cost of examinations or surveys, the administrative director may use the estimated average hourly cost for all persons performing examinations or surveys of workers’ compensation health care organizations for the fiscal year. The amount charged shall be remitted by the organization to the administrative director. (3) Reports of all examinations shall be open to public inspection, except that no examination shall be made public, unless the organization has had an opportunity to review the examination report and file a statement or response within 30 days, to be attached to the report. (Amended by Stats. 2008, Ch. 682, Sec. 9. Effective January 1, 2009.)
  90. 4600.7.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    The section creates a managed care fund, requires the administrative director to set fees and revenues, and directs how those funds and a General Fund loan repayment surcharge must be handled.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4600.7. (a) The Workers’ Compensation Managed Care Fund is hereby created in the State Treasury for the administration of Sections 4600.3 and 4600.5 by the Division of Workers’ Compensation. The administrative director shall establish a schedule of fees and revenues to be charged to certified health care organizations and applicants for certification to fully fund the administration of these provisions and to repay amounts received as a loan from the General Fund. All fees and revenues shall be deposited in the Workers’ Compensation Managed Care Fund and shall be used when appropriated by the Legislature solely for the purpose of carrying out the responsibilities of the Division of Workers’ Compensation under Section 4600.3 or 4600.5. (b) On and after July 1, 1998, no funds received as a loan from the General Fund shall be used to support the administration of Sections 4600.3 and 4600.5. The loan amount shall be repaid to the General Fund by assessing a surcharge on the enrollment fee for each of the next five fiscal years. In the event the surcharge does not produce sufficient revenue over this period, the surcharge shall be adjusted to fully repay the loan over the following three fiscal years, with the final assessment calculated by dividing the balance of the loan by the enrollees at the end of the final fiscal year. (Amended by Stats. 1998, Ch. 282, Sec. 1. Effective January 1, 1999.)
  91. 4601.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    An employee may request one change of physician, and the employer must provide the new provider within five working days.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4601. (a) If the employee so requests, the employer shall tender the employee one change of physician. The employee at any time may request that the employer tender this one-time change of physician. Upon request of the employee for a change of physician, the maximum amount of time permitted by law for the employer or insurance carrier to provide the employee an alternative physician or, if requested by the employee, a chiropractor, or an acupuncturist shall be five working days from the date of the request. Notwithstanding the 30-day time period specified in Section 4600, a request for a change of physician pursuant to this section may be made at any time. The employee is entitled, in any serious case, upon request, to the services of a consulting physician, chiropractor, or acupuncturist of his or her choice at the expense of the employer. The treatment shall be at the expense of the employer. (b) If an employee requesting a change of physician pursuant to subdivision (a) has notified his or her employer in writing prior to the date of injury that he or she has a personal chiropractor, the alternative physician tendered by the employer to the employee, if the employee so requests, shall be the employee’s personal chiropractor. For the purpose of this article, “personal chiropractor” means the employee’s regular chiropractor licensed pursuant to Chapter 2 (commencing with Section 1000) of Division 2 of the Business and Professions Code, who has previously directed treatment of the employee, and who retains the employee’s chiropractic treatment records, including his or her chiropractic history. (c) If an employee requesting a change of physician pursuant to subdivision (a) has notified his or her employer in writing prior to the date of injury that he or she has a personal acupuncturist, the alternative physician tendered by the employer to the employee, if the employee so requests, shall be the employee’s personal acupuncturist. For the purpose of this article, “personal acupuncturist” means the employee’s regular acupuncturist licensed pursuant to Chapter 12 (commencing with Section 4935) of Division 2 of the Business and Professions Code, who has previously directed treatment of the employee, and who retains the employee’s acupuncture treatment records, including his or her acupuncture history. (Amended by Stats. 1998, Ch. 440, Sec. 5. Effective January 1, 1999.)
  92. 4602.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    If the employee requests it, the employer must get certification of the competency of the consulting or additional physicians from the administrative director or appeals board.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4602. If the employee so requests, the employer shall procure certification by either the administrative director or the appeals board as the case may be of the competency, for the particular case, of the consulting or additional physicians. (Amended by Stats. 1965, Ch. 1513.)
  93. 4603.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    If an employer wants to change physicians or a chiropractor, it may petition the administrative director. If good cause is shown, the director may order a provider panel, and the employee must choose one provider from it.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4603. If the employer desires a change of physicians or chiropractor, he may petition the administrative director who, upon a showing of good cause by the employer, may order the employer to provide a panel of five physicians, or if requested by the employee, four physicians and one chiropractor competent to treat the particular case, from which the employee must select one. (Repealed and added by Stats. 1975, Ch. 1259.)
  94. 4603.2.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    This section sets notice, billing, payment, and review rules for medical treatment claims in workers’ compensation.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4603.2. (a) (1) Upon selecting a physician pursuant to Section 4600, the employee or physician shall notify the employer of the name and address, including the name of the medical group, if applicable, of the physician. The physician shall submit a report to the employer within five working days from the date of the initial examination, as required by Section 6409, and shall submit periodic reports at intervals that may be prescribed by rules and regulations adopted by the administrative director. (2) If the employer objects to the employee’s selection of the physician on the grounds that the physician is not within the medical provider network used by the employer, and there is a final determination that the employee was entitled to select the physician pursuant to Section 4600, the employee shall be entitled to continue treatment with that physician at the employer’s expense in accordance with this division, notwithstanding Section 4616.2. The employer shall be required to pay from the date of the initial examination if the physician’s report was submitted within five working days of the initial examination. If the physician’s report was submitted more than five working days after the initial examination, the employer and the employee shall not be required to pay for any services prior to the date the physician’s report was submitted. (3) If the employer objects to the employee’s selection of the physician on the grounds that the physician is not within the medical provider network used by the employer, and there is a final determination that the employee was not entitled to select a physician outside of the medical provider network, the employer is not liable for treatment provided by or at the direction of that physician or for any consequences of the treatment obtained outside the network. (b) (1) (A) A provider of services provided pursuant to Section 4600, including, but not limited to, physicians, hospitals, pharmacies, interpreters, copy services, transportation services, and home health care services, shall submit its request for payment with an itemization of services provided and the charge for each service, a copy of all reports showing the services performed, the prescription or referral from the primary treating physician if the services were performed by a person other than the primary treating physician, and any evidence of authorization for the services that may have been received. This section does not prohibit an employer, insurer, or third-party claims administrator from establishing, through written agreement, an alternative manual or electronic request for payment with providers for services provided pursuant to Section 4600. (B) Effective for services provided on or after January 1, 2017, the request for payment with an itemization of services provided and the charge for each service shall be submitted to the employer within 12 months of the date of service or within 12 months of the date of discharge for inpatient facility services. The administrative director shall adopt rules to implement the 12-month limitation period. The rules shall define circumstances that constitute good cause for an exception to the 12-month period, including provisions to address the circumstances of a nonoccupational injury or illness later found to be a compensable injury or illness. The request for payment is barred unless timely submitted. (C) The request for payment with an itemization of services provided and the charge for each service shall be submitted to the employer with the national provider identifier (NPI) number for the physician or provider who provided the service for which payment is sought in accordance with rules adopted by the administrative director pursuant to Section 4603.4. Failure to include the physician’s or provider’s NPI shall result in the request for payment being barred until the physician’s or provider’s NPI is submitted with the request for payment. This subparagraph does not preclude an employer, insurer, pharmacy benefit manager, or third-party claims administrator from requiring the physician’s or provider’s NPI at an earlier date. This subparagraph is declaratory of existing law. (D) Notwithstanding the requirements of this paragraph, a copy of the prescription shall not be required with a request for payment for pharmacy services, unless the provider of services has entered into a written agreement, as provided in this paragraph, that requires a copy of a prescription for a pharmacy service. (E) This section does not preclude an employer, insurer, pharmacy benefits manager, or third-party claims administrator from requesting a copy of the prescription during a review of any records of prescription drugs that were dispensed by a pharmacy. (2) Except as provided in subdivision (d) of Section 4603.4, or under contracts authorized under Section 5307.11, payment for medical treatment provided or prescribed by the treating physician selected by the employee or designated by the employer shall be made at reasonable maximum amounts in the official medical fee schedule, pursuant to Section 5307.1, in effect on the date of service. Payments shall be made by the employer with an explanation of review pursuant to Section 4603.3 within 45 days after receipt of each separate itemization of medical services provided, together with any required reports and any written authorization for services that may have been received by the physician. If the itemization or a portion thereof is contested, denied, or considered incomplete, the physician shall be notified, in the explanation of review, that the itemization is contested, denied, or considered incomplete, within 30 days after receipt of the itemization by the employer. An explanation of review that states an itemization is incomplete shall also state all additional information required to make a decision. A properly documented list of services provided and not paid at the rates then in effect under Section 5307.1 within the 45-day period shall be paid at the rates then in effect and increased by 15 percent, together with interest at the same rate as judgments in civil actions retroactive to the date of receipt of the itemization, unless the employer does both of the following: (A) Pays the provider at the rates in effect within the 45-day period. (B) Advises, in an explanation of review pursuant to Section 4603.3, the physician, or another provider of the items being contested, the reasons for contesting these items, and the remedies available to the physician or the other provider if the physician or provider disagrees. In the case of an itemization that includes services provided by a hospital, outpatient surgery center, or independent diagnostic facility, advice that a request has been made for an audit of the itemization shall satisfy the requirements of this paragraph. An employer’s liability to a physician or another provider under this section for delayed payments shall not affect its liability to an employee under Section 5814 or any other provision of this division. (3) Notwithstanding paragraph (1), if the employer is a governmental entity, payment for medical treatment provided or prescribed by the treating physician selected by the employee or designated by the employer shall be made within 60 days after receipt of each separate itemization, together with any required reports and any written authorization for services that may have been received by the physician. (4) Duplicate submissions of medical services itemizations, for which an explanation of review was previously provided, shall require no further or additional notification or objection by the employer to the medical provider and shall not subject the employer to any additional penalties or interest pursuant to this section for failing to respond to the duplicate submission. This paragraph applies only to duplicate submissions and does not apply to any other penalties or interest that may be applicable to the original submission. (5) (A) An employer may defer objecting to or paying any bill submitted by, or on behalf of, a provider whose liens are stayed pursuant to Section 4615, and the time limits for taking any action prescribed by paragraphs (2) and (3) shall not commence until the stay is lifted pursuant to Section 4615. (B) An employer may object to any bill submitted by, or on behalf of, a provider who has been suspended pursuant to Section 139.21. (c) Interest or an increase in compensation paid by an insurer pursuant to this section shall be treated in the same manner as an increase in compensation under subdivision (d) of Section 4650 for the purposes of any classification of risks and premium rates, and any system of merit rating approved or issued pursuant to Article 2 (commencing with Section 11730) of Chapter 3 of Part 3 of Division 2 of the Insurance Code. (d) (1) Whenever an employer or insurer employs an individual or contracts with an entity to conduct a review of an itemization submitted by a physician or medical provider, the employer or insurer shall make available to that individual or entity all documentation submitted together with that itemization by the physician or medical provider. When an individual or entity conducting an itemization review determines that additional information or documentation is necessary to review the itemization, the individual or entity shall contact the claims administrator or insurer to obtain the necessary information or documentation that was submitted by the physician or medical provider pursuant to subdivision (b). (2) (A) An individual or entity reviewing an itemization of service submitted by a physician or medical provider, including a medical provider network, an entity that provides ancillary services, as defined in Section 4616.5, or an entity providing services for or on behalf of the medical provider network or its providers, shall not alter the procedure codes listed or recommend reduction of the amount of the payment unless the documentation submitted by the physician or medical provider with the itemization of service has been reviewed by that individual or entity. If the reviewer does not recommend payment for services as itemized by the physician or medical provider, the explanation of review shall provide the physician or medical provider with a specific explanation as to why the reviewer altered the procedure code or changed other parts of the itemization and the specific deficiency in the itemization or documentation that caused the reviewer to conclude that the altered procedure code or amount recommended for payment more accurately represents the service performed. (B) The amendments to subparagraph (A) made by the act adding this subparagraph are declaratory of existing law. (e) (1) If the provider disputes the amount paid, the provider may request a second review within 90 days of service of the explanation of review or an order of the appeals board resolving the threshold issue as stated in the explanation of review pursuant to paragraph (5) of subdivision (a) of Section 4603.3. The request for a second review shall be submitted to the employer on a form prescribed by the administrative director and shall include all of the following: (A) The date of the explanation of review and the claim number or other unique identifying number provided on the explanation of review. (B) The item and amount in dispute. (C) The additional payment requested and the reason therefor. (D) The additional information provided in response to a request in the first explanation of review or any other additional information provided in support of the additional payment requested. (2) If the only dispute is the amount of payment and the provider does not request a second review within 90 days, the bill shall be deemed satisfied and neither the employer nor the employee shall be liable for any further payment. (3) Within 14 days of a request for second review, the employer shall respond with a final written determination on each of the items or amounts in dispute. Payment of any balance not in dispute shall be made within 21 days of receipt of the request for second review. This time limit may be extended by mutual written agreement. (4) If the provider contests the amount paid, after receipt of the second review, the provider shall request an independent bill review as provided for in Section 4603.6. (f) Except as provided in paragraph (4) of subdivision (e), the appeals board shall have jurisdiction over disputes arising out of this section pursuant to Section 5304. (Amended by Stats. 2019, Ch. 647, Sec. 5. (SB 537) Effective January 1, 2020.)
  95. 4603.3.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    An employer must give a review explanation when a medical services itemization is paid, adjusted, or denied, and the administrative director may require electronic versions.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4603.3. (a) Upon payment, adjustment, or denial of a complete or incomplete itemization of medical services, an employer shall provide an explanation of review in the manner prescribed by the administrative director that shall include all of the following: (1) A statement of the items or procedures billed and the amounts requested by the provider to be paid. (2) The amount paid. (3) The basis for any adjustment, change, or denial of the item or procedure billed. (4) The additional information required to make a decision for an incomplete itemization. (5) If a denial of payment is for some reason other than a fee dispute, the reason for the denial. (6) Information on whom to contact on behalf of the employer if a dispute arises over the payment of the billing. The explanation of review shall inform the medical provider of the time limit to raise any objection regarding the items or procedures paid or disputed and how to obtain an independent review of the medical bill pursuant to Section 4603.6. (b) The administrative director may adopt regulations requiring the use of electronic explanations of review. (Added by Stats. 2012, Ch. 363, Sec. 37. (SB 863) Effective January 1, 2013.)
  96. 4603.4.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    The administrative director must adopt rules for medical billing and electronic claims, and employers and providers must follow the related billing and acceptance requirements.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4603.4. (a) The administrative director shall adopt rules and regulations to do all of the following: (1) Ensure that all health care providers and facilities submit medical bills for payment on standardized forms. (2) Require acceptance by employers of electronic claims for payment of medical services. (3) Ensure confidentiality of medical information submitted on electronic claims for payment of medical services. (4) Require the timely submission of paper or electronic bills in conformity with subparagraph (B) of paragraph (1) of subdivision (b) of Section 4603.2. (b) To the extent feasible, standards adopted pursuant to subdivision (a) shall be consistent with existing standards under the federal Health Insurance Portability and Accountability Act of 1996. (c) Require all employers to accept electronic claims for payment of medical services. (d) Payment for medical treatment provided or prescribed by the treating physician selected by the employee or designated by the employer shall be made with an explanation of review by the employer within 15 working days after electronic receipt of an itemized electronic billing for services at or below the maximum fees provided in the official medical fee schedule adopted pursuant to Section 5307.1. If the billing is contested, denied, or incomplete, payment shall be made with an explanation of review of any uncontested amounts within 15 working days after electronic receipt of the billing, and payment of the balance shall be made in accordance with Section 4603.2. (Amended by Stats. 2016, Ch. 214, Sec. 2. (SB 1175) Effective January 1, 2017.)
  97. 4603.5.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    The administrative director must adopt notice rules, define reasonable geographic areas, and set time limits for notices and responses; employers must notify all employees of their rights under this section.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4603.5. The administrative director shall adopt rules pertaining to the format and content of notices required by this article; define reasonable geographic areas for the purposes of Section 4600; specify time limits for all such notices, and responses thereto; and adopt any other rules necessary to make effective the requirements of this article. Employers shall notify all employees of their rights under this section. (Added by Stats. 1975, Ch. 1259.)
  98. 4603.6.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    This section sets a process for independent bill review of a medical payment dispute, with deadlines for requesting review, submitting documents, assigning a reviewer, and appealing the determination.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4603.6. (a) If the only dispute is the amount of payment and the provider has received a second review that did not resolve the dispute, the provider may request an independent bill review within 30 calendar days of service of the second review pursuant to Section 4603.2 or 4622. If the provider fails to request an independent bill review within 30 days, the bill shall be deemed satisfied, and neither the employer nor the employee shall be liable for any further payment. If the employer has contested liability for any issue other than the reasonable amount payable for services, that issue shall be resolved prior to filing a request for independent bill review, and the time limit for requesting independent bill review shall not begin to run until the resolution of that issue becomes final, except as provided for in Section 4622. (b) A request for independent review shall be made on a form prescribed by the administrative director, and shall include copies of the original billing itemization, any supporting documents that were furnished with the original billing, the explanation of review, the request for second review together with any supporting documentation submitted with that request, and the final explanation of the second review. The administrative director may require that requests for independent bill review be submitted electronically. A copy of the request, together with all required documents, shall be served on the employer. Only the request form and the proof of payment of the fee required by subdivision (c) shall be filed with the administrative director. Upon notice of assignment of the independent bill reviewer, the requesting party shall submit the documents listed in this subdivision to the independent bill reviewer within 10 days. (c) The provider shall pay to the administrative director a fee determined by the administrative director to cover no more than the reasonable estimated cost of independent bill review and administration of the independent bill review program. The administrative director may prescribe different fees depending on the number of items in the bill or other criteria determined by regulation adopted by the administrative director. If any additional payment is found owing from the employer to the medical provider, the employer shall reimburse the provider for the fee in addition to the amount found owing. (d) Upon receipt of a request for independent bill review and the required fee, the administrative director or the administrative director’s designee shall assign the request to an independent bill reviewer within 30 days and notify the medical provider and employer of the independent reviewer assigned. (e) The independent bill reviewer shall review the materials submitted by the parties and make a written determination of any additional amounts to be paid to the medical provider and state the reasons for the determination. If the independent bill reviewer deems necessary, the independent bill reviewer may request additional documents from the medical provider or employer. The employer shall have no obligation to serve medical reports on the provider unless the reports are requested by the independent bill reviewer. If additional documents are requested, the parties shall respond with the documents requested within 30 days and shall provide the other party with copies of any documents submitted to the independent reviewer, and the independent reviewer shall make a written determination of any additional amounts to be paid to the medical provider and state the reasons for the determination within 60 days of the receipt of the administrative director’s assignment. The written determination of the independent bill reviewer shall be sent to the administrative director and provided to both the medical provider and the employer. (f) The determination of the independent bill reviewer shall be deemed a determination and order of the administrative director. The determination is final and binding on all parties unless an aggrieved party files with the appeals board a verified appeal from the medical bill review determination of the administrative director within 20 days of the service of the determination. The medical bill review determination of the administrative director shall be presumed to be correct and shall be set aside only upon clear and convincing evidence of one or more of the following grounds for appeal: (1) The administrative director acted without or in excess of his or her powers. (2) The determination of the administrative director was procured by fraud. (3) The independent bill reviewer was subject to a material conflict of interest that is in violation of Section 139.5. (4) The determination was the result of bias on the basis of race, national origin, ethnic group identification, religion, age, sex, sexual orientation, color, or disability. (5) The determination was the result of a plainly erroneous express or implied finding of fact, provided that the mistake of fact is a matter of ordinary knowledge based on the information submitted for review and not a matter that is subject to expert opinion. (g) If the determination of the administrative director is reversed, the dispute shall be remanded to the administrative director to submit the dispute to independent bill review by a different independent review organization. In the event that a different independent bill review organization is not available after remand, the administrative director shall submit the dispute to the original bill review organization for review by a different reviewer within the organization. In no event shall the appeals board or any higher court make a determination of ultimate fact contrary to the determination of the bill review organization. (h) Once the independent bill reviewer has made a determination regarding additional amounts to be paid to the medical provider, the employer shall pay the additional amounts per the timely payment requirements set forth in Sections 4603.2 and 4603.4. (Added by Stats. 2012, Ch. 363, Sec. 39. (SB 863) Effective January 1, 2013.)
  99. 4604.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    The appeals board must determine disputes between an employer and employee under this chapter if either party requests it, unless Section 4610.5 provides otherwise.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4604. Controversies between employer and employee arising under this chapter shall be determined by the appeals board, upon the request of either party, except as otherwise provided by Section 4610.5. (Amended by Stats. 2012, Ch. 363, Sec. 40. (SB 863) Effective January 1, 2013.)
  100. 4604.5.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    This section limits certain therapy visits for injured workers, with exceptions for written employer authorization and postsurgical services, and ties treatment guidelines to evidence-based standards.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4604.5. (a) The recommended guidelines set forth in the medical treatment utilization schedule adopted by the administrative director pursuant to Section 5307.27 shall be presumptively correct on the issue of extent and scope of medical treatment. The presumption is rebuttable and may be controverted by a preponderance of the scientific medical evidence establishing that a variance from the guidelines reasonably is required to cure or relieve the injured worker from the effects of his or her injury. The presumption created is one affecting the burden of proof. (b) The recommended guidelines set forth in the schedule adopted pursuant to subdivision (a) shall reflect practices that are evidence and scientifically based, nationally recognized, and peer reviewed. The guidelines shall be designed to assist providers by offering an analytical framework for the evaluation and treatment of injured workers, and shall constitute care in accordance with Section 4600 for all injured workers diagnosed with industrial conditions. (c) (1) Notwithstanding the medical treatment utilization schedule, for injuries occurring on and after January 1, 2004, an employee shall be entitled to no more than 24 chiropractic, 24 occupational therapy, and 24 physical therapy visits per industrial injury. (2) (A) Paragraph (1) shall not apply when an employer authorizes, in writing, additional visits to a health care practitioner for physical medicine services. Payment or authorization for treatment beyond the limits set forth in paragraph (1) shall not be deemed a waiver of the limits set forth by paragraph (1) with respect to future requests for authorization. (B) The Legislature finds and declares that the amendments made to subparagraph (A) by the act adding this subparagraph are declaratory of existing law. (3) Paragraph (1) shall not apply to visits for postsurgical physical medicine and postsurgical rehabilitation services provided in compliance with a postsurgical treatment utilization schedule established by the administrative director pursuant to Section 5307.27. (d) For all injuries not covered by the official utilization schedule adopted pursuant to Section 5307.27, authorized treatment shall be in accordance with other evidence-based medical treatment guidelines that are recognized generally by the national medical community and scientifically based. (Amended by Stats. 2012, Ch. 363, Sec. 41. (SB 863) Effective January 1, 2013.)
  101. 4605.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    An employee may hire a consulting doctor or attending doctors at the employee’s own expense, and certain medical evaluators or treating physicians must review any report made under this section and state whether they agree with it and why.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4605. Nothing contained in this chapter shall limit the right of the employee to provide, at his or her own expense, a consulting physician or any attending physicians whom he or she desires. Any report prepared by consulting or attending physicians pursuant to this section shall not be the sole basis of an award of compensation. A qualified medical evaluator or authorized treating physician shall address any report procured pursuant to this section and shall indicate whether he or she agrees or disagrees with the findings or opinions stated in the report, and shall identify the bases for this opinion. (Amended by Stats. 2012, Ch. 363, Sec. 42. (SB 863) Effective January 1, 2013.)
  102. 4606.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Certain public entities that were self-insured employers may provide specified medical and hospital treatment for covered former employees, if the entity’s governing body adopts a resolution.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4606. Any county, city and county, city, school district, or other public corporation within the state which was a self-insured employer under the “Workmen’s Compensation, Insurance and Safety Act,” enacted by Chapter 176 of the Statutes of 1913, may provide such medical, and hospital treatment, including nursing, medicines, medical and surgical supplies, crutches, and apparatus, including artificial members, which is reasonably required to cure or relieve from the effects of an injury to a former employee who was covered under such act, without regard to the 90-day limitation of subdivision (a) of Section 15 of such act for medical treatment. The provisions of this section shall not be operative in any such county, city and county, city, school district, or other public corporation unless adopted by a resolution of the governing body of such public entity. (Added by Stats. 1972, Ch. 451.)
  103. 4607.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    If someone tries and fails to end an appeals board award for continuing medical treatment, the appeals board may set reasonable attorney’s fees and charge them as costs to that person.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4607. Where a party to a proceeding institutes proceedings to terminate an award made by the appeals board to an applicant for continuing medical treatment and is unsuccessful in such proceedings, the appeals board may determine the amount of attorney’s fees reasonably incurred by the applicant in resisting the proceeding to terminate the medical treatment, and may assess such reasonable attorney’s fees as a cost upon the party instituting the proceedings to terminate the award of the appeals board. (Added by Stats. 1973, Ch. 663.)
  104. 4608.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Workers’ compensation insurers, self-insured employers, and their agents may not refuse to pay pharmacy benefits just because the claim form was reproduced, if the reproduced form is an exact copy.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4608. No workers’ compensation insurer, self-insured employer, or agent of an insurer or self-insured employer, shall refuse to pay pharmacy benefits solely because the claim form utilized is reproduced by the person providing the pharmacy benefits, provided the reproduced form is an exact copy of that used by the insurer, self-insured employer, or agent. (Added by Stats. 1984, Ch. 137, Sec. 1.)
  105. 4609.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    This section requires contracting agents and certain payors to disclose network and contracted-rate information, and it sets deadlines for providing summaries, website/phone access, and proof of entitlement to contracted rates.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4609. (a) In order to prevent the improper selling, leasing, or transferring of a health care provider’s contract, it is the intent of the Legislature that every arrangement that results in any payor paying a health care provider a reduced rate for health care services based on the health care provider’s participation in a network or panel shall be disclosed by the contracting agent to the provider in advance and shall actively encourage employees to use the network, unless the health care provider agrees to provide discounts without that active encouragement. (b) Beginning July 1, 2000, every contracting agent that sells, leases, assigns, transfers, or conveys its list of contracted health care providers and their contracted reimbursement rates to a payor, as defined in subparagraph (A) of paragraph (3) of subdivision (d), or another contracting agent shall, upon entering or renewing a provider contract, do all of the following: (1) Disclose whether the list of contracted providers may be sold, leased, transferred, or conveyed to other payors or other contracting agents, and specify whether those payors or contracting agents include workers’ compensation insurers or automobile insurers. (2) Disclose what specific practices, if any, payors utilize to actively encourage employees to use the list of contracted providers when obtaining medical care that entitles a payor to claim a contracted rate. For purposes of this paragraph, a payor is deemed to have actively encouraged employees to use the list of contracted providers if the employer provides information directly to employees during the period the employer has medical control advising them of the existence of the list of contracted providers through the use of a variety of advertising or marketing approaches that supply the names, addresses, and telephone numbers of contracted providers to employees; or in advance of a workplace injury, or upon notice of an injury or claim by an employee, the approaches may include, but are not limited to, the use of provider directories, the use of a list of all contracted providers in an area geographically accessible to the posting site, the use of wall cards that direct employees to a readily accessible listing of those providers at the same location as the wall cards, the use of wall cards that direct employees to a toll-free telephone number or Internet Web site address, or the use of toll-free telephone numbers or Internet Web site addresses supplied directly during the period the employer has medical control. However, Internet Web site addresses alone shall not be deemed to satisfy the requirements of this paragraph. Nothing in this paragraph shall prevent contracting agents or payors from providing only listings of providers located within a reasonable geographic range of an employee. A payor who otherwise meets the requirements of this paragraph is deemed to have met the requirements of this paragraph regardless of the employer’s ability to control medical treatment pursuant to Sections 4600 and 4600.3. (3) Disclose whether payors to which the list of contracted providers may be sold, leased, transferred, or conveyed may be permitted to pay a provider’s contracted rate without actively encouraging the employees to use the list of contracted providers when obtaining medical care. Nothing in this subdivision shall be construed to require a payor to actively encourage the employees to use the list of contracted providers when obtaining medical care in the case of an emergency. (4) Disclose, upon the initial signing of a contract, and within 15 business days of receipt of a written request from a provider or provider panel, a payor summary of all payors currently eligible to claim a provider’s contracted rate due to the provider’s and payor’s respective written agreements with any contracting agent. (5) Allow providers, upon the initial signing, renewal, or amendment of a provider contract, to decline to be included in any list of contracted providers that is sold, leased, transferred, or conveyed to payors that do not actively encourage the employees to use the list of contracted providers when obtaining medical care as described in paragraph (2). Each provider’s election under this paragraph shall be binding on the contracting agent with which the provider has the contract and any other contracting agent that buys, leases, or otherwise obtains the list of contracted providers. A provider shall not be excluded from any list of contracted providers that is sold, leased, transferred, or conveyed to payors that actively encourage the employees to use the list of contracted providers when obtaining medical care, based upon the provider’s refusal to be included on any list of contracted providers that is sold, leased, transferred, or conveyed to payors that do not actively encourage the employees to use the list of contracted providers when obtaining medical care. (6) If the payor’s explanation of benefits or explanation of review does not identify the name of the network that has a written agreement signed by the provider whereby the payor is entitled, directly or indirectly, to pay a preferred rate for the services rendered, the contracting agent shall do the following: (A) Maintain a Web site that is accessible to all contracted providers and updated at least quarterly and maintain a toll-free telephone number accessible to all contracted providers whereby providers may access payor summary information. (B) Disclose through the use of an Internet Web site, a toll-free telephone number, or through a delivery or mail service to its contracted providers, within 30 days, any sale, lease assignment, transfer or conveyance of the contracted reimbursement rates to another contracting agent or payor. (7) Nothing in this subdivision shall be construed to impose requirements or regulations upon payors, as defined in subparagraph (A) of paragraph (3) of subdivision (d). (c) Beginning July 1, 2000, a payor, as defined in subparagraph (B) of paragraph (3) of subdivision (d), shall do all of the following: (1) Provide an explanation of benefits or explanation of review that identifies the name of the network with which the payor has an agreement that entitles them to pay a preferred rate for the services rendered. (2) Demonstrate that it is entitled to pay a contracted rate within 30 business days of receipt of a written request from a provider who has received a claim payment from the payor. The provider shall include in the request a statement explaining why the payment is not at the correct contracted rate for the services provided. The failure of the provider to include a statement shall relieve the payor from the responsibility of demonstrating that it is entitled to pay the disputed contracted rate. The failure of a payor to make the demonstration to a properly documented request of the provider within 30 business days shall render the payor responsible for the lesser of the provider’s actual fee or, as applicable, any fee schedule pursuant to this division, which amount shall be due and payable within 10 days of receipt of written notice from the provider, and shall bar the payor from taking any future discounts from that provider without the provider’s express written consent until the payor can demonstrate to the provider that it is entitled to pay a contracted rate as provided in this subdivision. A payor shall be deemed to have demonstrated that it is entitled to pay a contracted rate if it complies with either of the following: (A) Describes the specific practices the payor utilizes to comply with paragraph (2) of subdivision (b), and demonstrates compliance with paragraph (1). (B) Identifies the contracting agent with whom the payor has a written agreement whereby the payor is not required to actively encourage employees to use the list of contracted providers pursuant to paragraph (5) of subdivision (b). (d) For the purposes of this section, the following terms have the following meanings: (1) “Contracting agent” means an insurer licensed under the Insurance Code to provide workers’ compensation insurance, a health care service plan, including a specialized health care service plan, a preferred provider organization, or a self-insured employer, while engaged, for monetary or other consideration, in the act of selling, leasing, transferring, assigning, or conveying a provider or provider panel to provide health care services to employees for work-related injuries. (2) “Employee” means a person entitled to seek health care services for a work-related injury. (3) (A) For the purposes of subdivision (b), “payor” means a health care service plan, including a specialized health care service plan, an insurer licensed under the Insurance Code to provide disability insurance that covers hospital, medical, or surgical benefits, automobile insurance, or workers’ compensation insurance, or a self-insured employer that is responsible to pay for health care services provided to beneficiaries. (B) For the purposes of subdivision (c), “payor” means an insurer licensed under the Insurance Code to provide workers’ compensation insurance, a self-insured employer, a third-party administrator or trust, or any other third party that is responsible to pay health care services provided to employees for work-related injuries, or an agent of an entity included in this definition. (4) “Payor summary” means a written summary that includes the payor’s name and the type of plan, including, but not limited to, a group health plan, an automobile insurance plan, and a workers’ compensation insurance plan. (5) “Provider” means any of the following: (A) Any person licensed or certified pursuant to Division 2 (commencing with Section 500) of the Business and Professions Code. (B) Any person licensed pursuant to the Chiropractic Initiative Act or the Osteopathic Initiative Act. (C) Any person licensed pursuant to Chapter 2.5 (commencing with Section 1440) of Division 2 of the Health and Safety Code. (D) A clinic, health dispensary, or health facility licensed pursuant to Division 2 (commencing with Section 1200) of the Health and Safety Code. (E) Any entity exempt from licensure pursuant to Section 1206 of the Health and Safety Code. (e) This section shall become operative on July 1, 2000. (Amended by Stats. 2001, Ch. 159, Sec. 159. Effective January 1, 2002.)
  106. 4610.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    This section requires employers to run a utilization review process for medical treatment and sets rules and deadlines for requests, reviews, disclosures, and reporting.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4610. (a) For purposes of this section, “utilization review” means utilization review or utilization management functions that prospectively, retrospectively, or concurrently review and approve, modify, or deny, based in whole or in part on medical necessity to cure and relieve, treatment recommendations by physicians, as defined in Section 3209.3, prior to, retrospectively, or concurrent with the provision of medical treatment services pursuant to Section 4600. (b) For all dates of injury occurring on or after January 1, 2018, emergency treatment services and medical treatment rendered for a body part or condition that is accepted as compensable by the employer and is addressed by the medical treatment utilization schedule adopted pursuant to Section 5307.27, by a member of the medical provider network or health care organization, or by a physician predesignated pursuant to subdivision (d) of Section 4600, within the 30 days following the initial date of injury, shall be authorized without prospective utilization review, except as provided in subdivision (c). The services rendered under this subdivision shall be consistent with the medical treatment utilization schedule. In the event that the employee is not subject to treatment with a medical provider network, health care organization, or predesignated physician pursuant to subdivision (d) of Section 4600, the employee shall be eligible for treatment under this section within 30 days following the initial date of injury if the treatment is rendered by a physician or facility selected by the employer. For treatment rendered by a medical provider network physician, health care organization physician, a physician predesignated pursuant to subdivision (d) of Section 4600, or an employer-selected physician, the report required under Section 6409 and a complete request for authorization shall be submitted by the physician within five days following the employee’s initial visit and evaluation. (c) Unless authorized by the employer or rendered as emergency medical treatment, the following medical treatment services, as defined in rules adopted by the administrative director, that are rendered through a member of the medical provider network or health care organization, a predesignated physician, an employer-selected physician, or an employer-selected facility, within the 30 days following the initial date of injury, shall be subject to prospective utilization review under this section: (1) Pharmaceuticals, to the extent they are neither expressly exempted from prospective review nor authorized by the drug formulary adopted pursuant to Section 5307.27. (2) Nonemergency inpatient and outpatient surgery, including all presurgical and postsurgical services. (3) Psychological treatment services. (4) Home health care services. (5) Imaging and radiology services, excluding x-rays. (6) All durable medical equipment, whose combined total value exceeds two hundred fifty dollars ($250), as determined by the official medical fee schedule. (7) Electrodiagnostic medicine, including, but not limited to, electromyography and nerve conduction studies. (8) Any other service designated and defined through rules adopted by the administrative director. (d) (1) Except for emergency treatment services, any request for payment for treatment provided under subdivision (b) shall comply with Section 4603.2 and be submitted to the employer, or its insurer or claims administrator, within 30 days of the date the service was provided. (2) (A) In the case of emergency treatment services, any request for payment for treatment provided under subdivision (b) shall comply with Section 4603.2 and be submitted to the employer, or its insurer or claims administrator, within 180 days of the date the service was provided. (B) For the purposes of this subdivision, “emergency treatment services” means treatment for an emergency medical condition defined in subdivision (b) of Section 1317.1 of the Health and Safety Code and provided in a licensed general acute care hospital, as defined in Section 1250 of the Health and Safety Code. (e) If a physician fails to submit the report required under Section 6409 and a complete request for authorization, as described in subdivision (b), an employer may remove the physician’s ability under this subdivision to provide further medical treatment to the employee that is exempt from prospective utilization review. (f) An employer may perform retrospective utilization review for any treatment provided pursuant to subdivision (b) solely for the purpose of determining if the physician is prescribing treatment consistent with the schedule for medical treatment utilization, including, but not limited to, the drug formulary adopted pursuant to Section 5307.27. (1) If it is found after retrospective utilization reviews that there is a pattern and practice of the physician or provider failing to render treatment consistent with the schedule for medical treatment utilization, including the drug formulary, the employer may remove the ability of the predesignated physician, employer-selected physician, or the member of the medical provider network or health care organization under this subdivision to provide further medical treatment to any employee that is exempt from prospective utilization review. The employer shall notify the physician or provider of the results of the retrospective utilization review and the requirement for prospective utilization review for all subsequent medical treatment. (2) The results of retrospective utilization review may constitute a showing of good cause for an employer’s petition requesting a change of physician or provider pursuant to Section 4603 and may serve as grounds for termination of the physician or provider from the medical provider network or health care organization. (g) Each employer shall establish a utilization review process in compliance with this section, either directly or through its insurer or an entity with which an employer or insurer contracts for these services. (1) Each utilization review process that modifies or denies requests for authorization of medical treatment shall be governed by written policies and procedures. These policies and procedures shall ensure that decisions based on the medical necessity to cure and relieve of proposed medical treatment services are consistent with the schedule for medical treatment utilization, including the drug formulary, adopted pursuant to Section 5307.27. (2) (A) Unless otherwise indicated in this section, a physician providing treatment under Section 4600 shall send any request for authorization for medical treatment, with supporting documentation, to the claims administrator for the employer, insurer, or other entity according to rules adopted by the administrative director. The employer, insurer, or other entity shall employ or designate a medical director who holds an unrestricted license to practice medicine in this state issued pursuant to Section 2050 or 2450 of the Business and Professions Code. The medical director shall ensure that the process by which the employer or other entity reviews and approves, modifies, or denies requests by physicians prior to, retrospectively, or concurrent with the provision of medical treatment services complies with the requirements of this section. This section does not limit the existing authority of the Medical Board of California. (B) A request for authorization, including its supporting documentation, shall not be altered or amended by any entity other than the requesting physician or provider prior to the submission of the request to the claims administrator in accordance with subparagraph (A). This subparagraph is declaratory of existing law. (3) (A) A person other than a licensed physician who is competent to evaluate the specific clinical issues involved in the medical treatment services, if these services are within the scope of the physician’s practice, requested by the physician, shall not modify or deny requests for authorization of medical treatment for reasons of medical necessity to cure and relieve or due to incomplete or insufficient information under subdivisions (i) and (j). (B) (i) The employer, or any entity conducting utilization review on behalf of the employer, shall neither offer nor provide any financial incentive or consideration to a physician based on the number of modifications or denials made by the physician under this section. (ii) An insurer or third-party administrator shall not refer utilization review services conducted on behalf of an employer under this section to an entity in which the insurer or third-party administrator has a financial interest as defined under Section 139.32. This prohibition does not apply if the insurer or third-party administrator provides the employer and the administrative director with prior written disclosure of both of the following: (I) The entity conducting the utilization review services. (II) The insurer or third-party administrator’s financial interest in the entity. (C) The administrative director has authority pursuant to this section to review any compensation agreement, payment schedule, or contract between the employer, or any entity conducting utilization review on behalf of the employer, and the utilization review physician. Any information disclosed to the administrative director pursuant to this paragraph shall be considered confidential information and not subject to disclosure pursuant to the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code). Disclosure of the information to the administrative director pursuant to this subdivision shall not waive the provisions of the Evidence Code relating to privilege. (4) A utilization review process that modifies or denies requests for authorization of medical treatment shall be accredited on or before July 1, 2018, and shall retain active accreditation while providing utilization review services, by an independent, nonprofit organization to certify that the utilization review process meets specified criteria, including, but not limited to, timeliness in issuing a utilization review decision, the scope of medical material used in issuing a utilization review decision, peer-to-peer consultation, internal appeal procedure, and requiring a policy preventing financial incentives to doctors and other providers based on the utilization review decision. The administrative director shall adopt rules to implement the selection of an independent, nonprofit organization for those accreditation purposes. Until those rules are adopted, the administrative director shall designate URAC as the accrediting organization. The administrative director may adopt rules to do any of the following: (A) Require additional specific criteria for measuring the quality of a utilization review process for purposes of accreditation. (B) Exempt nonprofit, public sector internal utilization review programs from the accreditation requirement pursuant to this section, if the administrative director has adopted minimum standards applicable to nonprofit, public sector internal utilization review programs that meet or exceed the accreditation standards developed pursuant to this section. (5) On or before July 1, 2018, each employer, either directly or through its insurer or an entity with which an employer or insurer contracts for utilization review services, shall submit a description of the utilization review process that modifies or denies requests for authorization of medical treatment and the written policies and procedures to the administrative director for approval. Approved utilization review process descriptions and the accompanying written policies and procedures shall be disclosed by the employer to employees and physicians and made available to the public by posting on the employer’s, claims administrator’s, or utilization review organization’s internet website. (h) The criteria or guidelines used in the utilization review process to determine whether to approve, modify, or deny medical treatment services shall be all of the following: (1) Developed with involvement from actively practicing physicians. (2) Consistent with the schedule for medical treatment utilization, including the drug formulary, adopted pursuant to Section 5307.27. (3) Evaluated at least annually, and updated if necessary. (4) Disclosed to the physician and the employee, if used as the basis of a decision to modify or deny services in a specified case under review. (5) Available to the public upon request. An employer shall only be required to disclose the criteria or guidelines for the specific procedures or conditions requested. An employer may charge members of the public reasonable copying and postage expenses related to disclosing criteria or guidelines pursuant to this paragraph. Criteria or guidelines may also be made available through electronic means. A charge shall not be required for an employee whose physician’s request for medical treatment services is under review. (i) In determining whether to approve, modify, or deny requests by physicians prior to, retrospectively, or concurrent with the provisions of medical treatment services to employees, all of the following requirements shall be met: (1) Except for treatment requests made pursuant to the formulary, prospective or concurrent decisions shall be made in a timely fashion that is appropriate for the nature of the employee’s condition, not to exceed five normal business days from the receipt of a request for authorization for medical treatment and supporting information reasonably necessary to make the determination, but in no event more than 14 days from the date of the medical treatment recommendation by the physician. Prospective decisions regarding requests for treatment covered by the formulary shall be made no more than five normal business days from the date of receipt of the medical treatment request. The request for authorization and supporting documentation may be submitted electronically under rules adopted by the administrative director. (2) In cases where the review is retrospective, a decision resulting in denial of all or part of the medical treatment service shall be communicated to the individual who received services, or to the individual’s designee, within 30 days of the receipt of the information that is reasonably necessary to make this determination. If payment for a medical treatment service is made within the time prescribed by Section 4603.2, a retrospective decision to approve the service need not otherwise be communicated. (3) If the employee’s condition is one in which the employee faces an imminent and serious threat to the employee’s health, including, but not limited to, the potential loss of life, limb, or other major bodily function, or the normal timeframe for the decisionmaking process, as described in paragraph (1), would be detrimental to the employee’s life or health or could jeopardize the employee’s ability to regain maximum function, decisions to approve, modify, or deny requests by physicians prior to, or concurrent with, the provision of medical treatment services to employees shall be made in a timely fashion that is appropriate for the nature of the employee’s condition, but not to exceed 72 hours after the receipt of the information reasonably necessary to make the determination. (4) (A) Final decisions to approve, modify, or deny requests by physicians for authorization prior to, or concurrent with, the provision of medical treatment services to employees shall be communicated to the requesting physician within 24 hours of the decision by telephone, facsimile, or, if agreed to by the parties, secure email. (B) Decisions resulting in modification or denial of all or part of the requested health care service shall be communicated in writing to the employee, and to the physician if the initial communication under subparagraph (A) was by telephone, within 24 hours for concurrent review, or within two normal business days of the decision for prospective review, as prescribed by the administrative director. If the request is modified or denied, disputes shall be resolved in accordance with Section 4610.5, if applicable, or otherwise in accordance with Section 4062. (C) In the case of concurrent review, medical care shall not be discontinued until the employee’s physician has been notified of the decision and a care plan has been agreed upon by the physician that is appropriate for the medical needs of the employee. Medical care provided during a concurrent review shall be care that is medically necessary to cure and relieve, and an insurer or self-insured employer shall only be liable for those services determined medically necessary to cure and relieve. If the insurer or self-insured employer disputes whether or not one or more services offered concurrently with a utilization review were medically necessary to cure and relieve, the dispute shall be resolved pursuant to Section 4610.5, if applicable, or otherwise pursuant to Section 4062. A compromise between the parties that an insurer or self-insured employer believes may result in payment for services that were not medically necessary to cure and relieve shall be reported by the insurer or the self-insured employer to the licensing board of the provider or providers who received the payments, in a manner set forth by the respective board and in a way that minimizes reporting costs both to the board and to the insurer or self-insured employer, for evaluation as to possible violations of the statutes governing appropriate professional practices. Fees shall not be levied upon insurers or self-insured employers making reports required by this section. (5) Communications regarding decisions to approve requests by physicians shall specify the specific medical treatment service approved. Responses regarding decisions to modify or deny medical treatment services requested by physicians shall include a clear and concise explanation of the reasons for the employer’s decision, a description of the criteria or guidelines used, and the clinical reasons for the decisions regarding medical necessity. If a utilization review decision to deny a medical service is due to incomplete or insufficient information, the decision shall specify all of the following: (A) The reason for the decision. (B) A specific description of the information that is needed. (C) The date and time of attempts made to contact the physician to obtain the necessary information. (D) A description of the manner in which the request was communicated. (j) (1) Unless otherwise indicated in this section, a physician providing treatment under Section 4600 shall send any request for authorization for medical treatment, with supporting documentation, to the claims administrator for the employer, insurer, or other entity according to rules adopted by the administrative director. If an employer, insurer, or other entity subject to this section requests medical information from a physician in order to determine whether to approve, modify, or deny requests for authorization, that employer, insurer, or other entity shall request only the information reasonably necessary to make the determination. (2) If the employer, insurer, or other entity cannot make a decision within the timeframes specified in paragraph (1), (2), or (3) of subdivision (i) because the employer or other entity is not in receipt of, or in possession of, all of the information reasonably necessary to make a determination, the employer shall immediately notify the physician and the employee, in writing, that the employer cannot make a decision within the required timeframe, and specify the information that must be provided by the physician for a determination to be made. Upon receipt of all information reasonably necessary and requested by the employer, the employer shall approve, modify, or deny the request for authorization within the timeframes specified in paragraph (1), (2), or (3) of subdivision (i). (k) A utilization review decision to modify or deny a treatment recommendation shall remain effective for 12 months from the date of the decision without further action by the employer with regard to a further recommendation by the same physician, or another physician within the requesting physician’s practice group, for the same treatment unless the further recommendation is supported by a documented change in the facts material to the basis of the utilization review decision. (l) Utilization review of a treatment recommendation shall not be required while the employer is disputing liability for injury or treatment of the condition for which treatment is recommended pursuant to Section 4062. (m) If utilization review is deferred pursuant to subdivision (l), and it is finally determined that the employer is liable for treatment of the condition for which treatment is recommended, the time for the employer to conduct retrospective utilization review in accordance with paragraph (2) of subdivision (i) shall begin on the date the determination of the employer’s liability becomes final, and the time for the employer to conduct prospective utilization review shall commence from the date of the employer’s receipt of a treatment recommendation after the determination of the employer’s liability. (n) Each employer, insurer, or other entity subject to this section shall maintain telephone access during California business hours for physicians to request authorization for health care services and to conduct peer-to-peer discussions regarding issues, including the appropriateness of a requested treatment, modification of a treatment request, or obtaining additional information needed to make a medical necessity decision. (o) The administrative director shall develop a system for the mandatory electronic reporting of documents related to every utilization review performed by each employer, which shall be administered by the Division of Workers’ Compensation. The administrative director shall adopt regulations specifying the documents to be submitted by the employer and the authorized transmission format and timeframe for their submission. For purposes of this subdivision, “employer” means the employer, the insurer of an insured employer, a claims administrator, or a utilization review organization, or other entity acting on behalf of any of them. (p) If the administrative director determines that the employer, insurer, or other entity subject to this section has failed to meet any of the timeframes in this section, or has failed to meet any other requirement of this section, the administrative director may assess, by order, administrative penalties for each failure. A proceeding for the issuance of an order assessing administrative penalties shall be subject to appropriate notice to, and an opportunity for a hearing with regard to, the person affected. The administrative penalties shall not be deemed to be an exclusive remedy for the administrative director. These penalties shall be deposited in the Workers’ Compensation Administration Revolving Fund. (q) The administrative director shall contract with an outside, independent research organization to evaluate the impact of the provision of medical treatment within the first 30 days after a claim is filed, for a claim filed on or after January 1, 2017, and before January 1, 2021. The report shall be provided to the administrative director, the Senate Committee on Labor and Industrial Relations, and the Assembly Committee on Insurance, pursuant to Section 9795 of the Government Code, before July 1, 2023. (Amended by Stats. 2023, Ch. 131, Sec. 143. (AB 1754) Effective January 1, 2024.)
  107. 4610.1.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    An employee is generally not entitled to a Section 5814 increase for delay caused by needed utilization review, but that does not bar an increase when the employer unreasonably delays or denies treatment because review completion was unreasonably delayed.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4610.1. An employee shall not be entitled to an increase in compensation under Section 5814 for unreasonable delay in the provision of medical treatment for periods of time necessary to complete the utilization review process in compliance with Section 4610. A determination by the appeals board or a final determination of the administrative director pursuant to independent medical review that medical treatment is appropriate shall not be conclusive evidence that medical treatment was unreasonably delayed or denied for purposes of penalties under Section 5814. In no case shall this section preclude an employee from entitlement to an increase in compensation under Section 5814 when an employer has unreasonably delayed or denied medical treatment due to an unreasonable delay in completion of the utilization review process set forth in Section 4610. (Amended by Stats. 2012, Ch. 363, Sec. 44. (SB 863) Effective January 1, 2013.)
  108. 4610.3.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    An employer generally cannot take back or change authorization for medical treatment after the treatment has been provided.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4610.3. (a) Regardless of whether an employer has established a medical provider network pursuant to Section 4616 or entered into a contract with a health care organization pursuant to Section 4600.5, an employer that authorizes medical treatment shall not rescind or modify that authorization after the medical treatment has been provided based on that authorization for any reason, including, but not limited to, the employer’s subsequent determination that the physician who treated the employee was not eligible to treat that injured employee. If the authorized medical treatment consists of a series of treatments or services, the employer may rescind or modify the authorization only for the treatments or services that have not already been provided. (b) This section shall not be construed to expand or alter the benefits available under, or the terms and conditions of, any contract, including, but not limited to, existing medical provider network and health care organization contracts. (c) This section shall not be construed to impact the ability of the employer to transfer treatment of an injured employee into a medical provider network or health care organization. This subdivision is declaratory of existing law. (d) This section shall not be construed to establish that a provider of authorized medical treatment is the physician primarily responsible for managing the injured employee’s care for purposes of rendering opinions on all medical issues necessary to determine eligibility for compensation. (Added by Stats. 2009, Ch. 436, Sec. 1. (AB 361) Effective January 1, 2010.)
  109. 4610.5.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    This section sets the process and deadlines for independent medical review of certain utilization review disputes about medical treatment or medication.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4610.5. (a) This section applies to the following disputes: (1) Any dispute over a utilization review decision regarding treatment for an injury occurring on or after January 1, 2013. (2) Any dispute over a utilization review decision if the decision is communicated to the requesting physician on or after July 1, 2013, regardless of the date of injury. (3) Any dispute occurring on or after January 1, 2018, over medication prescribed pursuant to the drug formulary adopted pursuant to Section 5307.27. (b) A dispute described in subdivision (a) shall be resolved only in accordance with this section. (c) For purposes of this section and Section 4610.6, the following definitions apply: (1) “Disputed medical treatment” means medical treatment that has been modified or denied by a utilization review decision on the basis of medical necessity. (2) “Medically necessary” and “medical necessity” mean medical treatment that is reasonably required to cure or relieve the injured employee of the effects of his or her injury and based on the following standards, which shall be applied as set forth in the medical treatment utilization schedule, including the drug formulary, adopted by the administrative director pursuant to Section 5307.27: (A) The guidelines, including the drug formulary, adopted by the administrative director pursuant to Section 5307.27. (B) Peer-reviewed scientific and medical evidence regarding the effectiveness of the disputed service. (C) Nationally recognized professional standards. (D) Expert opinion. (E) Generally accepted standards of medical practice. (F) Treatments that are likely to provide a benefit to a patient for conditions for which other treatments are not clinically efficacious. (3) “Utilization review decision” means a decision pursuant to Section 4610 to modify or deny, based in whole or in part on medical necessity to cure or relieve, a treatment recommendation or recommendations by a physician prior to, retrospectively, or concurrent with, the provision of medical treatment services pursuant to Section 4600 or subdivision (c) of Section 5402. “Utilization review decision” may also mean a determination, occurring on or after January 1, 2018, by a physician regarding the medical necessity of medication prescribed pursuant to the drug formulary adopted pursuant to Section 5307.27. (4) Unless otherwise indicated by context, “employer” means the employer, the insurer of an insured employer, a claims administrator, or a utilization review organization, or other entity acting on behalf of any of them. (d) If a utilization review decision denies or modifies a treatment recommendation based on medical necessity, the employee may request an independent medical review as provided by this section. (e) A utilization review decision may be reviewed or appealed only by independent medical review pursuant to this section. Neither the employee nor the employer shall have any liability for medical treatment furnished without the authorization of the employer if the treatment is modified or denied by a utilization review decision, unless the utilization review decision is overturned by independent medical review in accordance with this section. (f) As part of its notification to the employee regarding an initial utilization review decision based on medical necessity that denies or modifies a treatment recommendation, the employer shall provide the employee with a one-page form prescribed by the administrative director, and an addressed envelope, which the employee may return to the administrative director or the administrative director’s designee to initiate an independent medical review. The employee may also request independent medical review electronically under rules adopted by the administrative director. The employer shall include on the form any information required by the administrative director to facilitate the completion of the independent medical review. The form shall also include all of the following: (1) Notice that the utilization review decision is final unless the employee requests independent medical review. (2) A statement indicating the employee’s consent to obtain any necessary medical records from the employer or insurer and from any medical provider the employee may have consulted on the matter, to be signed by the employee. (3) Notice of the employee’s right to provide information or documentation, either directly or through the employee’s physician, regarding the following: (A) The treating physician’s recommendation indicating that the disputed medical treatment is medically necessary for the employee’s medical condition. (B) Medical information or justification that a disputed medical treatment, on an urgent care or emergency basis, was medically necessary for the employee’s medical condition. (C) Reasonable information supporting the employee’s position that the disputed medical treatment is or was medically necessary for the employee’s medical condition, including all information provided to the employee by the employer or by the treating physician, still in the employee’s possession, concerning the employer’s or the physician’s decision regarding the disputed medical treatment, as well as any additional material that the employee believes is relevant. (g) The independent medical review process may be terminated at any time upon the employer’s written authorization of the disputed medical treatment. Notice of the authorization, any settlement or award that may resolve the medical treatment dispute, or the requesting physician withdrawing the request for treatment, shall be communicated to the independent medical review organization by the employer within five days. (h) (1) The employee may submit a request for independent medical review to the division. The request may be made electronically under rules adopted by the administrative director. The request shall be made no later than as follows: (A) For formulary disputes, 10 days after the service of the utilization review decision to the employee. (B) For all other medical treatment disputes, 30 days after the service of the utilization review decision to the employee. (2) If at the time of a utilization review decision the employer is also disputing liability for the treatment for any reason besides medical necessity, the time for the employee to submit a request for independent medical review to the administrative director or administrative director’s designee is extended to 30 days after service of a notice to the employee showing that the other dispute of liability has been resolved. (3) If the employer fails to comply with subdivision (f) at the time of notification of its utilization review decision, the time limitations for the employee to submit a request for independent medical review shall not begin to run until the employer provides the required notice to the employee. (4) A provider of emergency medical treatment when the employee faced an imminent and serious threat to his or her health, including, but not limited to, the potential loss of life, limb, or other major bodily function, may submit a request for independent medical review on its own behalf. A request submitted by a provider pursuant to this paragraph shall be submitted to the administrative director or administrative director’s designee within the time limitations applicable for an employee to submit a request for independent medical review. (i) An employer shall not engage in any conduct that has the effect of delaying the independent review process. Engaging in that conduct or failure of the employer to promptly comply with this section is a violation of this section and, in addition to any other fines, penalties, and other remedies available to the administrative director, the employer shall be subject to an administrative penalty in an amount determined pursuant to regulations to be adopted by the administrative director, not to exceed five thousand dollars ($5,000) for each day that proper notification to the employee is delayed. The administrative penalties shall be paid to the Workers’ Compensation Administration Revolving Fund. (j) For purposes of this section, an employee may designate a parent, guardian, conservator, relative, or other designee of the employee as an agent to act on his or her behalf. A designation of an agent executed prior to the utilization review decision shall not be valid. The requesting physician may join with or otherwise assist the employee in seeking an independent medical review, and may advocate on behalf of the employee. (k) The administrative director or his or her designee shall expeditiously review requests and immediately notify the employee and the employer in writing as to whether the request for an independent medical review has been approved, in whole or in part, and, if not approved, the reasons therefor. If there appears to be any medical necessity issue, the dispute shall be resolved pursuant to an independent medical review, except that, unless the employer agrees that the case is eligible for independent medical review, a request for independent medical review shall be deferred if at the time of a utilization review decision the employer is also disputing liability for the treatment for any reason besides medical necessity. (l) Upon notice from the administrative director that an independent review organization has been assigned, the employer shall electronically provide to the independent medical review organization under rules adopted by the administrative director a copy and list of all of the following documents within 10 days of notice of assignment: (1) A copy of all of the employee’s medical records in the possession of the employer or under the control of the employer relevant to each of the following: (A) The employee’s current medical condition. (B) The medical treatment being provided by the employer. (C) The request for authorization and utilization review decision. (2) A copy of all information provided to the employee by the employer concerning employer and provider decisions regarding the disputed treatment. (3) A copy of any materials the employee or the employee’s provider submitted to the employer in support of the employee’s request for the disputed treatment. (4) A copy of any other relevant documents or information used by the employer or its utilization review organization in determining whether the disputed treatment should have been provided, and any statements by the employer or its utilization review organization explaining the reasons for the decision to deny or modify the recommended treatment on the basis of medical necessity. The employer shall concurrently provide a copy of the documents required by this paragraph to the employee and the requesting physician, except that documents previously provided to the employee or physician need not be provided again if a list of those documents is provided. (m) Any newly developed or discovered relevant medical records in the possession of the employer after the initial documents are provided to the independent medical review organization shall be forwarded immediately to the independent medical review organization. The employer shall concurrently provide a copy of medical records required by this subdivision to the employee or the employee’s treating physician, unless the offer of medical records is declined or otherwise prohibited by law. The confidentiality of medical records shall be maintained pursuant to applicable state and federal laws. (n) If there is an imminent and serious threat to the health of the employee, as specified in subdivision (c) of Section 1374.33 of the Health and Safety Code, all necessary information and documents required by subdivision (l) shall be delivered to the independent medical review organization within 24 hours of approval of the request for review. (o) The employer shall promptly issue a notification to the employee, after submitting all of the required material to the independent medical review organization, that lists documents submitted and includes copies of material not previously provided to the employee or the employee’s designee. (p) The claims administrator who issued the utilization review decision in dispute shall notify the independent medical review organization if there is a change in the claims administrator responsible for the claim. Notice shall be given to the independent medical review organization within five working days of the change in administrator taking effect. (Amended by Stats. 2016, Ch. 868, Sec. 5. (SB 1160) Effective January 1, 2017.)
  110. 4610.6.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    An independent medical review organization must review disputed medical treatment cases, decide medical necessity, and the employer must implement the resulting decision within the stated deadlines.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4610.6. (a) Upon receipt of a case pursuant to Section 4610.5, an independent medical review organization shall conduct the review in accordance with this article and any regulations or orders of the administrative director. The organization’s review shall be limited to an examination of the medical necessity of the disputed medical treatment. (b) Upon receipt of information and documents related to a case, the medical reviewer or reviewers selected to conduct the review by the independent medical review organization shall promptly review all pertinent medical records of the employee, provider reports, and any other information submitted to the organization or requested from any of the parties to the dispute by the reviewers. If the reviewers request information from any of the parties, a copy of the request and the response shall be provided to all of the parties. The reviewer or reviewers shall also review relevant information related to the criteria set forth in subdivision (c). (c) Following its review, the reviewer or reviewers shall determine whether the disputed health care service was medically necessary based on the specific medical needs of the employee and the standards of medical necessity as defined in subdivision (c) of Section 4610.5. (d) (1) The organization shall complete its review and make its determination in writing, and in layperson’s terms to the maximum extent practicable, and the determination shall be issued, as follows: (A) For a dispute over medication prescribed pursuant to the drug formulary submitted under subdivision (h) of Section 4610.5, within five working days from the date of receipt of the request for review and supporting documentation, or within less time as prescribed by the administrative director. (B) For all other medical treatment disputes submitted for review under subdivision (h) of Section 4610.5, within 30 days of receipt of the request for review and supporting documentation, or within less time as prescribed by the administrative director. (C) If the disputed medical treatment has not been provided and the employee’s provider or the administrative director certifies in writing that an imminent and serious threat to the health of the employee may exist, including, but not limited to, serious pain, the potential loss of life, limb, or major bodily function, or the immediate and serious deterioration of the health of the employee, the analyses and determinations of the reviewers shall be expedited and rendered within three days of the receipt of the information. (2) Subject to the approval of the administrative director, the deadlines for analyses and determinations involving both regular and expedited reviews may be extended for up to three days in extraordinary circumstances or for good cause. (e) The medical professionals’ analyses and determinations shall state whether the disputed health care service is medically necessary. Each analysis shall cite the employee’s medical condition, the relevant documents in the record, and the relevant findings associated with the provisions of subdivision (c) to support the determination. If more than one medical professional reviews the case, the recommendation of the majority shall prevail. If the medical professionals reviewing the case are evenly split as to whether the disputed health care service should be provided, the decision shall be in favor of providing the service. (f) The independent medical review organization shall provide the administrative director, the employer, the employee, and the employee’s provider with the analyses and determinations of the medical professionals reviewing the case, and a description of the qualifications of the medical professionals. The independent medical review organization shall keep the names of the reviewers confidential in all communications with entities or individuals outside the independent medical review organization. If more than one medical professional reviewed the case and the result was differing determinations, the independent medical review organization shall provide each of the separate reviewer’s analyses and determinations. (g) The determination of the independent medical review organization shall be deemed to be the determination of the administrative director and shall be binding on all parties. (h) A determination of the administrative director pursuant to this section may be reviewed only by a verified appeal from the medical review determination of the administrative director, filed with the appeals board for hearing pursuant to Chapter 3 (commencing with Section 5500) of Part 4 and served on all interested parties within 30 days of the date of mailing of the determination to the aggrieved employee or the aggrieved employer. The determination of the administrative director shall be presumed to be correct and shall be set aside only upon proof by clear and convincing evidence of one or more of the following grounds for appeal: (1) The administrative director acted without or in excess of the administrative director’s powers. (2) The determination of the administrative director was procured by fraud. (3) The independent medical reviewer was subject to a material conflict of interest that is in violation of Section 139.5. (4) The determination was the result of bias on the basis of race, national origin, ethnic group identification, religion, age, sex, sexual orientation, color, or disability. (5) The determination was the result of a plainly erroneous express or implied finding of fact, provided that the mistake of fact is a matter of ordinary knowledge based on the information submitted for review pursuant to Section 4610.5 and not a matter that is subject to expert opinion. (i) If the determination of the administrative director is reversed, the dispute shall be remanded to the administrative director to submit the dispute to independent medical review by a different independent review organization. In the event that a different independent medical review organization is not available after remand, the administrative director shall submit the dispute to the original medical review organization for review by a different reviewer in the organization. In no event shall a workers’ compensation administrative law judge, the appeals board, or any higher court make a determination of medical necessity contrary to the determination of the independent medical review organization. (j) Upon receiving the determination of the administrative director that a disputed health care service is medically necessary, the employer shall promptly implement the decision as provided by this section unless the employer has also disputed liability for any reason besides medical necessity. In the case of reimbursement for services already rendered, the employer shall reimburse the provider or employee, whichever applies, within 20 days, subject to resolution of any remaining issue of the amount of payment pursuant to Sections 4603.2 to 4603.6, inclusive. In the case of services not yet rendered, the employer shall authorize the services within five working days of receipt of the written determination from the independent medical review organization, or sooner if appropriate for the nature of the employee’s medical condition, and shall inform the employee and provider of the authorization. (k) Failure to pay for services already provided or to authorize services not yet rendered within the time prescribed by subdivision (l) is a violation of this section and, in addition to any other fines, penalties, and other remedies available to the administrative director, the employer shall be subject to an administrative penalty in an amount determined pursuant to regulations to be adopted by the administrative director, not to exceed five thousand dollars ($5,000) for each day the decision is not implemented. The administrative penalties shall be paid to the Workers’ Compensation Administration Revolving Fund. (l) The costs of independent medical review and the administration of the independent medical review system shall be borne by employers through a fee system established by the administrative director. After considering any relevant information on program costs, the administrative director shall establish a reasonable, per-case reimbursement schedule to pay the costs of independent medical review organization reviews and the cost of administering the independent medical review system, which may vary depending on the type of medical condition under review and on other relevant factors. (m) The administrative director may publish the results of independent medical review determinations after removing individually identifiable information. (n) If any provision of this section, or the application thereof to any person or circumstances, is held invalid, the remainder of the section, and the application of its provisions to other persons or circumstances, shall not be affected thereby. (Amended by Stats. 2016, Ch. 868, Sec. 6. (SB 1160) Effective January 1, 2017.)
  111. 4611.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    If a contracting agent sells, leases, or transfers a health provider’s contract to a payor, the provider’s rights and obligations are controlled by the underlying contract.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4611. (a) When a contracting agent sells, leases, or transfers a health provider’s contract to a payor, the rights and obligations of the provider shall be governed by the underlying contract between the health care provider and the contracting agent. (b) For purposes of this section, the following terms have the following meanings: (1) “Contracting agent” has the meaning set forth in paragraph (2) of subdivision (d) of Section 4609. (2) “Payor” has the meaning set forth in paragraph (3) of subdivision (d) of Section 4609. (Added by renumbering Section 4610 (as added by Stats. 2003, Ch. 203) by Stats. 2004, Ch. 183, Sec. 264. Effective January 1, 2005.)
  112. 4614.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    This section limits how much certain health care providers can be paid for work-related treatment under workers’ compensation and sets duties for the administrative director and carriers.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4614. (a) (1) Notwithstanding Section 5307.1, where the employee’s individual or organizational provider of health care services rendered under this division and paid on a fee-for-service basis is also the provider of health care services under contract with the employee’s health benefit program, and the service or treatment provided is included within the range of benefits of the employee’s health benefit program, and paid on a fee-for-service basis, the amount of payment for services provided under this division, for a work-related occurrence or illness, shall be no more than the amount that would have been paid for the same services under the health benefit plan, for a non-work-related occurrence or illness. (2) A health care service plan that arranges for health care services to be rendered to an employee under this division under a contract, and which is also the employee’s organizational provider for nonoccupational injuries and illnesses, with the exception of a nonprofit health care service plan that exclusively contracts with a medical group to provide or arrange for medical services to its enrollees in a designated geographic area, shall be paid by the employer for services rendered under this division only on a capitated basis. (b) (1) Where the employee’s individual or organizational provider of health care services rendered under this division who is not providing services under a contract is not the provider of health care services under contract with the employee’s health benefit program or where the services rendered under this division are not within the benefits provided under the employer-sponsored health benefit program, the provider shall receive payment that is no more than the average of the payment that would have been paid by five of the largest preferred provider organizations by geographic region. Physicians, as defined in Section 3209.3, shall be reimbursed at the same averaged rates, regardless of licensure, for the delivery of services under the same procedure code. This subdivision shall not apply to a health care service plan that provides its services on a capitated basis. (2) The administrative director shall identify the regions and the five largest carriers in each region. The carriers shall provide the necessary information to the administrative director in the form and manner requested by the administrative director. The administrative director shall make this information available to the affected providers on an annual basis. (c) Nothing in this section shall prohibit an individual or organizational health care provider from being paid fees different from those set forth in the official medical fee schedule by an employer, insurance carrier, third-party administrator on behalf of employers, or preferred provider organization representing an employer or insurance carrier provided that the administrative director has determined that the alternative negotiated rates between the organizational or individual provider and a payer, a third-party administrator on behalf of employers, or a preferred provider organization will produce greater savings in the aggregate than if each item on billings were to be charged at the scheduled rate. (d) For the purposes of this section, “organizational provider” means an entity that arranges for health care services to be rendered directly by individual caregivers. An organizational provider may be a health care service plan, disability insurer, health care organization, preferred provider organization, or workers’ compensation insurer arranging for care through a managed care network or on a fee-for-service basis. An individual provider is either an individual or institution that provides care directly to the injured worker. (Amended by Stats. 2002, Ch. 866, Sec. 11. Effective January 1, 2003.)
  113. 4614.1.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    A certified health care service plan may accept fee-for-service payment from a self-insured employer, a group of self-insured employers, or an employer’s insurer if the plan is not also the employee’s regular health-benefits plan.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4614.1. Notwithstanding subdivision (f) of Section 1345 of the Health and Safety Code, a health care service plan licensed pursuant to the Knox-Keene Health Care Service Plan Act and certified by the administrative director pursuant to Section 4600.5 to provide health care pursuant to Section 4600.3 shall be permitted to accept payment from a self-insured employer, a group of self-insured employers, or the insurer of an employer on a fee-for-service basis for the provision of such health care as long as the health care service plan is not both the health care organization in which the employee is enrolled and the plan through which the employee receives regular health benefits. (Amended by Stats. 1993, Ch. 1242, Sec. 35. Effective January 1, 1994.)
  114. 4615.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    If criminal charges are filed against certain medical providers, related liens are automatically stayed; the administrative director must post the names online, and the chief judge may lift the stay for good cause.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2. Medical and Hospital Treatment [4600 - 4615] ( Article 2 enacted by Stats. 1937, Ch. 90. ) ## 4615. (a) Upon the filing of criminal charges against a physician, practitioner, or provider for any crime described in subparagraph (A) of paragraph (1) of subdivision (a) of Section 139.21, the following shall occur: (1) Any lien filed by, or on behalf of, the physician, practitioner, or provider or any entity controlled, as defined in paragraph (3) of subdivision (a) of Section 139.21, by the physician, practitioner, or provider for medical treatment services under Section 4600 or medical-legal services under Section 4621, and any accrual of interest related to the lien, shall be automatically stayed. (2) Except as provided in subdivisions (b) and (c), the stay shall be in effect from the time of the filing of the charges until the disposition of the criminal proceedings. (b) Upon conviction, as defined in paragraph (4) of subdivision (a) of Section 139.21, of the physician, practitioner, or provider for any crime described in subparagraph (A) of paragraph (1) of subdivision (a) of Section 139.21, the automatic stay shall remain in effect for any liens not dismissed pursuant to paragraph (1) of subdivision (e) of Section 139.21 until the commencement of lien consolidation procedures under paragraph (2) of subdivision (e) of Section 139.21. (c) The automatic stay required by this section shall not preclude a physician, practitioner, or provider from requesting the dismissal with prejudice and forfeiture of sums claimed therein of any liens subject to the stay. Upon the receipt of that request and for good cause shown, the chief judge of the Division of Workers Compensation or his or her designee may lift the stay as to one or more of those liens and order that they be dismissed with prejudice. (d) The administrative director shall promptly post on the division’s Internet Web site the names of any physician, practitioner, or provider of medical treatment services whose liens are stayed pursuant to this section. (e) The automatic stay required by this section shall not preclude the appeals board from inquiring into and determining within a workers’ compensation proceeding whether a lien is stayed pursuant to subdivision (a) or whether a lien claimant is controlled by a physician, practitioner, or provider. (f) The administrative director may adopt rules for the implementation of this section. (g) Notwithstanding this section, the filing of new or additional criminal charges against a physician, practitioner, or provider who has been suspended pursuant to subparagraph (A) of paragraph (1) of subdivision (a) of Section 139.21 shall not stay liens that are subject to consolidation and adjudication pursuant to subdivisions (e) to (i), inclusive, of Section 139.21, unless a determination has been made pursuant to subdivision (i) of Section 139.21 that a lien did not arise from the conduct that subjected the physician, practitioner, or provider to suspension. (Amended by Stats. 2017, Ch. 300, Sec. 3. (AB 1422) Effective January 1, 2018.)
  115. 4616.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.3. Medical Provider Networks [4616 - 4616.7] ( Article 2.3 added by Stats. 2004, Ch. 34, Sec. 27. )

    Verify source ↗

    Medical provider networks may be created or changed by insurers, employers, or physician network service entities, but they must meet network, access, reporting, and approval requirements.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.3. Medical Provider Networks [4616 - 4616.7] ( Article 2.3 added by Stats. 2004, Ch. 34, Sec. 27. ) ## 4616. (a) (1) An insurer, employer, or entity that provides physician network services may establish or modify a medical provider network for the provision of medical treatment to injured employees. The network shall include physicians primarily engaged in the treatment of occupational injuries. The administrative director shall encourage the integration of occupational and nonoccupational providers. Subject to Section 3209.11, the number of physicians in the medical provider network shall be sufficient to enable treatment for injuries or conditions to be provided in a timely manner. The provider network shall include an adequate number and type of physicians, as described in Section 3209.3, or other providers, as described in Section 3209.5, to treat common injuries experienced by injured employees based on the type of occupation or industry in which the employee is engaged, and the geographic area where the employees are employed. (2) Medical treatment for injuries shall be readily available at reasonable times to all employees. To the extent feasible, all medical treatment for injuries shall be readily accessible to all employees. With respect to availability and accessibility of treatment, the administrative director shall consider the needs of rural areas, specifically those in which health facilities are located at least 30 miles apart and areas in which there is a health care shortage. (3) A treating physician shall be included in the network only if, at the time of entering into or renewing an agreement by which the physician would be in the network, the physician, or an authorized employee of the physician or the physician’s office, provides a separate written acknowledgment in which the physician affirmatively elects to be a member of the network. Copies of the written acknowledgment shall be provided to the administrative director upon the administrative director’s request. This paragraph shall not apply to a physician who is a shareholder, partner, or employee of a medical group that elects to be part of the network. (4) (A) (i) Commencing July 1, 2021, every medical provider network shall post on its internet website a roster of all participating providers, which includes all physicians and ancillary service providers in the medical provider network, and shall update the roster at least quarterly. Every network shall provide to the administrative director the internet website address of the network and of its roster of participating providers. The roster of participating providers shall include, at a minimum, the name of each individual provider and their office address and office telephone number. If the ancillary service is provided by an entity rather than an individual, then that entity’s name, address, and telephone number shall be listed. (ii) The administrative director shall post, on the division’s internet website, the internet website address of every approved medical provider network. (B) Every medical provider network shall post on its internet website information about how to contact the medical provider network contact and medical access assistants, and information about how to obtain a copy of any notification regarding the medical provider network that is required to be given to an employee by regulations adopted by the administrative director. (5) Every medical provider network shall provide one or more persons within the United States to serve as medical access assistants to help an injured employee find an available physician of the employee’s choice, and subsequent physicians if necessary, under Section 4616.3. Medical access assistants shall have a toll-free telephone number that injured employees may use and shall be available at least from 7 a.m. to 8 p.m. Pacific standard time, Monday through Saturday, to respond to injured employees, contact physicians’ offices during regular business hours, and schedule appointments. The administrative director shall promulgate regulations governing the provision of medical access assistants. (b) (1) An insurer, employer, or entity that provides physician network services shall submit a plan for the medical provider network to the administrative director for approval. The administrative director shall approve the plan for a period of four years if the administrative director determines that the plan meets the requirements of this section. If the administrative director does not act on the plan within 60 days of submitting the plan, it shall be deemed approved. Commencing January 1, 2014, existing approved plans shall be deemed approved for a period of four years from the approval date of the most recent application or modification submitted prior to 2014. Plans for reapproval for medical provider networks shall be submitted at least six months before the expiration of the four-year approval period. Commencing January 1, 2016, a modification that updates an entire medical provider network plan to bring the plan into full compliance with all current statutes and regulations shall be deemed approved for a period of four years from the modification approval date. An approved modification that does not update an entire medical provider network plan to bring the plan into full compliance with all current statutes and regulations shall not alter the expiration of the medical provider network’s four-year approval period. Upon a showing that the medical provider network was approved or deemed approved by the administrative director, there shall be a conclusive presumption on the part of the appeals board that the medical provider network was validly formed. (2) Every medical provider network shall establish and follow procedures to continuously review the quality of care, performance of medical personnel, utilization of services and facilities, and costs. (3) Every medical provider network shall submit geocoding of its network for reapproval to establish that the number and geographic location of physicians in the network meets the required access standards. (4) Approval of a plan may be denied, revoked, or suspended if the medical provider network fails to meet the requirements of this article. Any person contending that a medical provider network is not validly constituted may petition the administrative director to suspend or revoke the approval of the medical provider network. The administrative director may adopt regulations establishing a schedule of administrative penalties not to exceed five thousand dollars ($5,000) per violation, or probation, or both, in lieu of revocation or suspension for less severe violations of the requirements of this article. Penalties, probation, suspension, or revocation shall be ordered by the administrative director only after notice and opportunity to be heard. Unless suspended or revoked by the administrative director, the administrative director’s approval of a medical provider network shall be binding on all persons and all courts. A determination of the administrative director may be reviewed only by an appeal of the determination of the administrative director filed as an original proceeding before the reconsideration unit of the workers’ compensation appeals board on the same grounds and within the same time limits after issuance of the determination as would be applicable to a petition for reconsideration of a decision of a workers’ compensation administrative law judge. (c) Physician compensation may not be structured in order to achieve the goal of reducing, delaying, or denying medical treatment or restricting access to medical treatment. (d) If the employer or insurer meets the requirements of this section, the administrative director may not withhold approval or disapprove an employer’s or insurer’s medical provider network based solely on the selection of providers. In developing a medical provider network, an employer or insurer shall have the exclusive right to determine the members of their network. (e) All treatment provided shall be provided in accordance with the medical treatment utilization schedule established pursuant to Section 5307.27. (f) Only a licensed physician who is competent to evaluate the specific clinical issues involved in the medical treatment services, when these services are within the scope of the physician’s practice, may modify, delay, or deny requests for authorization of medical treatment. (g) Every contracting agent that sells, leases, assigns, transfers, or conveys its medical provider networks and their contracted reimbursement rates to an insurer, employer, entity that provides physician network services, or another contracting agent shall, upon entering or renewing a provider contract, disclose to the provider whether the medical provider network may be sold, leased, transferred, or conveyed to other insurers, employers, entities that provide physician network services, or another contracting agent, and specify whether those insurers, employers, entities that provide physician network services, or contracting agents include workers’ compensation insurers. (h) On or before November 1, 2004, the administrative director, in consultation with the Department of Managed Health Care, shall adopt regulations implementing this article. The administrative director shall develop regulations that establish procedures for purposes of making medical provider network modifications. (i) The administrative director has the authority and discretion to investigate complaints, conduct random reviews, and take enforcement action against medical provider networks, an entity that provides ancillary services, or an entity providing services for or on behalf of the medical provider network or its providers regarding noncompliance with the requirements of this section or Section 4603.2 or 4610. (Amended by Stats. 2022, Ch. 609, Sec. 6. (SB 1002) Effective January 1, 2023.)
  116. 4616.1.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.3. Medical Provider Networks [4616 - 4616.7] ( Article 2.3 added by Stats. 2004, Ch. 34, Sec. 27. )

    Verify source ↗

    Certain insurers, employers, and physician network service entities must file economic profiling policies with the administrative director and give copies to listed medical professionals; the administrative director must disclose approved filings on request but keep confidential information private.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.3. Medical Provider Networks [4616 - 4616.7] ( Article 2.3 added by Stats. 2004, Ch. 34, Sec. 27. ) ## 4616.1. (a) An insurer, employer, or entity that provides physician network services that offers a medical provider network under this division and that uses economic profiling shall file with the administrative director a description of any policies and procedures related to economic profiling utilized. The filing shall describe how these policies and procedures are used in utilization review, peer review, incentive and penalty programs, and in provider retention and termination decisions. The insurer, employer, or entity that provides physician network services shall provide a copy of the filing to an individual physician, provider, medical group, or individual practice association. (b) The administrative director shall make each approved medical provider network economic profiling policy filing available to the public upon request. The administrative director may not publicly disclose any information submitted pursuant to this section that is determined by the administrative director to be confidential pursuant to state or federal law. (c) For the purposes of this article, “economic profiling” shall mean any evaluation of a particular physician, provider, medical group, or individual practice association based in whole or in part on the economic costs or utilization of services associated with medical care provided or authorized by the physician, provider, medical group, or individual practice association. (Amended by Stats. 2012, Ch. 363, Sec. 48. (SB 863) Effective January 1, 2013.)
  117. 4616.2.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.3. Medical Provider Networks [4616 - 4616.7] ( Article 2.3 added by Stats. 2004, Ch. 34, Sec. 27. )

    Verify source ↗

    Medical provider networks must file and update continuity of care policies, give notice to employees, and help continue treatment in specified cases when a provider’s contract ends.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.3. Medical Provider Networks [4616 - 4616.7] ( Article 2.3 added by Stats. 2004, Ch. 34, Sec. 27. ) ## 4616.2. (a) A medical provider network shall file a written continuity of care policy with the administrative director. (b) If approved by the administrative director, the provisions of the written continuity of care policy shall replace all prior continuity of care policies. A medical provider network shall file a revision of the continuity of care policy with the administrative director if it makes a material change to the policy. (c) The medical provider network shall provide all employees entering the workers’ compensation system notice of the medical provider network’s written continuity of care policy and information regarding the process for an employee to request a review under the policy and, upon request, a copy of the medical provider network’s written continuity of care policy. (d) (1) At the request of an injured employee, completion of treatment shall be provided by a terminated provider as set forth in this section. (2) The completion of treatment shall be provided by a terminated provider to an injured employee who, at the time of the contract’s termination, was receiving services from that provider for one of the conditions described in paragraph (3). (3) The employer or its claims administrator shall provide for the completion of treatment for the following conditions subject to coverage through the workers’ compensation system: (A) An acute condition. An acute condition is a medical condition that involves a sudden onset of symptoms due to an illness, injury, or other medical problem that requires prompt medical attention and that has a limited duration. Completion of treatment shall be provided for the duration of the acute condition. (B) A serious chronic condition. A serious chronic condition is a medical condition due to a disease, illness, or other medical problem or medical disorder that is serious in nature and that persists without full cure or worsens over an extended period of time or requires ongoing treatment to maintain remission or prevent deterioration. Completion of treatment shall be provided for a period of time necessary to complete a course of treatment and to arrange for a safe transfer to another provider, as determined by the employer or its claims administrator in consultation with the injured employee and the terminated provider and consistent with good professional practice. Completion of treatment under this paragraph shall not exceed 12 months from the contract termination date. (C) A terminal illness. A terminal illness is an incurable or irreversible condition that has a high probability of causing death within one year or less. Completion of treatment shall be provided for the duration of a terminal illness. (D) Performance of a surgery or other procedure that is authorized by the employer or its claims administrator as part of a documented course of treatment and has been recommended and documented by the provider to occur within 180 days of the contract’s termination date. (4) (A) The employer or its claims administrator may require the terminated provider whose services are continued beyond the contract termination date pursuant to this section to agree in writing to be subject to the same contractual terms and conditions that were imposed upon the provider prior to termination. If the terminated provider does not agree to comply or does not comply with these contractual terms and conditions, the employer or its claims administrator is not required to continue the provider’s services beyond the contract termination date. (B) Unless otherwise agreed by the terminated provider and the employer or its claims administrator, the services rendered pursuant to this section shall be compensated at rates and methods of payment similar to those used by the medical provider network for currently contracting providers providing similar services who are practicing in the same or a similar geographic area as the terminated provider. The employer or its claims administrator is not required to continue the services of a terminated provider if the provider does not accept the payment rates provided for in this paragraph. (5) An employer or its claims administrator shall ensure that the requirements of this section are met. (6) This section shall not require an employer or its claims administrator to provide for completion of treatment by a provider whose contract with the medical provider network has been terminated or not renewed for reasons relating to a medical disciplinary cause or reason, as defined in paragraph (6) of subdivision (a) of Section 805 of the Business and Professions Code, or fraud or other criminal activity. (7) Nothing in this section shall preclude an employer or its claims administrator from providing continuity of care beyond the requirements of this section. (Amended by Stats. 2015, Ch. 542, Sec. 2. (SB 542) Effective January 1, 2016.)
  118. 4616.3.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.3. Medical Provider Networks [4616 - 4616.7] ( Article 2.3 added by Stats. 2004, Ch. 34, Sec. 27. )

    Verify source ↗

    Employers must arrange an initial medical evaluation and treatment after notice of injury or a workers’ compensation claim, and must tell the employee about the medical provider network and related access rights.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.3. Medical Provider Networks [4616 - 4616.7] ( Article 2.3 added by Stats. 2004, Ch. 34, Sec. 27. ) ## 4616.3. (a) If the injured employee notifies the employer of the injury or files a claim for workers’ compensation with the employer, the employer shall arrange an initial medical evaluation and begin treatment as required by Section 4600. (b) The employer shall notify the employee of the existence of the medical provider network established pursuant to this article, the employee’s right to change treating physicians within the network after the first visit, and the method by which the list of participating providers may be accessed by the employee. The employer’s failure to provide notice as required by this subdivision or failure to post the notice as required by Section 3550 shall not be a basis for the employee to treat outside the network unless it is shown that the failure to provide notice resulted in a denial of medical care. (c) If an injured employee disputes either the diagnosis or the treatment prescribed by the treating physician, the employee may seek the opinion of another physician in the medical provider network. If the injured employee disputes the diagnosis or treatment prescribed by the second physician, the employee may seek the opinion of a third physician in the medical provider network. (d) (1) Selection by the injured employee of a treating physician and any subsequent physicians shall be based on the physician’s specialty or recognized expertise in treating the particular injury or condition in question. (2) Treatment by a specialist who is not a member of the medical provider network may be permitted on a case-by-case basis if the medical provider network does not contain a physician who can provide the approved treatment and the treatment is approved by the employer or the insurer. (Amended by Stats. 2012, Ch. 363, Sec. 50. (SB 863) Effective January 1, 2013.)
  119. 4616.4.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.3. Medical Provider Networks [4616 - 4616.7] ( Article 2.3 added by Stats. 2004, Ch. 34, Sec. 27. )

    Verify source ↗

    The administrative director must arrange and manage medical provider network independent medical reviews, and injured employees can request review when a treatment dispute remains after the third physician’s opinion.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.3. Medical Provider Networks [4616 - 4616.7] ( Article 2.3 added by Stats. 2004, Ch. 34, Sec. 27. ) ## 4616.4. (a) (1) The administrative director shall contract with individual physicians, as described in paragraph (2), or an independent medical review organization to perform medical provider network (MPN) independent medical reviews pursuant to this section. (2) Only a physician licensed pursuant to Chapter 5 (commencing with Section 2000) of the Business and Professions Code may be an MPN independent medical reviewer. (3) The administrative director shall ensure that an MPN independent medical reviewer or those within the review organization shall do all of the following: (A) Be appropriately credentialed and privileged. (B) Ensure that the reviews provided by the medical professionals are timely, clear, and credible, and that reviews are monitored for quality on an ongoing basis. (C) Ensure that the method of selecting medical professionals for individual cases achieves a fair and impartial panel of medical professionals who are qualified to render recommendations regarding the clinical conditions consistent with the medical utilization schedule established pursuant to Section 5307.27. (D) Ensure the confidentiality of medical records and the review materials, consistent with the requirements of this section and applicable state and federal law. (E) Ensure the independence of the medical professionals retained to perform the reviews through conflict-of-interest policies and prohibitions, and ensure adequate screening for conflicts of interest. (4) A medical professional selected by the administrative director or the independent medical review organization to review medical treatment decisions shall be a physician, as specified in paragraph (2) of subdivision (a), who meets the following minimum requirements: (A) The medical professional shall be a clinician knowledgeable in the treatment of the employee’s medical condition, knowledgeable about the proposed treatment, and familiar with guidelines and protocols in the area of treatment under review. (B) Notwithstanding any other law, the medical professional shall hold a nonrestricted license in any state of the United States, and for a physician, a current certification by a recognized American medical specialty board in the area or areas appropriate to the condition or treatment under review. (C) The medical professional shall have no history of disciplinary action or sanctions, including, but not limited to, loss of staff privileges or participation restrictions taken or pending by any hospital, government, or regulatory body. (b) If, after the third physician’s opinion, the treatment or diagnostic service remains disputed, the injured employee may request an MPN independent medical review regarding the disputed treatment or diagnostic service still in dispute after the third physician’s opinion in accordance with Section 4616.3. The standard to be utilized for an MPN independent medical review is identical to that contained in the medical treatment utilization schedule established in Section 5307.27. (c) An application for an MPN independent medical review shall be submitted to the administrative director on a one-page form provided by the administrative director entitled “MPN Independent Medical Review Application.” The form shall contain a signed release from the injured employee, or a person authorized pursuant to law to act on behalf of the injured employee, authorizing the release of medical and treatment information. The injured employee may provide any relevant material or documentation with the application. The administrative director or the independent medical review organization shall assign the MPN independent medical reviewer. (d) Following receipt of the application for an MPN independent medical review, the employer or insurer shall provide the MPN independent medical reviewer, assigned pursuant to subdivision (c), with all information that was considered in relation to the disputed treatment or diagnostic service, including both of the following: (1) A copy of all correspondence from, and received by, any treating physician who provided a treatment or diagnostic service to the injured employee in connection with the injury. (2) A complete and legible copy of all medical records and other information used by the physicians in making a decision regarding the disputed treatment or diagnostic service. (e) Upon receipt of information and documents related to the application for an MPN independent medical review, the MPN independent medical reviewer shall conduct a physical examination of the injured employee at the employee’s discretion. The MPN independent medical reviewer may order any diagnostic tests necessary to make his or her determination regarding medical treatment. Utilizing the medical treatment utilization schedule established pursuant to Section 5307.27, and taking into account any reports and information provided, the MPN independent medical reviewer shall determine whether the disputed health care service was consistent with Section 5307.27 based on the specific medical needs of the injured employee. (f) The MPN independent medical reviewer shall issue a report to the administrative director, in writing, and in layperson’s terms to the maximum extent practicable, containing his or her analysis and determination as to whether the disputed health care service was consistent with the medical treatment utilization schedule established pursuant to Section 5307.27, within 30 days of the examination of the injured employee, or within less time as prescribed by the administrative director. If the disputed health care service has not been provided and the MPN independent medical reviewer certifies in writing that an imminent and serious threat to the health of the injured employee may exist, including, but not limited to, serious pain, the potential loss of life, limb, or major bodily function, or the immediate and serious deterioration of the injured employee, the report shall be expedited and rendered within three days of the examination by the MPN independent medical reviewer. Subject to the approval of the administrative director, the deadlines for analyses and determinations involving both regular and expedited reviews may be extended by the administrative director for up to three days in extraordinary circumstances or for good cause. (g) The MPN independent medical reviewer’s analysis shall cite the injured employee’s medical condition, the relevant documents in the record, and the relevant findings associated with the documents or any other information submitted to the MPN independent medical reviewer in order to support the determination. (h) The administrative director shall immediately adopt the determination of the MPN independent medical reviewer, and shall promptly issue a written decision to the parties. (i) If the determination of the MPN independent medical reviewer finds that the disputed treatment or diagnostic service is consistent with Section 5307.27, the injured employee may seek the disputed treatment or diagnostic service from a physician of his or her choice from within or outside the medical provider network. Treatment outside the medical provider network shall be provided consistent with Section 5307.27. The employer shall be liable for the cost of any approved medical treatment in accordance with Section 5307.1 or 5307.11. (Amended by Stats. 2017, Ch. 561, Sec. 174. (AB 1516) Effective January 1, 2018.)
  120. 4616.5.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.3. Medical Provider Networks [4616 - 4616.7] ( Article 2.3 added by Stats. 2004, Ch. 34, Sec. 27. )

    Verify source ↗

    This section defines key terms used in the article, including “employer,” “entity that provides physician network services,” and “entity that provides ancillary services.”

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.3. Medical Provider Networks [4616 - 4616.7] ( Article 2.3 added by Stats. 2004, Ch. 34, Sec. 27. ) ## 4616.5. (a) For purposes of this article, “employer” means a self-insured employer, joint powers authority, or the state. (b) For purposes of this article, “entity that provides physician network services” means a medical network licensed by the Department of Insurance or Department of Managed Health Care, or a third-party claims adjusting organization licensed by the Department of Insurance or certified by the Office of Self-Insurance Plans, or a legal entity that offers medical management or physician network services within California. (c) For purposes of this article, “entity that provides ancillary services” means an entity that provides medical services or goods, as authorized by Section 4600, by a nonphysician, including, but not limited to, interpreter services, physical therapy, and pharmaceutical services. (Amended by Stats. 2019, Ch. 647, Sec. 8. (SB 537) Effective January 1, 2020.)
  121. 4616.6.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.3. Medical Provider Networks [4616 - 4616.7] ( Article 2.3 added by Stats. 2004, Ch. 34, Sec. 27. )

    Verify source ↗

    The appeals board may not order additional examinations to resolve controversies under this article.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.3. Medical Provider Networks [4616 - 4616.7] ( Article 2.3 added by Stats. 2004, Ch. 34, Sec. 27. ) ## 4616.6. No additional examinations shall be ordered by the appeals board and no other reports shall be admissable to resolve any controversy arising out of this article. (Added by Stats. 2004, Ch. 34, Sec. 27. Effective April 19, 2004.)
  122. 4616.7.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.3. Medical Provider Networks [4616 - 4616.7] ( Article 2.3 added by Stats. 2004, Ch. 34, Sec. 27. )

    Verify source ↗

    Several health care and insurance entities are treated as approved under this article if they meet the article’s requirements, as determined by the administrative director.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.3. Medical Provider Networks [4616 - 4616.7] ( Article 2.3 added by Stats. 2004, Ch. 34, Sec. 27. ) ## 4616.7. (a) A health care organization certified pursuant to Section 4600.5 shall be deemed approved pursuant to this article if the requirements of this article are met, as determined by the administrative director. (b) A health care service plan, licensed pursuant to Chapter 2.2 (commencing with Section 1340) of Division 2 of the Health and Safety Code, shall be deemed approved for purposes of this article if it has a reasonable number of physicians with competency in occupational medicine, as determined by the administrative director. (c) A group disability insurance policy, as defined in subdivision (b) of Section 106 of the Insurance Code, that covers hospital, surgical, and medical care expenses shall be deemed approved for purposes of this article if it has a reasonable number of physicians with competency in occupational medicine, as determined by the administrative director. For the purposes of this section, a group disability insurance policy shall not include Medicare supplement, vision-only, dental-only, and Champus-supplement insurance. For purposes of this section, a group disability insurance policy shall not include hospital indemnity, accident-only, and specified disease insurance that pays benefits on a fixed benefit, cash-payment-only basis. (d) Any Taft-Hartley health and welfare fund shall be deemed approved for purposes of this article if it has a reasonable number of physicians with competency in occupational medicine, as determined by the administrative director. (Amended by Stats. 2012, Ch. 363, Sec. 51. (SB 863) Effective January 1, 2013.)
  123. 4620.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.5. Medical-Legal Expenses [4620 - 4628] ( Article 2.5 added by Stats. 1984, Ch. 596, Sec. 4. )

    Verify source ↗

    This section defines medical-legal expenses and contested claims, and it requires the employer or insurance carrier to pay for a qualified interpreter for an injured employee who cannot effectively communicate in English during a medical examination, with a limited exception for provisionally certified interpreters.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.5. Medical-Legal Expenses [4620 - 4628] ( Article 2.5 added by Stats. 1984, Ch. 596, Sec. 4. ) ## 4620. (a) For purposes of this article, a medical-legal expense means any costs and expenses incurred by or on behalf of any party, the administrative director, or the board, which expenses may include X-rays, laboratory fees, other diagnostic tests, medical reports, medical records, medical testimony, and, as needed, interpreter’s fees by a certified interpreter pursuant to Article 8 (commencing with Section 11435.05) of Chapter 4.5 of Part 1 of Division 3 of Title 2 of, or Section 68566 of, the Government Code, for the purpose of proving or disproving a contested claim. (b) A contested claim exists when the employer knows or reasonably should know that the employee is claiming entitlement to any benefit arising out of a claimed industrial injury and one of the following conditions exists: (1) The employer rejects liability for a claimed benefit. (2) The employer fails to accept liability for benefits after the expiration of a reasonable period of time within which to decide if it will contest the claim. (3) The employer fails to respond to a demand for payment of benefits after the expiration of any time period fixed by statute for the payment of indemnity. (c) Costs of medical evaluations, diagnostic tests, and interpreters incidental to the production of a medical report do not constitute medical-legal expenses unless the medical report is capable of proving or disproving a disputed medical fact, the determination of which is essential to an adjudication of the employee’s claim for benefits. In determining whether a report meets the requirements of this subdivision, a judge shall give full consideration to the substance as well as the form of the report, as required by applicable statutes and regulations. (d) If the injured employee cannot effectively communicate with an examining physician because he or she cannot proficiently speak or understand the English language, the injured employee is entitled to the services of a qualified interpreter during the medical examination. Upon request of the injured employee, the employer or insurance carrier shall pay the costs of the interpreter services, as set forth in the fee schedule adopted by the administrative director pursuant to Section 5811. An employer shall not be required to pay for the services of an interpreter who is provisionally certified unless either the employer consents in advance to the selection of the individual who provides the interpreting service or the injured worker requires interpreting service in a language other than the languages designated pursuant to Section 11435.40 of the Government Code. (Amended by Stats. 2012, Ch. 363, Sec. 52. (SB 863) Effective January 1, 2013.)
  124. 4621.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.5. Medical-Legal Expenses [4620 - 4628] ( Article 2.5 added by Stats. 1984, Ch. 596, Sec. 4. )

    Verify source ↗

    This section requires reimbursement for certain medical-legal expenses and limits when comprehensive medical-legal evaluations may be done and paid for.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.5. Medical-Legal Expenses [4620 - 4628] ( Article 2.5 added by Stats. 1984, Ch. 596, Sec. 4. ) ## 4621. (a) In accordance with the rules of practice and procedure of the appeals board, the employee, or the dependents of a deceased employee, shall be reimbursed for his or her medical-legal expenses and reasonably, actually, and necessarily incurred, except as provided in Section 4064. The reasonableness of, and necessity for, incurring these expenses shall be determined with respect to the time when the expenses were actually incurred. Costs for medical evaluations, diagnostic tests, and interpreters’ services incidental to the production of a medical report shall not be incurred earlier than the date of receipt by the employer, the employer’s insurance carrier, or, if represented, the attorney of record, of all reports and documents required by the administrative director incidental to the services. This subdivision is not applicable unless there has been compliance with Section 4620. (b) Except as provided in subdivision (c) and Sections 4061 and 4062, no comprehensive medical-legal evaluations, except those at the request of an employer, shall be performed during the first 60 days after the notice of claim has been filed pursuant to Section 5401, and neither the employer nor the employee shall be liable for any expenses incurred for comprehensive medical-legal evaluations performed within the first 60 days after the notice of claim has been filed pursuant to Section 5401. (c) Comprehensive medical-legal evaluations may be performed at any time after the claim form has been filed pursuant to Section 5401 if the employer has rejected the claim. (d) Where, at the request of the employer, the employer’s insurance carrier, the administrative director, the appeals board, or a referee, the employee submits to examination by a physician, he or she shall be entitled to receive, in addition to all other benefits herein provided, all reasonable expenses of transportation, meals, and lodging incident to reporting for the examination to the same extent and manner as provided for in Section 4600. (Amended by Stats. 1993, Ch. 121, Sec. 43. Effective July 16, 1993.)
  125. 4622.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.5. Medical-Legal Expenses [4620 - 4628] ( Article 2.5 added by Stats. 1984, Ch. 596, Sec. 4. )

    Verify source ↗

    This section requires employers to pay covered medical-legal expenses on time, creates a second-review process for billing disputes, and allows added charges and interest if payment is late.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.5. Medical-Legal Expenses [4620 - 4628] ( Article 2.5 added by Stats. 1984, Ch. 596, Sec. 4. ) ## 4622. All medical-legal expenses for which the employer is liable shall, upon receipt by the employer of all reports and documents required by the administrative director incident to the services, be paid to whom the funds and expenses are due, as follows: (a) (1) Except as provided in subdivision (b), within 60 days after receipt by the employer of each separate, written billing and report, and if payment is not made within this period, that portion of the billed sum then unreasonably unpaid shall be increased by 10 percent, together with interest thereon at the rate of 7 percent per annum retroactive to the date of receipt of the bill and report by the employer. If the employer, within the 60-day period, contests the reasonableness and necessity for incurring the fees, services, and expenses using the explanation of review required by Section 4603.3, payment shall be made within 20 days of the service of an order of the appeals board or the administrative director pursuant to Section 4603.6 directing payment. (2) The penalty provided for in paragraph (1) shall not apply if both of the following occur: (A) The employer pays the provider that portion of his or her charges that do not exceed the amount deemed reasonable pursuant to subdivision (e) within 60 days of receipt of the report and itemized billing. (B) The employer prevails. (b) (1) If the provider contests the amount paid, the provider may request a second review within 90 days of the service of the explanation of review. The request for a second review shall be submitted to the employer on a form prescribed by the administrative director and shall include all of the following: (A) The date of the explanation of review and the claim number or other unique identifying number provided on the explanation of review. (B) The party or parties requesting the service. (C) Any item and amount in dispute. (D) The additional payment requested and the reason therefor. (E) Any additional information requested in the original explanation of review and any other information provided in support of the additional payment requested. (2) If the provider does not request a second review within 90 days, the bill will be deemed satisfied and neither the employer nor the employee shall be liable for any further payment. (3) Within 14 days of the request for second review, the employer shall respond with a final written determination on each of the items or amounts in dispute, including whether additional payment will be made. (4) If the provider contests the amount paid, after receipt of the second review, the provider shall request an independent bill review as provided for in Section 4603.6. (c) If the employer denies all or a portion of the amount billed for any reason other than the amount to be paid pursuant to the fee schedules in effect on the date of service, the provider may object to the denial within 90 days of the service of the explanation of review. If the provider does not object to the denial within 90 days, neither the employer nor the employee shall be liable for the amount that was denied. If the provider objects to the denial within 90 days of the service of the explanation of review, the employer shall file a petition and a declaration of readiness to proceed with the appeals board within 60 days of service of the objection. If the employer prevails before the appeals board, the appeals board shall order the physician to reimburse the employer for the amount of the paid charges found to be unreasonable. (d) If requested by the employee, or the dependents of a deceased employee, within 20 days from the filing of an order of the appeals board directing payment, and where payment is not made within that period, that portion of the billed sum then unpaid shall be increased by 10 percent, together with interest thereon at the rate of 7 percent per annum retroactive to the date of the filing of the order of the board directing payment. (e) (1) Using the explanation of review as described in Section 4603.3, the employer shall notify the provider of the services, the employee, or if represented, his or her attorney, if the employer contests the reasonableness or necessity of incurring these expenses, and shall indicate the reasons therefor. (2) The appeals board shall promulgate all necessary and reasonable rules and regulations to insure compliance with this section, and shall take such further steps as may be necessary to guarantee that the rules and regulations are enforced. (3) The provisions of Sections 5800 and 5814 shall not apply to this section. (f) Nothing contained in this section shall be construed to create a rebuttable presumption of entitlement to payment of an expense upon receipt by the employer of the required reports and documents. This section is not applicable unless there has been compliance with Sections 4620 and 4621. (Amended by Stats. 2012, Ch. 363, Sec. 53. (SB 863) Effective January 1, 2013.)
  126. 4625.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.5. Medical-Legal Expenses [4620 - 4628] ( Article 2.5 added by Stats. 1984, Ch. 596, Sec. 4. )

    Verify source ↗

    Medical-legal bills must be submitted to the employer within 12 months of service, and qualifying charges must be paid promptly; the employer may seek reimbursement through the appeals board if it disputes paid charges as unreasonable.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.5. Medical-Legal Expenses [4620 - 4628] ( Article 2.5 added by Stats. 1984, Ch. 596, Sec. 4. ) ## 4625. (a) Effective for services provided on or after January 1, 2017, all bills for medical-legal evaluation or medical-legal expense shall be submitted to the employer within 12 months of the date of service in the manner prescribed by the administrative director. The administrative director shall adopt rules to define circumstances that constitute good cause for an exception to the 12-month period. Bills for medical-legal charges are barred unless timely submitted. (b) Notwithstanding subdivision (d) of Section 4628, all charges for medical-legal expenses for which the employer is liable that are not in excess of those set forth in the official medical-legal fee schedule adopted pursuant to Section 5307.6 shall be paid promptly pursuant to Section 4622. (c) If the employer contests the reasonableness of the charges it has paid, the employer may file a petition with the appeals board to obtain reimbursement of the charges from the physician that are considered to be unreasonable. (Amended by Stats. 2016, Ch. 214, Sec. 3. (SB 1175) Effective January 1, 2017.)
  127. 4626.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.5. Medical-Legal Expenses [4620 - 4628] ( Article 2.5 added by Stats. 1984, Ch. 596, Sec. 4. )

    Verify source ↗

    Charges for X-rays, laboratory services, and other diagnostic tests used in an industrial medical-legal evaluation must be billed under the official medical fee schedule and itemized separately.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.5. Medical-Legal Expenses [4620 - 4628] ( Article 2.5 added by Stats. 1984, Ch. 596, Sec. 4. ) ## 4626. All charges for X-rays, laboratory services, and other diagnostic tests provided in connection with an industrial medical-legal evaluation shall be billed in accordance with the official medical fee schedule adopted by the administrative director pursuant to Section 5307.1 and shall be itemized separately in accordance with rules promulgated by the administrative director. (Added by Stats. 1984, Ch. 596, Sec. 4. Effective July 19, 1984.)
  128. 4627.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.5. Medical-Legal Expenses [4620 - 4628] ( Article 2.5 added by Stats. 1984, Ch. 596, Sec. 4. )

    Verify source ↗

    The board and the administrative director may adopt reasonable rules and regulations to interpret this article and enforce compliance with it.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.5. Medical-Legal Expenses [4620 - 4628] ( Article 2.5 added by Stats. 1984, Ch. 596, Sec. 4. ) ## 4627. The board and the administrative director may promulgate such reasonable rules and regulations as may be necessary to interpret this article and compel compliance with its provisions. (Added by Stats. 1984, Ch. 596, Sec. 4. Effective July 19, 1984.)
  129. 4628.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.5. Medical-Legal Expenses [4620 - 4628] ( Article 2.5 added by Stats. 1984, Ch. 596, Sec. 4. )

    Verify source ↗

    This section restricts who may examine the injured employee or help prepare a medical-legal report, limits what may be charged, and requires specific disclosures and declarations in the report.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 2.5. Medical-Legal Expenses [4620 - 4628] ( Article 2.5 added by Stats. 1984, Ch. 596, Sec. 4. ) ## 4628. (a) Except as provided in subdivision (c), no person, other than the physician who signs the medical-legal report, except a nurse performing those functions routinely performed by a nurse, such as taking blood pressure, shall examine the injured employee or participate in the nonclerical preparation of the report, including all of the following: (1) Taking a complete history. (2) Reviewing and summarizing prior medical records. (3) Composing and drafting the conclusions of the report. (b) The report shall disclose the date when and location where the evaluation was performed; that the physician or physicians signing the report actually performed the evaluation; whether the evaluation performed and the time spent performing the evaluation was in compliance with the guidelines established by the administrative director pursuant to paragraph (5) of subdivision (j) of Section 139.2 or Section 5307.6 and shall disclose the name and qualifications of each person who performed any services in connection with the report, including diagnostic studies, other than its clerical preparation. If the report discloses that the evaluation performed or the time spent performing the evaluation was not in compliance with the guidelines established by the administrative director, the report shall explain, in detail, any variance and the reason or reasons therefor. (c) If the initial outline of a patient’s history or excerpting of prior medical records is not done by the physician, the physician shall review the excerpts and the entire outline and shall make additional inquiries and examinations as are necessary and appropriate to identify and determine the relevant medical issues. (d) No amount may be charged in excess of the direct charges for the physician’s professional services and the reasonable costs of laboratory examinations, diagnostic studies, and other medical tests, and reasonable costs of clerical expense necessary to producing the report. Direct charges for the physician’s professional services shall include reasonable overhead expense. (e) Failure to comply with the requirements of this section shall make the report inadmissible as evidence and shall eliminate any liability for payment of any medical-legal expense incurred in connection with the report. (f) Knowing failure to comply with the requirements of this section shall subject the physician to a civil penalty of up to one thousand dollars ($1,000) for each violation to be assessed by a workers’ compensation judge or the appeals board. All civil penalties collected under this section shall be deposited in the Workers’ Compensation Administration Revolving Fund. (g) A physician who is assessed a civil penalty under this section may be terminated, suspended, or placed on probation as a qualified medical evaluator pursuant to subdivisions (k) and (l) of Section 139.2. (h) Knowing failure to comply with the requirements of this section shall subject the physician to contempt pursuant to the judicial powers vested in the appeals board. (i) Any person billing for medical-legal evaluations, diagnostic procedures, or diagnostic services performed by persons other than those employed by the reporting physician or physicians, or a medical corporation owned by the reporting physician or physicians shall specify the amount paid or to be paid to those persons for the evaluations, procedures, or services. This subdivision shall not apply to any procedure or service defined or valued pursuant to Section 5307.1. (j) The report shall contain a declaration by the physician signing the report, under penalty of perjury, stating: “I declare under penalty of perjury that the information contained in this report and its attachments, if any, is true and correct to the best of my knowledge and belief, except as to information that I have indicated I received from others. As to that information, I declare under penalty of perjury that the information accurately describes the information provided to me and, except as noted herein, that I believe it to be true.” The foregoing declaration shall be dated and signed by the reporting physician and shall indicate the county wherein it was signed. (k) The physician shall provide a curriculum vitae upon request by a party and include a statement concerning the percent of the physician’s total practice time that is annually devoted to medical treatment. (Amended by Stats. 2003, Ch. 639, Sec. 29. Effective January 1, 2004.)
  130. 4650.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    The employer must pay temporary disability and permanent disability indemnity on set deadlines, and late payments generally get a 10% increase paid to the employee.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4650. (a) If an injury causes temporary disability, the first payment of temporary disability indemnity shall be made not later than 14 days after knowledge of the injury and disability, on which date all indemnity then due shall be paid, unless liability for the injury is earlier denied. (b) (1) If the injury causes permanent disability, the first payment shall be made within 14 days after the date of last payment of temporary disability indemnity, except as provided in paragraph (2). When the last payment of temporary disability indemnity has been made pursuant to subdivision (c) of Section 4656, and regardless of whether the extent of permanent disability can be determined at that date, the employer nevertheless shall commence the timely payment required by this subdivision and shall continue to make these payments until the employer’s reasonable estimate of permanent disability indemnity due has been paid, and if the amount of permanent disability indemnity due has been determined, until that amount has been paid. (2) Prior to an award of permanent disability indemnity, a permanent disability indemnity payment shall not be required if the employer has offered the employee a position that pays at least 85 percent of the wages and compensation paid to the employee at the time of injury or if the employee is employed in a position that pays at least 100 percent of the wages and compensation paid to the employee at the time of injury, provided that when an award of permanent disability indemnity is made, the amount then due shall be calculated from the last date for which temporary disability indemnity was paid, or the date the employee’s disability became permanent and stationary, whichever is earlier. (c) Payment of temporary or permanent disability indemnity subsequent to the first payment shall be made as due every two weeks on the day designated with the first payment. (d) If any indemnity payment is not made timely as required by this section, the amount of the late payment shall be increased 10 percent and shall be paid, without application, to the employee, unless the employer continues the employee’s wages under a salary continuation plan, as defined in subdivision (g). No increase shall apply to any payment due prior to or within 14 days after the date the claim form was submitted to the employer under Section 5401. No increase shall apply when, within the 14-day period specified under subdivision (a), the employer is unable to determine whether temporary disability indemnity payments are owed and advises the employee, in the manner prescribed in rules and regulations adopted pursuant to Section 138.4, why payments cannot be made within the 14-day period, what additional information is required to make the decision whether temporary disability indemnity payments are owed, and when the employer expects to have the information required to make the decision. (e) If the employer is insured for its obligation to provide compensation, the employer shall be obligated to reimburse the insurer for the amount of increase in indemnity payments, made pursuant to subdivision (d), if the late payment which gives rise to the increase in indemnity payments, is due less than seven days after the insurer receives the completed claim form from the employer. Except as specified in this subdivision, an employer shall not be obligated to reimburse an insurer nor shall an insurer be permitted to seek reimbursement, directly or indirectly, for the amount of increase in indemnity payments specified in this section. (f) If an employer is obligated under subdivision (e) to reimburse the insurer for the amount of increase in indemnity payments, the insurer shall notify the employer in writing, within 30 days of the payment, that the employer is obligated to reimburse the insurer and shall bill and collect the amount of the payment no later than at final audit. However, the insurer shall not be obligated to collect, and the employer shall not be obligated to reimburse, amounts paid pursuant to subdivision (d) unless the aggregate total paid in a policy year exceeds one hundred dollars ($100). The employer shall have 60 days, following notice of the obligation to reimburse, to appeal the decision of the insurer to the Department of Insurance. The notice of the obligation to reimburse shall specify that the employer has the right to appeal the decision of the insurer as provided in this subdivision. (g) For purposes of this section, “salary continuation plan” means a plan that meets both of the following requirements: (1) The plan is paid for by the employer pursuant to statute, collective bargaining agreement, memorandum of understanding, or established employer policy. (2) The plan provides the employee on his or her regular payday with salary not less than the employee is entitled to receive pursuant to statute, collective bargaining agreement, memorandum of understanding, or established employer policy and not less than the employee would otherwise receive in indemnity payments. (Amended by Stats. 2012, Ch. 363, Sec. 54. (SB 863) Effective January 1, 2013.)
  131. 4650.5.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    For certain public employees injured by a criminal act of violence, disability payments start on the first day they leave work because of the injury.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4650.5. Notwithstanding Section 4650, in the case of state civil service employees, employees of the Regents of the University of California, and employees of the Board of Trustees of the California State University, the disability payment shall be made from the first day the injured employee leaves work as a result of the injury, if the injury is the result of a criminal act of violence against the employee. (Amended by Stats. 1983, Ch. 142, Sec. 102.)
  132. 4651.1.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    If a petition says a disability has decreased or ended, the disability is presumed to continue for at least one week after filing, unless the employee had already returned to work by then.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4651.1. Where a petition is filed with the appeals board concerning a continuing award of such appeals board, in which it is alleged that the disability has decreased or terminated, there shall be a rebuttable presumption that such temporary disability continues for at least one week following the filing of such petition. In such case, payment for such week shall be made in accordance with the provisions of Sections 4650 and 4651 of this code. Where the employee has returned to work at or prior to the date of such filing, however, no such presumption shall apply. Service of a copy of such petition on the employee shall be made as provided by Section 5316 of this code. (Amended by Stats. 1965, Ch. 1513.)
  133. 4651.2.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Petitions filed under Section 4651.1 may not be granted while the injured worker is pursuing a rehabilitation plan under Section 139.5.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4651.2. No petitions filed under Section 4651.1 shall be granted while the injured workman is pursuing a rehabilitation plan under Section 139.5 of this code. (Added by Stats. 1965, Ch. 1513.)
  134. 4651.3.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    If a petition under Section 4651.1 is filed and then wholly denied, the appeals board may set reasonable attorney’s fees and charge them as costs to the party that filed the petition.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4651.3. Where a petition is filed with the appeals board pursuant to the provisions of Section 4651.1, and is subsequently denied wholly by the appeals board, the board may determine the amount of attorney’s fees reasonably incurred by the applicant in resisting the petition and may assess such reasonable attorney’s fees as a cost upon the party filing the petition to decrease or terminate the award of the appeals board. (Added by Stats. 1971, Ch. 1558.)
  135. 4652.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Temporary disability indemnity is generally not recoverable for the first 3 days after the employee leaves work because of the injury, unless the disability lasts more than 14 days or the employee is hospitalized as an inpatient for treatment required by the injury.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4652. Except as otherwise provided by Section 4650.5, no temporary disability indemnity is recoverable for the disability suffered during the first three days after the employee leaves work as a result of the injury unless temporary disability continues for more than 14 days or the employee is hospitalized as an inpatient for treatment required by the injury, in either of which cases temporary disability indemnity shall be payable from the date of disability. For purposes of calculating the waiting period, the day of the injury shall be included unless the employee was paid full wages for that day. (Amended by Stats. 1989, Ch. 892, Sec. 36.)
  136. 4653.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    If an injury causes temporary total disability, the disability payment is two-thirds of the employee’s average weekly earnings during the disability period.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4653. If the injury causes temporary total disability, the disability payment is two-thirds of the average weekly earnings during the period of such disability, consideration being given to the ability of the injured employee to compete in an open labor market. (Amended by Stats. 1973, Ch. 1023.)
  137. 4654.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    For temporary partial disability, the disability payment is two-thirds of the weekly wage loss, and it is reduced by unemployment compensation and extended duration benefits received during that period.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4654. If the injury causes temporary partial disability, the disability payment is two-thirds of the weekly loss in wages during the period of such disability. However, such disability payment shall be reduced by the sum of unemployment compensation benefits and extended duration benefits received by the employee during the period of temporary partial disability. (Amended by Stats. 1973, Ch. 1023.)
  138. 4655.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    If an injury causes temporary disability that is sometimes total and sometimes partial, the weekly disability payment for each period follows sections 4653 and 4654.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4655. If the injury causes temporary disability which is at times total and at times partial, the weekly disability payment during the period of each total or partial disability is in accordance with sections 4653 and 4654 respectively. (Enacted by Stats. 1937, Ch. 90.)
  139. 4656.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Temporary disability payments are capped at set week limits depending on the injury date and, in some cases, the type of injury.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4656. (a) Aggregate disability payments for a single injury occurring prior to January 1, 1979, causing temporary disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury. (b) Aggregate disability payments for a single injury occurring on or after January 1, 1979, and prior to April 19, 2004, causing temporary partial disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury. (c) (1) Aggregate disability payments for a single injury occurring on or after April 19, 2004, causing temporary disability shall not extend for more than 104 compensable weeks within a period of two years from the date of commencement of temporary disability payment. (2) Aggregate disability payments for a single injury occurring on or after January 1, 2008, causing temporary disability shall not extend for more than 104 compensable weeks within a period of five years from the date of injury. (3) Notwithstanding paragraphs (1) and (2), for an employee who suffers from the following injuries or conditions, aggregate disability payments for a single injury occurring on or after April 19, 2004, causing temporary disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury: (A) Acute and chronic hepatitis B. (B) Acute and chronic hepatitis C. (C) Amputations. (D) Severe burns. (E) Human immunodeficiency virus (HIV). (F) High-velocity eye injuries. (G) Chemical burns to the eyes. (H) Pulmonary fibrosis. (I) Chronic lung disease. (d) Notwithstanding subdivisions (a), (b), and (c), for an employee who suffers from an injury or condition defined in Section 3212.1, aggregate disability payments for a single injury occurring on or after January 1, 2023, causing temporary disability shall not extend for more than 240 compensable weeks. (Amended by Stats. 2022, Ch. 835, Sec. 2. (SB 1127) Effective January 1, 2023.)
  140. 4657.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    For temporary partial disability, weekly wage loss is calculated as the difference between the injured employee’s average weekly earnings and what the employee is likely to earn during the disability.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4657. In case of temporary partial disability the weekly loss in wages shall consist of the difference between the average weekly earnings of the injured employee and the weekly amount which the injured employee will probably be able to earn during the disability, to be determined in view of the nature and extent of the injury. In computing such probable earnings, due regard shall be given to the ability of the injured employee to compete in an open labor market. If evidence of exact loss of earnings is lacking, such weekly loss in wages may be computed from the proportionate loss of physical ability or earning power caused by the injury. (Enacted by Stats. 1937, Ch. 90.)
  141. 4658.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    This section sets how permanent disability payments are calculated for injuries in different date ranges, including percentage-based week schedules and a cap on average weekly earnings.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4658. (a) For injuries occurring prior to January 1, 1992, if the injury causes permanent disability, the percentage of disability to total disability shall be determined, and the disability payment computed and allowed, according to paragraph (1). However, in no event shall the disability payment allowed be less than the disability payment computed according to paragraph (2). (1) Column 1—Range of percentage of permanent disability incurred: Column 2—Number of weeks for which two-thirds of average weekly earnings allowed for each 1 percent of permanent disability within percentage range: Under 10 ........................ 3 10–19.75 ........................ 4 20–29.75 ........................ 5 30–49.75 ........................ 6 50–69.75 ........................ 7 70–99.75 ........................ 8 The number of weeks for which payments shall be allowed set forth in column 2 above based upon the percentage of permanent disability set forth in column 1 above shall be cumulative, and the number of benefit weeks shall increase with the severity of the disability. The following schedule is illustrative of the computation of the number of benefit weeks: Column 1— Percentage of permanent disability incurred: Column 2— Cumulative number of benefit weeks: 5 ........................ 15.00 10 ........................ 30.25 15 ........................ 50.25 20 ........................ 70.50 25 ........................ 95.50 30 ........................ 120.75 35 ........................ 150.75 40 ........................ 180.75 45 ........................ 210.75 50 ........................ 241.00 55 ........................ 276.00 60 ........................ 311.00 65 ........................ 346.00 70 ........................ 381.25 75 ........................ 421.25 80 ........................ 461.25 85 ........................ 501.25 90 ........................ 541.25 95 ........................ 581.25 100 ........................ for life (2) Two-thirds of the average weekly earnings for four weeks for each 1 percent of disability, where, for the purposes of this subdivision, the average weekly earnings shall be taken at not more than seventy-eight dollars and seventy-five cents ($78.75). (b) This subdivision shall apply to injuries occurring on or after January 1, 1992. If the injury causes permanent disability, the percentage of disability to total disability shall be determined, and the disability payment computed and allowed, according to paragraph (1). However, in no event shall the disability payment allowed be less than the disability payment computed according to paragraph (2). (1) Column 1—Range of percentage of permanent disability incurred: Column 2—Number of weeks for which two-thirds of average weekly earnings allowed for each 1 percent of permanent disability within percentage range: Under 10 ........................ 3 10–19.75 ........................ 4 20–24.75 ........................ 5 25–29.75 ........................ 6 30–49.75 ........................ 7 50–69.75 ........................ 8 70–99.75 ........................ 9 The numbers set forth in column 2 above are based upon the percentage of permanent disability set forth in column 1 above and shall be cumulative, and shall increase with the severity of the disability in the manner illustrated in subdivision (a). (2) Two-thirds of the average weekly earnings for four weeks for each 1 percent of disability, where, for the purposes of this subdivision, the average weekly earnings shall be taken at not more than seventy-eight dollars and seventy-five cents ($78.75). (c) This subdivision shall apply to injuries occurring on or after January 1, 2004. If the injury causes permanent disability, the percentage of disability to total disability shall be determined, and the disability payment computed and allowed as follows: Column 1—Range of percentage of permanent disability incurred: Column 2—Number of weeks for which two-thirds of average weekly earnings allowed for each 1 percent of permanent disability within percentage range: Under 10 ........................ 4 10–19.75 ........................ 5 20–24.75 ........................ 5 25–29.75 ........................ 6 30–49.75 ........................ 7 50–69.75 ........................ 8 70–99.75 ........................ 9 The numbers set forth in column 2 above are based upon the percentage of permanent disability set forth in column 1 above and shall be cumulative, and shall increase with the severity of the disability in the manner illustrated in subdivision (a). (d) (1) This subdivision shall apply to injuries occurring on or after January 1, 2005, and as additionally provided in paragraph (4). If the injury causes permanent disability, the percentage of disability to total disability shall be determined, and the basic disability payment computed as follows: Column 1—Range of percentage of permanent disability incurred: Column 2—Number of weeks for which two-thirds of average weekly earnings allowed for each 1 percent of permanent disability within percentage range: 0.25–9.75 ........................ 3 10–14.75 ........................ 4 15–24.75 ........................ 5 25–29.75 ........................ 6 30–49.75 ........................ 7 50–69.75 ........................ 8 70–99.75 ........................ 16 The numbers set forth in column 2 above are based upon the percentage of permanent disability set forth in column 1 above and shall be cumulative, and shall increase with the severity of the disability in the manner illustrated in subdivision (a). (2) If, within 60 days of a disability becoming permanent and stationary, an employer does not offer the injured employee regular work, modified work, or alternative work, in the form and manner prescribed by the administrative director, for a period of at least 12 months, each disability payment remaining to be paid to the injured employee from the date of the end of the 60-day period shall be paid in accordance with paragraph (1) and increased by 15 percent. This paragraph shall not apply to an employer that employs fewer than 50 employees. (3) (A) If, within 60 days of a disability becoming permanent and stationary, an employer offers the injured employee regular work, modified work, or alternative work, in the form and manner prescribed by the administrative director, for a period of at least 12 months, and regardless of whether the injured employee accepts or rejects the offer, each disability payment remaining to be paid to the injured employee from the date the offer was made shall be paid in accordance with paragraph (1) and decreased by 15 percent. (B) If the regular work, modified work, or alternative work is terminated by the employer before the end of the period for which disability payments are due the injured employee, the amount of each of the remaining disability payments shall be paid in accordance with paragraph (1) and increased by 15 percent. An employee who voluntarily terminates employment shall not be eligible for payment under this subparagraph. This paragraph shall not apply to an employer that employs fewer than 50 employees. (4) For compensable claims arising before April 30, 2004, the schedule provided in this subdivision shall not apply to the determination of permanent disabilities when there has been either a comprehensive medical-legal report or a report by a treating physician, indicating the existence of permanent disability, or when the employer is required to provide the notice required by Section 4061 to the injured worker. (e) This subdivision shall apply to injuries occurring on or after January 1, 2013. If the injury causes permanent disability, the percentage of disability to total disability shall be determined, and the disability payment computed and allowed as follows: Column 1—Range of percentage of permanent disability incurred: Column 2—Number of weeks for which two-thirds of average weekly earnings allowed for each 1 percent of permanent disability within percentage range: 0.25–9.75 ........................ 3 10–14.75 ........................ 4 15–24.75 ........................ 5 25–29.75 ........................ 6 30–49.75 ........................ 7 50–69.75 ........................ 8 70–99.75 ........................ 16 (1) The numbers set forth in column 2 above are based upon the percentage of permanent disability set forth in column 1 above and shall be cumulative, and shall increase with the severity of the disability in the manner illustrated in subdivision (a). (2) If the permanent disability directly caused by the industrial injury is total, payment shall be made as provided in Section 4659. (Amended by Stats. 2012, Ch. 363, Sec. 55. (SB 863) Effective January 1, 2013.)
  142. 4658.1.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    This section defines regular work, modified work, and alternative work for disability payments, and lets the employee waive the distance requirement.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4658.1. As used in this article, the following definitions apply: (a) “Regular work” means the employee’s usual occupation or the position in which the employee was engaged at the time of injury and that offers wages and compensation equivalent to those paid to the employee at the time of injury, and located within a reasonable commuting distance of the employee’s residence at the time of injury. (b) “Modified work” means regular work modified so that the employee has the ability to perform all the functions of the job and that offers wages and compensation that are at least 85 percent of those paid to the employee at the time of injury, and located within a reasonable commuting distance of the employee’s residence at the time of injury. (c) “Alternative work” means work that the employee has the ability to perform, that offers wages and compensation that are at least 85 percent of those paid to the employee at the time of injury, and that is located within reasonable commuting distance of the employee’s residence at the time of injury. (d) For the purpose of determining whether wages and compensation are equivalent to those paid at the time of injury, the wages and compensation for any increase in working hours over the average hours worked at the time of injury shall not be considered. (e) For the purpose of determining whether wages and compensation are equivalent to those paid at the time of injury, actual wages and compensation shall be determined without regard to the minimums and maximums set forth in Chapter 1 (commencing with Section 4451). (f) The condition that regular work, modified work, or alternative work be located within a reasonable distance of the employee’s residence at the time of injury may be waived by the employee. The condition shall be deemed to be waived if the employee accepts the regular work, modified work, or alternative work and does not object to the location within 20 days of being informed of the right to object. The condition shall be conclusively deemed to be satisfied if the offered work is at the same location and the same shift as the employment at the time of injury. (Added by Stats. 2004, Ch. 34, Sec. 31. Effective April 19, 2004.)
  143. 4658.5.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    This section gives certain injured employees a voucher benefit for retraining or skill enhancement, sets voucher limits by disability percentage, and limits employer liability while the voucher is used.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4658.5. (a) This section shall apply to injuries occurring on or after January 1, 2004, and before January 1, 2013. (b) Except as provided in Section 4658.6, if the injury causes permanent partial disability and the injured employee does not return to work for the employer within 60 days of the termination of temporary disability, the injured employee shall be eligible for a supplemental job displacement benefit in the form of a nontransferable voucher for education-related retraining or skill enhancement, or both, at state-approved or accredited schools, as follows: (1) Up to four thousand dollars ($4,000) for permanent partial disability awards of less than 15 percent. (2) Up to six thousand dollars ($6,000) for permanent partial disability awards between 15 and 25 percent. (3) Up to eight thousand dollars ($8,000) for permanent partial disability awards between 26 and 49 percent. (4) Up to ten thousand dollars ($10,000) for permanent partial disability awards between 50 and 99 percent. (c) The voucher may be used for payment of tuition, fees, books, and other expenses required by the school for retraining or skill enhancement. No more than 10 percent of the voucher moneys may be used for vocational or return-to-work counseling. The administrative director shall adopt regulations governing the form of payment, direct reimbursement to the injured employee upon presentation to the employer of appropriate documentation and receipts, and other matters necessary to the proper administration of the supplemental job displacement benefit. (d) A voucher issued on or after January 1, 2013, shall expire two years after the date the voucher is furnished to the employee or five years after the date of injury, whichever is later. The employee shall not be entitled to payment or reimbursement of any expenses that have not been incurred and submitted with appropriate documentation to the employer prior to the expiration date. (e) An employer shall not be liable for compensation for injuries incurred by the employee while utilizing the voucher. (Amended by Stats. 2012, Ch. 363, Sec. 56. (SB 863) Effective January 1, 2013.)
  144. 4658.6.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    An employer is not liable for the supplemental job displacement benefit if it timely offers qualifying modified work or alternative work and the employee rejects or does not accept it.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4658.6. The employer shall not be liable for the supplemental job displacement benefit pursuant to Section 4658.5 if the employer meets either of the following conditions: (a) Within 30 days of the termination of temporary disability indemnity payments, the employer offers, and the employee rejects, or fails to accept, in the form and manner prescribed by the administrative director, modified work, accommodating the employee’s work restrictions, lasting at least 12 months. (b) Within 30 days of the termination of temporary disability indemnity payments, the employer offers, and the employee rejects, or fails to accept, in the form and manner prescribed by the administrative director, alternative work meeting all of the following conditions: (1) The employee has the ability to perform the essential functions of the job provided. (2) The job provided is in a regular position lasting at least 12 months. (3) The job provided offers wages and compensation that are within 15 percent of those paid to the employee at the time of injury. (4) The job is located within reasonable commuting distance of the employee’s residence at the time of injury. (Amended by Stats. 2012, Ch. 363, Sec. 57. (SB 863) Effective January 1, 2013.)
  145. 4658.7.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    This section gives some injured employees a supplemental job displacement voucher, but only if the injury causes permanent partial disability and no qualifying job offer is made in time.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4658.7. (a) This section shall apply to injuries occurring on or after January 1, 2013. (b) If the injury causes permanent partial disability, the injured employee shall be entitled to a supplemental job displacement benefit as provided in this section unless the employer makes an offer of regular, modified, or alternative work, as defined in Section 4658.1, that meets both of the following criteria: (1) The offer is made no later than 60 days after receipt by the claims administrator of the first report received from either the primary treating physician, an agreed medical evaluator, or a qualified medical evaluator, in the form created by the administrative director pursuant to subdivision (h), finding that the disability from all conditions for which compensation is claimed has become permanent and stationary and that the injury has caused permanent partial disability. (A) If the employer or claims administrator has provided the physician with a job description of the employee’s regular work, proposed modified work, or proposed alternative work, the physician shall evaluate and describe in the form whether the work capacities and activity restrictions are compatible with the physical requirements set forth in that job description. (B) The claims administrator shall forward the form to the employer for the purpose of fully informing the employer of work capacities and activity restrictions resulting from the injury that are relevant to potential regular, modified, or alternative work. (2) The offer is for regular work, modified work, or alternative work lasting at least 12 months. (c) The supplemental job displacement benefit shall be offered to the employee within 20 days after the expiration of the time for making an offer of regular, modified, or alternative work pursuant to paragraph (1) of subdivision (b). (d) The supplemental job displacement benefit shall be in the form of a voucher redeemable as provided in this section up to an aggregate of six thousand dollars ($6,000). (e) The voucher may be applied to any of the following expenses at the choice of the injured employee: (1) Payment for education-related retraining or skill enhancement, or both, at a California public school or with a provider that is certified and on the state’s Eligible Training Provider List (EPTL), as authorized by the federal Workforce Investment Act (P.L. 105-220), including payment of tuition, fees, books, and other expenses required by the school for retraining or skill enhancement. (2) Payment for occupational licensing or professional certification fees, related examination fees, and examination preparation course fees. (3) Payment for the services of licensed placement agencies, vocational or return-to-work counseling, and résumé preparation, all up to a combined limit of 10 percent of the amount of the voucher. (4) Purchase of tools required by a training or educational program in which the employee is enrolled. (5) Purchase of computer equipment, up to one thousand dollars ($1,000). (6) Up to five hundred dollars ($500) as a miscellaneous expense reimbursement or advance, payable upon request and without need for itemized documentation or accounting. The employee shall not be entitled to any other voucher payment for transportation, travel expenses, telephone or Internet access, clothing or uniforms, or incidental expenses. (f) The voucher shall expire two years after the date the voucher is furnished to the employee, or five years after the date of injury, whichever is later. The employee shall not be entitled to payment or reimbursement of any expenses that have not been incurred and submitted with appropriate documentation to the employer prior to the expiration date. (g) Settlement or commutation of a claim for the supplemental job displacement benefit shall not be permitted under Chapter 2 (commencing with Section 5000) or Chapter 3 (commencing with Section 5100) of Part 3. (h) The administrative director shall adopt regulations for the administration of this section, including, but not limited to, both of the following: (1) The time, manner, and content of notices of rights under this section. (2) The form of a mandatory attachment to a medical report to be forwarded to the employer pursuant to paragraph (1) of subdivision (b) for the purpose of fully informing the employer of work capacities and of activity restrictions resulting from the injury that are relevant to potential regular work, modified work, or alternative work. (i) An employer shall not be liable for compensation for injuries incurred by the employee while utilizing the voucher. (Added by Stats. 2012, Ch. 363, Sec. 58. (SB 863) Effective January 1, 2013.)
  146. 4659.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    The section sets how certain permanent disability payments are calculated and capped, and requires annual increases for eligible life pensions or total permanent disability indemnity.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4659. (a) If the permanent disability is at least 70 percent, but less than 100 percent, 1.5 percent of the average weekly earnings for each 1 percent of disability in excess of 60 percent is to be paid during the remainder of life, after payment for the maximum number of weeks specified in Section 4658 has been made. For the purposes of this subdivision only, average weekly earnings shall be taken at not more than one hundred seven dollars and sixty-nine cents ($107.69). For injuries occurring on or after July 1, 1994, average weekly wages shall not be taken at more than one hundred fifty-seven dollars and sixty-nine cents ($157.69). For injuries occurring on or after July 1, 1995, average weekly wages shall not be taken at more than two hundred seven dollars and sixty-nine cents ($207.69). For injuries occurring on or after July 1, 1996, average weekly wages shall not be taken at more than two hundred fifty-seven dollars and sixty-nine cents ($257.69). For injuries occurring on or after January 1, 2006, average weekly wages shall not be taken at more than five hundred fifteen dollars and thirty-eight cents ($515.38). (b) If the permanent disability is total, the indemnity based upon the average weekly earnings determined under Section 4453 shall be paid during the remainder of life. (c) For injuries occurring on or after January 1, 2003, an employee who becomes entitled to receive a life pension or total permanent disability indemnity as set forth in subdivisions (a) and (b) shall have that payment increased annually commencing on January 1, 2004, and each January 1 thereafter, by an amount equal to the percentage increase in the “state average weekly wage” as compared to the prior year. For purposes of this subdivision, “state average weekly wage” means the average weekly wage paid by employers to employees covered by unemployment insurance as reported by the United States Department of Labor for California for the 12 months ending March 31 of the calendar year preceding the year in which the injury occurred. (Amended by Stats. 2002, Ch. 6, Sec. 67. Effective January 1, 2003.)
  147. 4660.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    The administrative director must update the permanent disability schedule at least every five years and adopt implementing regulations by January 1, 2005.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4660. This section shall only apply to injuries occurring before January 1, 2013. (a) In determining the percentages of permanent disability, account shall be taken of the nature of the physical injury or disfigurement, the occupation of the injured employee, and his or her age at the time of the injury, consideration being given to an employee’s diminished future earning capacity. (b) (1) For purposes of this section, the “nature of the physical injury or disfigurement” shall incorporate the descriptions and measurements of physical impairments and the corresponding percentages of impairments published in the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment (5th Edition). (2) For purposes of this section, an employee’s diminished future earning capacity shall be a numeric formula based on empirical data and findings that aggregate the average percentage of long-term loss of income resulting from each type of injury for similarly situated employees. The administrative director shall formulate the adjusted rating schedule based on empirical data and findings from the Evaluation of California’s Permanent Disability Rating Schedule, Interim Report (December 2003), prepared by the RAND Institute for Civil Justice, and upon data from additional empirical studies. (c) The administrative director shall amend the schedule for the determination of the percentage of permanent disability in accordance with this section at least once every five years. This schedule shall be available for public inspection and, without formal introduction in evidence, shall be prima facie evidence of the percentage of permanent disability to be attributed to each injury covered by the schedule. (d) The schedule shall promote consistency, uniformity, and objectivity. The schedule and any amendment thereto or revision thereof shall apply prospectively and shall apply to and govern only those permanent disabilities that result from compensable injuries received or occurring on and after the effective date of the adoption of the schedule, amendment or revision, as the fact may be. For compensable claims arising before January 1, 2005, the schedule as revised pursuant to changes made in legislation enacted during the 2003–04 Regular and Extraordinary Sessions shall apply to the determination of permanent disabilities when there has been either no comprehensive medical-legal report or no report by a treating physician indicating the existence of permanent disability, or when the employer is not required to provide the notice required by Section 4061 to the injured worker. (e) On or before January 1, 2005, the administrative director shall adopt regulations to implement the changes made to this section by the act that added this subdivision. (Amended by Stats. 2012, Ch. 363, Sec. 59. (SB 863) Effective January 1, 2013.)
  148. 4660.1.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    This section sets rules for rating permanent disability for injuries on or after January 1, 2013, gives the administrative director power to set or amend age and occupational modifiers, and requires a state commission to study and report on earnings loss for injured employees.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4660.1. This section applies to injuries occurring on or after January 1, 2013. (a) In determining the percentages of permanent partial or permanent total disability, account shall be taken of the nature of the physical injury or disfigurement, the occupation of the injured employee, and the employee’s age at the time of injury. (b) For purposes of this section, the “nature of the physical injury or disfigurement” shall incorporate the descriptions and measurements of physical impairments and the corresponding percentages of impairments published in the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment (5th Edition) with the employee’s whole person impairment, as provided in the Guides, multiplied by an adjustment factor of 1.4. (c) (1) Except as provided in paragraph (2), the impairment ratings for sleep dysfunction, sexual dysfunction, or psychiatric disorder, or any combination thereof, arising out of a compensable physical injury shall not increase. This section does not limit the ability of an injured employee to obtain treatment for sleep dysfunction, sexual dysfunction, or psychiatric disorder, if any, that are a consequence of an industrial injury. (2) An increased impairment rating for psychiatric disorder is not subject to paragraph (1) if the compensable psychiatric injury resulted from either of the following: (A) Being a victim of a violent act or direct exposure to a significant violent act within the meaning of Section 3208.3. (B) A catastrophic injury, including, but not limited to, loss of a limb, paralysis, severe burn, or severe head injury. (d) The administrative director may formulate a schedule of age and occupational modifiers and may amend the schedule for the determination of the age and occupational modifiers in accordance with this section. The Schedule for Rating Permanent Disabilities pursuant to the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment (5th Edition) and the schedule of age and occupational modifiers shall be available for public inspection and, without formal introduction in evidence, shall be prima facie evidence of the percentage of permanent disability to be attributed to each injury covered by the schedule. Until the schedule of age and occupational modifiers is amended, for injuries occurring on or after January 1, 2013, permanent disabilities shall be rated using the age and occupational modifiers in the permanent disability rating schedule adopted as of January 1, 2005. (e) The schedule of age and occupational modifiers shall promote consistency, uniformity, and objectivity. (f) The schedule of age and occupational modifiers and any amendment thereto or revision thereof shall apply prospectively and shall apply to and govern only those permanent disabilities that result from compensable injuries received or occurring on and after the effective date of the adoption of the schedule, amendment, or revision, as the case may be. (g) This section does not preclude a finding of permanent total disability in accordance with Section 4662. (h) In enacting the act adding this section, it is not the intent of the Legislature to overrule the holding in Milpitas Unified School District v. Workers’ Comp. Appeals Bd. (Guzman) (2010) 187 Cal.App.4th 808. (i) The Commission on Health and Safety and Workers’ Compensation shall conduct a study to compare average loss of earnings for employees who sustained work-related injuries with permanent disability ratings under the schedule, and shall report the results of the study to the appropriate policy and fiscal committees of the Legislature no later than January 1, 2016. (Amended by Stats. 2019, Ch. 497, Sec. 189. (AB 991) Effective January 1, 2020.)
  149. 4661.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    If an injury causes both temporary and permanent disability, the injured employee is entitled to compensation for the permanent disability in addition to any temporary disability payment.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4661. Where an injury causes both temporary and permanent disability, the injured employee is entitled to compensation for any permanent disability sustained by him in addition to any payment received by such injured employee for temporary disability. Every computation made pursuant to this section shall be made only with reference to disability resulting from an original injury sustained after this section as amended during the 1949 Regular Session of the Legislature becomes effective; provided, however, that all rights presently existing under this section shall be continued in force. (Amended by Stats. 1949, Ch. 107.)
  150. 4661.5.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    If a temporary total disability indemnity payment is made two years or more after the injury, it must be calculated using the Section 4453 average weekly earnings amount in effect on the payment date, unless that would reduce the payment.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4661.5. Notwithstanding any other provision of this division, when any temporary total disability indemnity payment is made two years or more from the date of injury, the amount of this payment shall be computed in accordance with the temporary disability indemnity average weekly earnings amount specified in Section 4453 in effect on the date each temporary total disability payment is made unless computing the payment on this basis produces a lower payment because of a reduction in the minimum average weekly earnings applicable under Section 4453. (Amended by Stats. 1989, Ch. 892, Sec. 38.)
  151. 4662.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Certain listed permanent disabilities are conclusively presumed to be total; in all other cases, permanent total disability is decided based on the facts.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4662. (a) Any of the following permanent disabilities shall be conclusively presumed to be total in character: (1) Loss of both eyes or the sight thereof. (2) Loss of both hands or the use thereof. (3) An injury resulting in a practically total paralysis. (4) An injury to the brain resulting in permanent mental incapacity. (b) In all other cases, permanent total disability shall be determined in accordance with the fact. (Amended by Stats. 2014, Ch. 144, Sec. 46. (AB 1847) Effective January 1, 2015.)
  152. 4663.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Physicians handling permanent-disability reports for claimed industrial injuries must address causation and include an apportionment determination; employees must disclose prior permanent disabilities or impairments on request.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4663. (a) Apportionment of permanent disability shall be based on causation. (b) A physician who prepares a report addressing the issue of permanent disability due to a claimed industrial injury shall address in that report the issue of causation of the permanent disability. (c) In order for a physician’s report to be considered complete on the issue of permanent disability, the report must include an apportionment determination. A physician shall make an apportionment determination by finding what approximate percentage of the permanent disability was caused by the direct result of injury arising out of and occurring in the course of employment and what approximate percentage of the permanent disability was caused by other factors both before and subsequent to the industrial injury, including prior industrial injuries. If the physician is unable to include an apportionment determination in his or her report, the physician shall state the specific reasons why the physician could not make a determination of the effect of that prior condition on the permanent disability arising from the injury. The physician shall then consult with other physicians or refer the employee to another physician from whom the employee is authorized to seek treatment or evaluation in accordance with this division in order to make the final determination. (d) An employee who claims an industrial injury shall, upon request, disclose all previous permanent disabilities or physical impairments. (e) Subdivisions (a), (b), and (c) do not apply to injuries or illnesses covered under Sections 3212, 3212.1, 3212.2, 3212.3, 3212.4, 3212.5, 3212.6, 3212.7, 3212.8, 3212.85, 3212.9, 3212.10, 3212.11, 3212.12, 3213, and 3213.2. (Amended by Stats. 2016, Ch. 86, Sec. 218. (SB 1171) Effective January 1, 2017.)
  153. 4664.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    An employer is liable only for the part of permanent disability directly caused by the work injury, and permanent disability awards are capped at 100% unless the injury or illness is conclusively presumed total under Section 4662.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 3. Disability Payments [4650 - 4664] ( Article 3 enacted by Stats. 1937, Ch. 90. ) ## 4664. (a) The employer shall only be liable for the percentage of permanent disability directly caused by the injury arising out of and occurring in the course of employment. (b) If the applicant has received a prior award of permanent disability, it shall be conclusively presumed that the prior permanent disability exists at the time of any subsequent industrial injury. This presumption is a presumption affecting the burden of proof. (c) (1) The accumulation of all permanent disability awards issued with respect to any one region of the body in favor of one individual employee shall not exceed 100 percent over the employee’s lifetime unless the employee’s injury or illness is conclusively presumed to be total in character pursuant to Section 4662. As used in this section, the regions of the body are the following: (A) Hearing. (B) Vision. (C) Mental and behavioral disorders. (D) The spine. (E) The upper extremities, including the shoulders. (F) The lower extremities, including the hip joints. (G) The head, face, cardiovascular system, respiratory system, and all other systems or regions of the body not listed in subparagraphs (A) to (F), inclusive. (2) Nothing in this section shall be construed to permit the permanent disability rating for each individual injury sustained by an employee arising from the same industrial accident, when added together, from exceeding 100 percent. (Added by Stats. 2004, Ch. 34, Sec. 35. Effective April 19, 2004.)
  154. 4700.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    When an injured employee dies, the employer’s liability under the referenced articles is not affected, no temporary or permanent disability payments are made after death, and accrued unpaid compensation goes to dependents or, if none, to the deceased employee’s representative, heirs, or other entitled persons without administration.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. ) ## 4700. The death of an injured employee does not affect the liability of the employer under Articles 2 (commencing with Section 4600) and 3 (commencing with Section 4650). Neither temporary nor permanent disability payments shall be made for any period of time subsequent to the death of the employee. Any accrued and unpaid compensation shall be paid to the dependents, or, if there are no dependents, to the personal representative of the deceased employee or heirs or other persons entitled thereto, without administration. (Amended by Stats. 1983, Ch. 142, Sec. 103.)
  155. 4701.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    If a work injury causes death, the employer must pay death-related benefits, including burial expenses and a death benefit for dependents.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. ) ## 4701. If an injury causes death, either with or without disability, the employer shall be liable, in addition to any other benefits provided by this division, for all of the following: (a) Reasonable expenses of the employee’s burial, in accordance with the following: (1) Up to two thousand dollars ($2,000) for injuries occurring prior to January 1, 1991. (2) Up to five thousand dollars ($5,000) for injuries occurring on or after January 1, 1991, and prior to January 1, 2013. (3) Up to ten thousand dollars ($10,000) for injuries occurring on or after January 1, 2013. (b) A death benefit, to be allowed to the dependents when the employee leaves any person dependent upon him or her for support. (Amended by Stats. 2012, Ch. 363, Sec. 61. (SB 863) Effective January 1, 2013.)
  156. 4702.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Section 4702 sets death benefit amounts for different dependent situations and requires payment in installments, with a minimum weekly rate of $224.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. ) ## 4702. (a) Except as otherwise provided in this section and Sections 4553, 4554, 4557, and 4558, and notwithstanding any amount of compensation paid or otherwise owing to the surviving dependent, personal representative, heir, or other person entitled to a deceased employee’s accrued and unpaid compensation, the death benefit in cases of total dependency shall be as follows: (1) In the case of two total dependents and regardless of the number of partial dependents, for injuries occurring before January 1, 1991, ninety-five thousand dollars ($95,000), for injuries occurring on or after January 1, 1991, one hundred fifteen thousand dollars ($115,000), for injuries occurring on or after July 1, 1994, one hundred thirty-five thousand dollars ($135,000), for injuries occurring on or after July 1, 1996, one hundred forty-five thousand dollars ($145,000), and for injuries occurring on or after January 1, 2006, two hundred ninety thousand dollars ($290,000). (2) In the case of one total dependent and one or more partial dependents, for injuries occurring before January 1, 1991, seventy thousand dollars ($70,000), for injuries occurring on or after January 1, 1991, ninety-five thousand dollars ($95,000), for injuries occurring on or after July 1, 1994, one hundred fifteen thousand dollars ($115,000), for injuries occurring on or after July 1, 1996, one hundred twenty-five thousand dollars ($125,000), and for injuries occurring on or after January 1, 2006, two hundred fifty thousand dollars ($250,000), plus four times the amount annually devoted to the support of the partial dependents, but not more than the following: for injuries occurring before January 1, 1991, a total of ninety-five thousand dollars ($95,000), for injuries occurring on or after January 1, 1991, one hundred fifteen thousand dollars ($115,000), for injuries occurring on or after July 1, 1994, one hundred twenty-five thousand dollars ($125,000), for injuries occurring on or after July 1, 1996, one hundred forty-five thousand dollars ($145,000), and for injuries occurring on or after January 1, 2006, two hundred ninety thousand dollars ($290,000). (3) In the case of one total dependent and no partial dependents, for injuries occurring before January 1, 1991, seventy thousand dollars ($70,000), for injuries occurring on or after January 1, 1991, ninety-five thousand dollars ($95,000), for injuries occurring on or after July 1, 1994, one hundred fifteen thousand dollars ($115,000), for injuries occurring on or after July 1, 1996, one hundred twenty-five thousand dollars ($125,000), and for injuries occurring on or after January 1, 2006, two hundred fifty thousand dollars ($250,000). (4) (A) In the case of no total dependents and one or more partial dependents, for injuries occurring before January 1, 1991, four times the amount annually devoted to the support of the partial dependents, but not more than seventy thousand dollars ($70,000), for injuries occurring on or after January 1, 1991, a total of ninety-five thousand dollars ($95,000), for injuries occurring on or after July 1, 1994, one hundred fifteen thousand dollars ($115,000), and for injuries occurring on or after July 1, 1996, but before January 1, 2006, one hundred twenty-five thousand dollars ($125,000). (B) In the case of no total dependents and one or more partial dependents, eight times the amount annually devoted to the support of the partial dependents, for injuries occurring on or after January 1, 2006, but not more than two hundred fifty thousand dollars ($250,000). (5) In the case of three or more total dependents and regardless of the number of partial dependents, one hundred fifty thousand dollars ($150,000), for injuries occurring on or after July 1, 1994, one hundred sixty thousand dollars ($160,000), for injuries occurring on or after July 1, 1996, and three hundred twenty thousand dollars ($320,000), for injuries occurring on or after January 1, 2006. (6) (A) In the case of a police officer who has no total dependents and no partial dependents, for injuries occurring on or after January 1, 2003, and prior to January 1, 2004, two hundred fifty thousand dollars ($250,000) to the estate of the deceased police officer. (B) For injuries occurring on or after January 1, 2004, in the case of no total dependents and no partial dependents, two hundred fifty thousand dollars ($250,000) to the estate of the deceased employee. (b) A death benefit in all cases shall be paid in installments in the same manner and amounts as temporary total disability indemnity would have to be made to the employee, unless the appeals board otherwise orders. However, no payment shall be made at a weekly rate of less than two hundred twenty-four dollars ($224). (c) Disability indemnity shall not be deducted from the death benefit and shall be paid in addition to the death benefit when the injury resulting in death occurs after September 30, 1949. (d) All rights under this section existing prior to January 1, 1990, shall be continued in force. (Amended by Stats. 2006, Ch. 119, Sec. 2. Effective January 1, 2007.)
  157. 4703.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    This section sets how death benefits are allocated among dependents of a deceased employee.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. ) ## 4703. Subject to the provisions of Section 4704, this section shall determine the right to a death benefit. If there is any person wholly dependent for support upon a deceased employee, that person shall receive a full death benefit as set forth in Section 4702 for one total dependent, and any additional partial dependents shall receive a death benefit as set forth in subdivision (b) of Section 4702 to a maximum aggregate amount of twenty-five thousand dollars ($25,000). If there are two or more persons wholly dependent for support upon a deceased employee, those persons shall receive the death benefit set forth in subdivision (a) of Section 4702, and any person partially dependent shall receive no part thereof. If there is more than one person wholly dependent for support upon a deceased employee, the death benefit shall be divided equally among them. If there is more than one person partially dependent for support upon a deceased employee, and no person wholly dependent for support, the amount allowed as a death benefit shall be divided among the persons so partially dependent in proportion to the relative extent of their dependency. (Amended by Stats. 1981, Ch. 210, Sec. 1.)
  158. 4703.5.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Death benefits for totally dependent children continue until the youngest child turns 18, or 19 if the child is still in high school and the death was in qualifying public-safety service cases, with a minimum weekly payment of $224.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. ) ## 4703.5. (a) In the case of one or more totally dependent children, as defined in Section 3501, after payment of the amount specified in Section 4702, and notwithstanding the maximum limitations specified in Sections 4702 and 4703, payment of death benefits shall continue until the youngest child attains 18 years of age, or until the death of a child physically or mentally incapacitated from earning, in the same manner and amount as temporary total disability indemnity would have been paid to the employee, except that no payment shall be made at a weekly rate of less than two hundred twenty-four dollars ($224). (b) (1) Notwithstanding the age limitation in subdivision (a), the payment of death benefits shall continue until the youngest child attains 19 years of age if the child is still attending high school and is receiving the death benefits as a child of an active member of a sheriff’s office, an active member of a police or fire department of a city, county, city and county, district, or other public or municipal corporation or political subdivision, an individual described in Chapter 4.5 (commencing with Section 830) of Title 3 of Part 2 of the Penal Code who is primarily engaged in active law enforcement activities, active firefighting member of the Department of Forestry and Fire Protection, or an active member of any county forestry or firefighting department or unit killed in the performance of duty. (2) Paragraph (1) shall not apply with respect to a child of a person whose principal duties are clerical or otherwise do not clearly fall within the scope of active law enforcement or active firefighting services, such as stenographers, telephone operators, and other office workers. (Amended by Stats. 2013, Ch. 786, Sec. 2. (AB 607) Effective January 1, 2014.)
  159. 4703.6.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Section 4703.5 also applies to certain totally dependent minor children of qualifying safety members who were killed in the line of duty before January 1, 1990.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. ) ## 4703.6. The provisions of Section 4703.5 shall also apply to a totally dependent minor child of a local safety member as defined in Article 4 (commencing with Section 20420) of Chapter 4 of Part 3 of Division 5 of Title 2 of the Government Code, or a safety member as defined in Section 31469.3 of the Government Code, other than a member performing duties related to juvenile hall group counseling and group supervision, or a safety member subject to any public retirement system, or a patrol member as defined in Section 20390 of the Government Code, if that member was killed in the line of duty prior to January 1, 1990, and the totally dependent minor child is otherwise entitled to benefits under Section 4703.5. (Amended by Stats. 2002, Ch. 296, Sec. 1. Effective August 28, 2002. Applicable from January 1, 2002, by Sec. 2 of Ch. 296.)
  160. 4704.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    The appeals board may allocate or reassign death benefits among dependents, and the benefit must be paid as the board determines.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. ) ## 4704. The appeals board may set apart or reassign the death benefit to any one or more of the dependents in accordance with their respective needs and in a just and equitable manner, and may order payment to a dependent subsequent in right, or not otherwise entitled thereto, upon good cause being shown therefor. The death benefit shall be paid to such one or more of the dependents of the deceased or to a trustee appointed by the appeals board for the benefit of the person entitled thereto, as determined by the appeals board. (Amended by Stats. 1965, Ch. 1513.)
  161. 4705.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    The person receiving the death benefit must use it for the beneficiaries and follow the appeals board’s findings and directions.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. ) ## 4705. The person to whom the death benefit is paid for the use of the several beneficiaries shall apply it in compliance with the findings and directions of the appeals board. (Amended by Stats. 1965, Ch. 1513.)
  162. 4706.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    If a dependent beneficiary dies and no dependent survives, the appeals board can order the remaining death benefit paid to certain heirs. If there is no surviving dependent or heir, it may also order burial expenses paid, up to the Section 4701 limit.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. ) ## 4706. (a) If a dependent beneficiary of any deceased employee dies and there is no surviving dependent, the payments of the death benefit accrued and payable at the time of the death of the sole remaining dependent shall be paid upon the order of the appeals board to the heirs of the dependent or, if none, to the heirs of the deceased employee, without administration. (b) In the event there is no surviving dependent and no surviving heir, the appeals board may order the burial expense of the deceased employee, not to exceed the amount specified in Section 4701, paid to the proper person, without administration. (Amended by Stats. 1972, Ch. 1334.)
  163. 4706.5.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Employers must pay specified death-benefit-related amounts to the Department of Industrial Relations when a worker dies in covered circumstances and no eligible survivor exists.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. ) ## 4706.5. (a) Whenever any fatal injury is suffered by an employee under circumstances that would entitle the employee to compensation benefits, but for his or her death, and the employee does not leave surviving any person entitled to a dependency death benefit, the employer shall pay a sum to the Department of Industrial Relations equal to the total dependency death benefit that would be payable to a surviving spouse with no dependent minor children. (b) When the deceased employee leaves no surviving dependent, personal representative, heir, or other person entitled to the accrued and unpaid compensation referred to in Section 4700, the accrued and unpaid compensation shall be paid by the employer to the Department of Industrial Relations. (c) The payments to be made to the Department of Industrial Relations, as required by subdivisions (a) and (b), shall be deposited in the General Fund and shall be credited, as a reimbursement, to any appropriation to the Department of Industrial Relations for payment of the additional compensation for subsequent injury provided in Article 5 (commencing with Section 4751), in the fiscal year in which the Controller’s receipt is issued. (d) The payments to be made to the Department of Industrial Relations, as required by subdivision (a), shall be paid to the department in a lump sum in the manner provided in subdivision (b) of Section 5101. (e) The Department of Industrial Relations shall keep a record of all payments due the state under this section, and shall take any steps as may be necessary to collect those amounts. (f) Each employer, or the employer’s insurance carrier, shall notify the administrative director, in any form as the administrative director may prescribe, of each employee death, except when the employer has actual knowledge or notice that the deceased employee left a surviving dependent. (g) When, after a reasonable search, the employer concludes that the deceased employee left no one surviving who is entitled to a dependency death benefit, and concludes that the death was under circumstances that would entitle the employee to compensation benefits, the employer may voluntarily make the payment referred to in subdivision (a). Payments so made shall be construed as payments made pursuant to an appeals board findings and award. Thereafter, if the appeals board finds that the deceased employee did in fact leave a person surviving who is entitled to a dependency death benefit, upon that finding, all payments referred to in subdivision (a) that have been made shall be forthwith returned to the employer, or if insured, to the employer’s workers’ compensation carrier that indemnified the employer for the loss. (h) This section does not apply where there is no surviving person entitled to a dependency death benefit or accrued and unpaid compensation if a death benefit is paid to any person under paragraph (6) of subdivision (a) of Section 4702. (Amended by Stats. 2006, Ch. 119, Sec. 3. Effective January 1, 2007.)
  164. 4707.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    This section limits death benefits for an active member of the Public Employees’ Retirement System, except for burial expenses up to $1,000, unless a specified PERS death benefit will not be paid; surviving spouse and children may receive any difference if the death allowance is lower.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. ) ## 4707. (a) Except as provided in subdivision (b), no benefits, except reasonable expenses of burial not exceeding one thousand dollars ($1,000), shall be awarded under this division on account of the death of an employee who is an active member of the Public Employees’ Retirement System unless it is determined that a special death benefit, as defined in the Public Employees’ Retirement Law, or the benefit provided in lieu of the special death benefit in Sections 21547 and 21548 of the Government Code, will not be paid by the Public Employees’ Retirement System to the surviving spouse or children under 18 years of age, of the deceased, on account of the death, but if the total death allowance paid to the surviving spouse and children is less than the benefit otherwise payable under this division the surviving spouse and children are entitled, under this division, to the difference. The amendments to this section during the 1977–78 Regular Session shall be applied retroactively to July 1, 1976. (b) The limitation prescribed by subdivision (a) does not apply to local safety members, or patrol members, as defined in Section 20390 of the Government Code, of the Public Employees’ Retirement System. This subdivision shall be applied retroactively. (c) The limitation prescribed by subdivision (a) does not apply to state safety members, as defined in Section 20400 of the Government Code, peace officers, as defined in Sections 830, 830.1, 830.2, subdivision (e) of Section 830.3, 830.4, and 830.5 of the Penal Code, firefighters for the Department of Forestry and Fire Protection who are members of Bargaining Unit 8 of the Public Employees’ Retirement System. This subdivision shall be applied retroactively to January 1, 2019, for injuries not previously claimed or resolved, and shall not supersede any statutes of limitations otherwise provided by the Labor Code. (Amended by Stats. 2023, Ch. 448, Sec. 1. (AB 621) Effective January 1, 2024.)
  165. 4708.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    If someone applies for a death benefit after the death of a Public Employees’ Retirement System member, the system must be joined as a defendant and the appeals board must decide whether the death was caused by a work-related injury or illness.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. ) ## 4708. Upon application of any party in interest for a death benefit provided by this division on the death of an employee member of the Public Employees’ Retirement System, the latter shall be joined as a defendant, and the appeals board shall determine whether the death resulted from injury or illness arising out of and in the course of his employment, for the purpose of enabling the appeals board to apply the provision of this division and the board of administration to apply the provisions of the Public Employees’ Retirement Law. (Amended by Stats. 1969, Ch. 639.)
  166. 4709.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Certain dependents of covered peace officers, corrections employees, and firefighters may receive a scholarship, if the loss or disability happened in the line of duty and other conditions are met.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4. Death Benefits [4700 - 4709] ( Article 4 enacted by Stats. 1937, Ch. 90. ) ## 4709. (a) Notwithstanding any other law, a dependent of a peace officer, as defined in Section 830.1, 830.2, 830.3, 830.31, 830.32, 830.33, 830.34, 830.35, 830.36, 830.37, 830.38, 830.39, 830.4, 830.5, or 830.6 of the Penal Code, or a Sheriff’s Special Officer of the County of Orange, who is killed in the performance of duty or who dies or is totally disabled as a result of an accident or an injury caused by external violence or physical force, incurred in the performance of duty, if the death, accident, or injury is compensable under this division or Division 4.5 (commencing with Section 6100) shall be entitled to a scholarship at a qualifying institution described in subdivision (l) of Section 69432.7 of the Education Code. The scholarship shall be in an amount equal to the amount provided a student who has been awarded a Cal Grant scholarship as specified in Chapter 1.7 (commencing with Section 69430) of Part 42 of Division 5 of Title 3 of the Education Code. (b) A dependent of an officer or employee of the Department of Corrections and Rehabilitation or the Department of Corrections and Rehabilitation, Division of Juvenile Justice, described in Section 20403 of the Government Code, who is killed in the performance of duty, or who dies or is totally disabled as a result of an accident or an injury incurred in the performance of duty, if the death, accident, or injury is caused by the direct action of an inmate, and is compensable under this division or Division 4.5 (commencing with Section 6100), shall also be entitled to a scholarship specified in this section. (c) Notwithstanding any other law, a dependent of a firefighter employed by a county, city, city and county, district, or other political subdivision of the state, who is killed in the performance of duty or who dies or is totally disabled as a result of an accident or injury incurred in the performance of duty, if the death, accident, or injury is compensable under this division or Division 4.5 (commencing with Section 6100), shall also be entitled to a scholarship specified in this section. (d) Notwithstanding any other law, the dependent of a firefighter employed by a tribal fire department, who is killed in the performance of duty or who dies or is totally disabled as a result of an accident or injury incurred in the performance of duty, is entitled to a scholarship specified in this section. (e) This section shall not be interpreted to allow the admittance of the dependent into a college or university unless the dependent is otherwise qualified to gain admittance to the college or university. (f) The scholarship provided for by this section shall be paid out of funds annually appropriated in the Budget Act to the Student Aid Commission established by Article 2 (commencing with Section 69510) of Chapter 2 of Part 42 of Division 5 of Title 3 of the Education Code. (g) The receipt of a scholarship provided for by this section shall not preclude a dependent from receiving a Cal Grant award pursuant to Chapter 1.7 (commencing with Section 69430) of Part 42 of Division 5 of Title 3 of the Education Code, any other grant, or any fee waivers that may be provided by an institution of higher education. The receipt of a Cal Grant award pursuant to Chapter 1.7 (commencing with Section 69430) of Part 42 of Division 5 of Title 3 of the Education Code, any other grant, or any fee waivers that may be provided by an institution of higher education shall not preclude a dependent from receiving a scholarship provided for by this section. (h) As used in this section, “dependent” means the children (natural or adopted) or spouse, at the time of the death or injury, of the peace officer, law enforcement officer, or firefighter. (i) Eligibility for a scholarship under this section shall be limited to a person who demonstrates financial need as determined by the Student Aid Commission pursuant to Article 1.5 (commencing with Section 69503) of Chapter 2 of Part 42 of Division 5 of Title 3 of the Education Code. For purposes of determining financial need, the proceeds of death benefits received by the dependent, including, but not limited to, a continuation of income received from the Public Employees’ Retirement System, the proceeds from the federal Public Safety Officers’ Benefits Act, life insurance policies, proceeds from Sections 4702 and 4703.5, a private scholarship if receipt is predicated upon the recipient being the survivor of a deceased public safety officer, the scholarship awarded pursuant to Section 68120 of the Education Code, and any interest received from these benefits, shall not be considered. (Amended by Stats. 2022, Ch. 85, Sec. 1. (AB 2661) Effective January 1, 2023.)
  167. 4720.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4.5. Public Official Death Benefits [4720 - 4728] ( Article 4.5 added by Stats. 1979, Ch. 983. )

    Verify source ↗

    This section defines “elected public official” and “assassination” for this article.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4.5. Public Official Death Benefits [4720 - 4728] ( Article 4.5 added by Stats. 1979, Ch. 983. ) ## 4720. As used in this article: (a) “Elected public official” means any person other than the President or Vice President of the United States who holds any federal, state, local, or special district elective office as a result of winning election in California to such office or being appointed to fill a vacancy in such office. (b) “Assassination” means the killing of an elected public official as a direct result of an intentional act perpetrated by an individual or individuals acting to prevent, or retaliate for, the performance of official duties, acting because of the public position held by the official, or acting because of pathological reasons. (Added by Stats. 1979, Ch. 983.)
  168. 4721.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4.5. Public Official Death Benefits [4720 - 4728] ( Article 4.5 added by Stats. 1979, Ch. 983. )

    Verify source ↗

    If an elected public official is killed by assassination, the surviving spouse or dependent minor children are entitled to a special death benefit.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4.5. Public Official Death Benefits [4720 - 4728] ( Article 4.5 added by Stats. 1979, Ch. 983. ) ## 4721. The surviving spouse or dependent minor children of an elected public official who is killed by assassination shall be entitled to a special death benefit which shall be in addition to any other benefits provided for by this division or Division 4.5 (commencing with Section 6100). (Amended by Stats. 1983, Ch. 142, Sec. 106.)
  169. 4722.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4.5. Public Official Death Benefits [4720 - 4728] ( Article 4.5 added by Stats. 1979, Ch. 983. )

    Verify source ↗

    This section directs who receives a special death benefit after a deceased elected public official dies, depending on whether there is a surviving spouse, dependent minor children, or a dependent parent.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4.5. Public Official Death Benefits [4720 - 4728] ( Article 4.5 added by Stats. 1979, Ch. 983. ) ## 4722. If the deceased elected public official is survived by a spouse with or without dependent minor children, such special death benefit shall be payable to the surviving spouse. If the deceased elected public official leaves no surviving spouse but one or more dependent minor children, benefits shall be paid to a guardian ad litem and trustee for such child or children appointed by the Workers’ Compensation Appeals Board. In the absence of a surviving spouse and dependent minor children, the benefit shall be payable to any legally recognized dependent parent of the deceased elected public official. (Added by Stats. 1979, Ch. 983.)
  170. 4723.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4.5. Public Official Death Benefits [4720 - 4728] ( Article 4.5 added by Stats. 1979, Ch. 983. )

    Verify source ↗

    People eligible for the special death benefit must choose, within one year of the elected public official’s death, between an annual benefit and a $150,000 lump sum.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4.5. Public Official Death Benefits [4720 - 4728] ( Article 4.5 added by Stats. 1979, Ch. 983. ) ## 4723. The person or persons to whom the special death benefit is payable pursuant to Section 4722 shall, within one year of the date of death of the elected public official, choose either of the following benefits: (a) An annual benefit equal to one-half of the average annual salary paid to the elected public official in his or her elected capacity, less credit for any other death benefit provided for under existing law or by public funds, except benefits payable pursuant to this division or Division 4.5 (commencing with Section 6100). Payments shall be paid not less frequently than monthly, and shall be paid from the date of death until the spouse dies or remarries, or until the youngest minor dependent child reaches the age of 18 years, whichever occurs last. If payments are being made to a dependent parent or parents they shall continue during dependency. (b) A lump-sum benefit of one hundred fifty thousand dollars ($150,000), less any other death benefit provided for under existing law or by public funds, except benefits payable pursuant to this division or Division 4.5 (commencing with Section 6100). (Amended by Stats. 1983, Ch. 142, Sec. 107.)
  171. 4724.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4.5. Public Official Death Benefits [4720 - 4728] ( Article 4.5 added by Stats. 1979, Ch. 983. )

    Verify source ↗

    People entitled to the special death benefit under Section 4722 must file a claim with the Department of General Services.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4.5. Public Official Death Benefits [4720 - 4728] ( Article 4.5 added by Stats. 1979, Ch. 983. ) ## 4724. The person or persons to whom the special death benefit is payable pursuant to Section 4722 shall file a claim therefor with the Department of General Services, which shall be processed pursuant to the provisions of Chapter 3 (commencing with Section 900) of Part 2 of Division 3.6 of Title 1 of the Government Code. (Amended by Stats. 2016, Ch. 31, Sec. 192. (SB 836) Effective June 27, 2016.)
  172. 4725.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4.5. Public Official Death Benefits [4720 - 4728] ( Article 4.5 added by Stats. 1979, Ch. 983. )

    Verify source ↗

    The State Compensation Insurance Fund must act as the disbursing agent for payments under this article, and it may receive a negotiated fee for that service.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4.5. Public Official Death Benefits [4720 - 4728] ( Article 4.5 added by Stats. 1979, Ch. 983. ) ## 4725. The State Compensation Insurance Fund shall be the disbursing agent for payments made pursuant to this article and shall receive a fee for its services to be negotiated by the Department of General Services. Unless otherwise provided herein, payments shall be made in accordance with the provisions of this division. (Amended by Stats. 2016, Ch. 31, Sec. 193. (SB 836) Effective June 27, 2016.)
  173. 4726.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4.5. Public Official Death Benefits [4720 - 4728] ( Article 4.5 added by Stats. 1979, Ch. 983. )

    Verify source ↗

    The Department of General Services and the Administrative Director of the Division of Workers’ Compensation must jointly adopt rules and regulations needed to carry out this article.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4.5. Public Official Death Benefits [4720 - 4728] ( Article 4.5 added by Stats. 1979, Ch. 983. ) ## 4726. The Department of General Services and the Administrative Director of the Division of Workers’ Compensation shall jointly adopt rules and regulations as may be necessary to carry out the provisions of this article. (Amended by Stats. 2016, Ch. 31, Sec. 194. (SB 836) Effective June 27, 2016.)
  174. 4727.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4.5. Public Official Death Benefits [4720 - 4728] ( Article 4.5 added by Stats. 1979, Ch. 983. )

    Verify source ↗

    A person convicted of a crime connected to the assassination of an elected public official cannot receive benefits under this article.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4.5. Public Official Death Benefits [4720 - 4728] ( Article 4.5 added by Stats. 1979, Ch. 983. ) ## 4727. Any person who is convicted of any crime in connection with the assassination of an elected public official shall not be eligible for any benefits pursuant to this article. (Added by Stats. 1979, Ch. 983.)
  175. 4728.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4.5. Public Official Death Benefits [4720 - 4728] ( Article 4.5 added by Stats. 1979, Ch. 983. )

    Verify source ↗

    A qualifying dependent of an elected public official killed in the specified circumstances is entitled to a scholarship, if financial need is demonstrated.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 4.5. Public Official Death Benefits [4720 - 4728] ( Article 4.5 added by Stats. 1979, Ch. 983. ) ## 4728. (a) A dependent of an elected public official, who was intentionally killed while holding office, in retaliation for, or to prevent the performance of, an official duty, shall be entitled to a scholarship at any institution described in subdivision (k) of Section 69535 of the Education Code. The scholarship shall be in an amount equal to the amount provided a student who has been awarded a Cal Grant scholarship as specified in Article 3 (commencing with Section 69530) of Chapter 2 of Part 42 of the Education Code. Eligibility for a scholarship under this section shall be limited to a person who demonstrates financial need as determined by the Student Aid Commission pursuant to Article 1.5 (commencing with Section 69503) of Chapter 2 of Part 42 of the Education Code. (b) The scholarship provided for by this section shall be paid out of funds annually appropriated in the Budget Act to the Student Aid Commission established by Article 2 (commencing with Section 69510) of Chapter 2 of Part 42 of the Education Code. (c) The receipt of a scholarship provided for by this section shall not preclude a dependent from receiving a Cal Grant award pursuant to Article 3 (commencing with Section 69530) of Chapter 2 of Part 42 of the Education Code, any other grant, or any fee waivers that may be provided by an institution of higher education. The receipt of a Cal Grant award pursuant to Article 3 (commencing with Section 69530) of Chapter 2 of Part 42 of the Education Code, any other grant, or any fee waivers that may be provided by an institution of higher education shall not preclude a dependent from receiving a scholarship provided for by this section. (d) This section shall apply to a student receiving a scholarship on the effective date of the section unless that application would result in the student receiving a scholarship on less favorable terms or in a lesser amount, in which case the student shall continue to receive the scholarship on the same terms and conditions in effect prior to the effective date of this section. (e) As used in this section, “dependent” means the children (natural or adopted) or spouse, at the time of the death or injury, of the elected public official. (Added by Stats. 1995, Ch. 646, Sec. 3. Effective January 1, 1996.)
  176. 4751.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 5. Subsequent Injuries Payments [4751 - 4756] ( Article 5 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    An employee with a prior permanent partial disability may receive additional compensation after a later compensable injury if the combined disability reaches at least 70% total and the stated alternative conditions are met.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 5. Subsequent Injuries Payments [4751 - 4756] ( Article 5 enacted by Stats. 1937, Ch. 90. ) ## 4751. If an employee who is permanently partially disabled receives a subsequent compensable injury resulting in additional permanent partial disability so that the degree of disability caused by the combination of both disabilities is greater than that which would have resulted from the subsequent injury alone, and the combined effect of the last injury and the previous disability or impairment is a permanent disability equal to 70 percent or more of total, he shall be paid in addition to the compensation due under this code for the permanent partial disability caused by the last injury compensation for the remainder of the combined permanent disability existing after the last injury as provided in this article; provided, that either (a) the previous disability or impairment affected a hand, an arm, a foot, a leg, or an eye, and the permanent disability resulting from the subsequent injury affects the opposite and corresponding member, and such latter permanent disability, when considered alone and without regard to, or adjustment for, the occupation or age of the employee, is equal to 5 percent or more of total, or (b) the permanent disability resulting from the subsequent injury, when considered alone and without regard to or adjustment for the occupation or the age of the employee, is equal to 35 percent or more of total. (Amended by Stats. 1959, Ch. 1034.)
  177. 4753.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 5. Subsequent Injuries Payments [4751 - 4756] ( Article 5 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    Additional compensation for a subsequent injury must be reduced by certain payments the employee received for a preexisting disability or impairment, with stated exceptions.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 5. Subsequent Injuries Payments [4751 - 4756] ( Article 5 enacted by Stats. 1937, Ch. 90. ) ## 4753. Such additional compensation is not in addition to but shall be reduced to the extent of any monetary payments received by the employee, from any source whatsoever, for or on account of such preexisting disability or impairment, except as to payments being made to the employee or to which he is entitled as a pension or other compensation for disability incurred in service in the armed forces of the United States, and except as to payments being made to him or to which he is entitled as assistance under the provisions of Chapter 2 (commencing with Section 11200), Chapter 3 (commencing with Section 12000), Chapter 4 (commencing with Section 12500), Chapter 5 (commencing with Section 13000), or Chapter 6 (commencing with Section 13500) of Part 3, or Part 5 (commencing with Section 17000), of Division 9 of the Welfare and Institutions Code, and excluding from such monetary payments received by the employee for or on account of such preexisting disability or impairment a sum equal to all sums reasonably and necessarily expended by the employee for or on account of attorney’s fees, costs and expenses incidental to the recovery of such monetary payments. All cases under this section and under Section 4751 shall be governed by the terms of this section and Section 4751 as in effect on the date of the particular subsequent injury. (Amended by Stats. 1971, Ch. 438.)
  178. 4753.5.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 5. Subsequent Injuries Payments [4751 - 4756] ( Article 5 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    In hearings, investigations, or proceedings, the state must be represented by the Attorney General or by Department of Industrial Relations attorneys appointed by the director. Related representation expenses are reimbursed from the Workers’ Compensation Administration Revolving Fund, and certain witness or medical-service fees cannot exceed appeals-board-prescribed amounts.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 5. Subsequent Injuries Payments [4751 - 4756] ( Article 5 enacted by Stats. 1937, Ch. 90. ) ## 4753.5. In any hearing, investigation, or proceeding, the state shall be represented by the Attorney General, or the attorneys of the Department of Industrial Relations, as appointed by the director. Expenses incident to representation, including costs for investigation, medical examinations, other expert reports, fees for witnesses, and other necessary and proper expenses, but excluding the salary of any of the Attorney General’s deputies, shall be reimbursed from the Workers’ Compensation Administration Revolving Fund. No witness fees or fees for medical services shall exceed those fees prescribed by the appeals board for the same services in those cases where the appeals board, by rule, has prescribed fees. Reimbursement pursuant to this section shall be in addition to, and in augmentation of, any other appropriations made or funds available for the use or support of the legal representation. (Amended by Stats. 2006, Ch. 538, Sec. 489. Effective January 1, 2007.)
  179. 4754.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 5. Subsequent Injuries Payments [4751 - 4756] ( Article 5 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    The appeals board must set and award special additional compensation, and direct the State Compensation Insurance Fund to pay it.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 5. Subsequent Injuries Payments [4751 - 4756] ( Article 5 enacted by Stats. 1937, Ch. 90. ) ## 4754. The appeals board shall fix and award the amounts of special additional compensation to be paid under this article, and shall direct the State Compensation Insurance Fund to pay the additional compensation so awarded. Such additional compensation may be paid only from funds appropriated for such purpose. Out of any such appropriation the fund may reimburse itself for the cost of service rendered in payment of compensation awards pursuant to this article and maintenance of accounts and records pertaining thereto, which cost shall not exceed 5 percent of the amount of award paid. (Amended by Stats. 1965, Ch. 1513.)
  180. 4754.5.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 5. Subsequent Injuries Payments [4751 - 4756] ( Article 5 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    The Attorney General or the Department of Industrial Relations may release claims by compromise, and a compromise-and-release agreement is valid only if the appeals board approves it.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 5. Subsequent Injuries Payments [4751 - 4756] ( Article 5 enacted by Stats. 1937, Ch. 90. ) ## 4754.5. Nothing in this article shall impair the right of the Attorney General or the Department of Industrial Relations to release by compromise any claims brought under the provisions of this article. No such compromise and release agreement is valid unless it is approved by the appeals board; however, the provisions of Sections 5000 to 5004, inclusive, of this code, shall not apply to such compromise and release agreements. (Amended by Stats. 1981, Ch. 894, Sec. 8.)
  181. 4755.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 5. Subsequent Injuries Payments [4751 - 4756] ( Article 5 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    The State Compensation Insurance Fund may draw up to $50,000 from the Subsequent Injuries Benefits Trust Fund as a cash revolving fund, and the director must assign certain claims adjustment and legal representation services for subsequent injuries.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 5. Subsequent Injuries Payments [4751 - 4756] ( Article 5 enacted by Stats. 1937, Ch. 90. ) ## 4755. (a) The State Compensation Insurance Fund may draw from the State Treasury out of the Subsequent Injuries Benefits Trust Fund for the purposes specified in Section 4751, without at the time presenting vouchers and itemized statements, a sum not to exceed in the aggregate fifty thousand dollars ($50,000), to be used as a cash revolving fund. The revolving fund shall be deposited in any banks and under any conditions as the Department of Finance determines. The Controller shall draw his or her warrants in favor of the State Compensation Insurance Fund for the amounts so withdrawn and the Treasurer shall pay these warrants. (b) Expenditures made from the revolving fund in payments on claims for any additional compensation and for adjusting services are exempted from the operation of Section 16003 of the Government Code. Reimbursement of the revolving fund for these expenditures shall be made upon presentation to the Controller of an abstract or statement of the expenditures. The abstract or statement shall be in any form as the Controller requires. (c) The director shall assign claims adjustment services and legal representation services respecting matters concerning subsequent injuries. The director or his or her representative may make these service assignments within the department, or he or she may contract for these services with the State Compensation Insurance Fund, for a fee in addition to that authorized by Section 4754, except insofar as these matters might conflict with the interests of the State Compensation Insurance Fund. The administrative costs associated with these services shall be reimbursed from the Workers’ Compensation Administration Revolving Fund, except when a budget impasse requires advances as provided in subdivision (d) of Section 62.5. To the extent permitted by state law, the director may contract for audits or reports of services under this section. (Amended by Stats. 2012, Ch. 728, Sec. 121. (SB 71) Effective January 1, 2013.)
  182. 4756.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 5. Subsequent Injuries Payments [4751 - 4756] ( Article 5 enacted by Stats. 1937, Ch. 90. )

    Verify source ↗

    People cannot be denied compensation from the Subsequent Injuries Benefits Trust Fund just because of citizenship or immigration status.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 5. Subsequent Injuries Payments [4751 - 4756] ( Article 5 enacted by Stats. 1937, Ch. 90. ) ## 4756. (a) The Legislature finds and declares that it is in the best interest of the State of California to provide a person, regardless of his or her citizenship or immigration status, with the benefits provided pursuant to this article, and therefore enacts this section pursuant to Section 1621(d) of Title 8 of the United States Code. (b) A person shall not be prohibited from receiving compensation paid or payable from the Subsequent Injuries Benefits Trust Fund solely because of his or her citizenship or immigration status. (c) It is the intent of the Legislature to override Section 15740 of Article 1 of Subchapter 2.1.1 of Chapter 8 of Division 1 of Title 8 of the California Code of Regulations. (d) The provisions of this section are declaratory of existing law. (Added by Stats. 2015, Ch. 290, Sec. 2. (SB 623) Effective January 1, 2016.)
  183. 4800.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. )

    Verify source ↗

    Certain qualifying Department of Justice peace officer/firefighter-class members, and specified Fish and Wildlife and harbor police officers, may receive leave without loss of salary when disabled by injury in the course of duty, for up to one year.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. ) ## 4800. (a) Whenever any member of the Department of Justice falling within the “state peace officer/firefighter” class is disabled by injury arising out of and in the course of his or her duties, he or she shall become entitled, regardless of his or her period of service with the Department of Justice to leave of absence while so disabled without loss of salary, in lieu of disability payments under this chapter, for a period not exceeding one year. This section applies only to members of the Department of Justice whose principal duties consist of active law enforcement and does not apply to persons employed in the Department of Justice whose principal duties are those of telephone operator, clerk, stenographer, machinist, mechanic, or otherwise clearly not falling within the scope of active law enforcement service, even though this person is subject to occasional call or is occasionally called upon to perform duties within the scope of active law enforcement service. (b) This section applies to law enforcement officers employed by the Department of Fish and Wildlife who are described in subdivision (e) of Section 830.2 of the Penal Code. (c) This section applies to harbor police officers employed by the San Francisco Port Commission who are described in Section 20402 of the Government Code. (d) This section shall does not apply to periods of disability that occur subsequent to termination of employment by resignation, retirement, or dismissal. When this section does not apply, the employee shall be eligible for those benefits that would apply if this section had not been enacted. (Amended by Stats. 2017, Ch. 561, Sec. 175. (AB 1516) Effective January 1, 2018.)
  184. 4800.5.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. )

    Verify source ↗

    Some California Highway Patrol sworn members disabled by a qualifying single injury may take paid leave, up to one year, instead of disability payments.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. ) ## 4800.5. (a) Whenever any sworn member of the Department of the California Highway Patrol is disabled by a single injury, excluding disabilities that are the result of cumulative trauma or cumulative injuries, arising out of and in the course of his or her duties, he or she shall become entitled, regardless of his or her period of service with the patrol, to leave of absence while so disabled without loss of salary, in lieu of disability payments under this chapter, for a period of not exceeding one year. This section shall apply only to members of the Department of the California Highway Patrol whose principal duties consist of active law enforcement and shall not apply to persons employed in the Department of the California Highway Patrol whose principal duties are those of telephone operator, clerk, stenographer, machinist, mechanic, or otherwise clearly not falling within the scope of active law enforcement service, even though this person is subject to occasional call or is occasionally called upon to perform the duties of active law enforcement service. (b) Benefits payable for eligible sworn members of the Department of the California Highway Patrol whose disability is solely the result of cumulative trauma or injury shall be limited to the actual period of temporary disability or entitlement to maintenance allowance, or for one year, whichever is less. (c) This section shall not apply to periods of disability that occur subsequent to termination of employment by resignation, retirement, or dismissal. When this section does not apply, the employee shall be eligible for those benefits that would apply had this section not been enacted. (d) The appeals board may determine, upon request of any party, whether or not the disability referred to in this section arose out of and in the course of duty. In any action in which a dispute exists regarding the nature of the injury or the period of temporary disability or entitlement to maintenance allowance, or both, and upon the request of any party thereto, the appeals board shall determine when the disability commenced and ceased, and the amount of benefits provided by this division to which the employee is entitled during the period of this disability. The appeals board shall have the jurisdiction to award and enforce payment of these benefits, subject to subdivision (a) or (b), pursuant to Part 4 (commencing with Section 5300). A decision issued by the appeals board under this section is final and binding upon the parties subject to the rights of appeal contained in Chapter 7 (commencing with Section 5900) of Part 4. (e) Except as provided in subdivision (g), this section shall apply for periods of disability commencing on or after January 1, 1995. (f) This section does not apply to peace officers designated under subdivision (a) of Section 2250.1 of the Vehicle Code. (g) Peace officers of the California State Police Division who become sworn members of the Department of the California Highway Patrol as a result of the Governor’s Reorganization Plan No. 1 of 1995, other than those officers described in subdivision (f), shall be eligible for injury benefits accruing to sworn members of the Department of the California Highway Patrol under this division only for injuries occurring on or after July 12, 1995. (Amended by Stats. 1996, Ch. 305, Sec. 42. Effective January 1, 1997.)
  185. 4801.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. )

    Verify source ↗

    The appeals board must decide whether certain listed disabilities arose out of and in the course of duty, and it must also decide when such a disability ends in disputed cases.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. ) ## 4801. It shall be the duty of the appeals board to determine in the case of members of the California Highway Patrol, upon request of the Department of the California Highway Patrol or Department of Justice, and, in the case of the harbor policemen, upon the request of the San Francisco Port Commission, whether or not the disability referred to in Section 4800 arose out of and in the course of duty. The appeals board shall, also, in any disputed case, determine when such disability ceases. (Amended by Stats. 1971, Ch. 1089.)
  186. 4802.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. )

    Verify source ↗

    Certain disabled California Highway Patrol, Department of Justice, or harbor police members are entitled to medical, surgical, and hospital benefits from the date of injury, even if retired under PERS.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. ) ## 4802. Any such member of the California Highway Patrol or Department of Justice, or any such harbor policeman, so disabled is entitled from the date of injury and regardless of retirement under the Public Employees’ Retirement System, to the medical, surgical and hospital benefits prescribed by this division as part of the compensation for persons injured in the course of and arising out of their employment, at the expense of the Department of the California Highway Patrol, the Department of Justice, or the San Francisco Port Commission, as the case may be, and such expense shall be charged upon the fund out of which the compensation of the member is paid. (Amended by Stats. 1972, Ch. 1377.)
  187. 4803.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. )

    Verify source ↗

    If a covered member’s disability lasts more than one year, the person moves onto the division’s disability indemnity rules (not Section 4800), the compensation is paid from the relevant department’s support funds, and the leave of absence continues.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. ) ## 4803. Whenever such disability of such member of the California Highway Patrol, or Department of Justice, or of such harbor policeman, continues for a period beyond one year, such member or harbor policeman shall thereafter be subject, as to disability indemnity, to the provisions of this division other than Section 4800, which refers to temporary disability only, during the remainder of the disability, except that such compensation shall be paid out of funds available for the support of the Department of the California Highway Patrol, the Department of Justice, or the San Francisco Port Commission, as the case may be, and the leave of absence shall continue. (Amended by Stats. 1972, Ch. 1377.)
  188. 4804.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. )

    Verify source ↗

    A member of the California Highway Patrol or a harbor policeman may not receive disability indemnity as temporary disability at the same time as wages or salary payments.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. ) ## 4804. No disability indemnity shall be paid to said member of the California Highway Patrol or harbor policeman as temporary disability concurrently with wages or salary payments. (Amended by Stats. 1967, Ch. 1553.)
  189. 4804.1.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. )

    Verify source ↗

    Some University of California fire department members disabled by duty-related injury may take up to one year of leave without losing salary, instead of disability payments.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. ) ## 4804.1. Whenever any member of a University of California fire department specified in Section 3212.4 falling within the active “firefighting and prevention service” class is disabled by injury arising out of and in the course of his duties, he shall become entitled, regardless of his period of service with a University of California fire department, to leave of absence while so disabled without loss of salary, in lieu of disability payments under this chapter, for a period of not exceeding one year. This section shall apply only to members of a University of California fire department whose principal duties consist of active firefighting and prevention service and shall not apply to persons employed in a University of California fire department whose principal duties are those of telephone operator, clerk, stenographer, machinist, mechanic, or otherwise clearly not falling within the scope of active firefighting and prevention service, even though such person is subject to occasional call or is occasionally called upon to perform duties within the scope of active firefighting and prevention service. (Added by Stats. 1972, Ch. 1149.)
  190. 4804.2.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. )

    Verify source ↗

    The appeals board must decide, on request of the Regents, whether a specified University of California fire department disability arose out of and in the course of duty, and it must also decide when that disability ends in any disputed case.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. ) ## 4804.2. It shall be the duty of the appeals board to determine in the case of members of a University of California fire department specified in Section 4804. 1, upon request of the Regents of the University of California, whether or not the disability referred to in Section 4804.1 arose out of and in the course of duty. The appeals board shall, also in any disputed case, determine when such disability ceases. (Added by Stats. 1972, Ch. 1149.)
  191. 4804.3.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. )

    Verify source ↗

    A disabled specified University of California fire department member is entitled to medical, surgical, and hospital benefits from the date of injury, even if retired.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. ) ## 4804.3. Any such member of a University of California fire department specified in Section 4804.1, so disabled is entitled from the date of injury and regardless of retirement under the Public Employees’ Retirement System, or other retirement system, to the medical, surgical, and hospital benefits prescribed by this division as part of the compensation for persons injured in the course of and arising out of their employment, at the expense of the Regents of the University of California, and such expense shall be charged upon the fund out of which the compensation of the member is paid. (Added by Stats. 1972, Ch. 1149.)
  192. 4804.4.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. )

    Verify source ↗

    If the disability of a specified University of California fire department member lasts more than one year, the member remains subject to the division’s disability-indemnity rules other than Section 4804.1, and the leave of absence continues.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. ) ## 4804.4. Whenever such disability of such member of a University of California fire department, specified in Section 4804.1, continues for a period beyond one year, such member shall thereafter be subject, as to disability indemnity, to the provisions of this division other than Section 4804.1, which refers to temporary disability only, during the remainder of the disability, except that such compensation shall be paid out of funds available for the support of the Regents of the University of California, and the leave of absence shall continue. (Added by Stats. 1972, Ch. 1149.)
  193. 4804.5.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. )

    Verify source ↗

    No disability indemnity may be paid to the specified University of California fire department member as temporary disability at the same time as wages or salary payments.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. ) ## 4804.5. No disability indemnity shall be paid to said member of a University of California fire department, specified in Section 4804.1, as temporary disability concurrently with wages or salary payments. (Added by Stats. 1972, Ch. 1149.)
  194. 4806.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. )

    Verify source ↗

    Certain University of California Police Department members injured in the line of duty are entitled to up to one year of paid leave instead of disability payments.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. ) ## 4806. Whenever any member of the University of California Police Department falling within the “law enforcement” class is disabled by injury arising out of and in the course of his duties, he shall become entitled, regardless of his period of service with the police department, to leave of absence while so disabled without loss of salary, in lieu of disability payments under this chapter, for a period of not exceeding one year. This section shall apply only to members of the University of California Police Department whose principal duties consist of active law enforcement, and shall not apply to persons employed in the University of California Police Department whose principal duties are those of telephone operator, clerk, stenographer, machinist, mechanic or otherwise clearly not falling within the scope of active law enforcement service, even though such person is subject to occasional call or is occasionally called upon to perform duties within the scope of active law enforcement service. This section shall apply only to those members of the University of California Police Department specified in Section 3213. (Added by Stats. 1971, Ch. 918.)
  195. 4807.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. )

    Verify source ↗

    The appeals board must decide, for University of California Police Department members, whether the Section 4806 disability arose out of and in the course of duty, and in disputed cases it must decide when the disability ends.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. ) ## 4807. It shall be the duty of the appeals board to determine, in the case of members of the University of California Police Department, upon the request of the Regents of the University of California, whether or not the disability referred to in Section 4806 arose out of and in the course of duty. The appeals board shall, also in any disputed case, determine when such disability ceases. (Added by Stats. 1971, Ch. 918.)
  196. 4808.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. )

    Verify source ↗

    A disabled University of California Police Department member is entitled to specified medical, surgical, and hospital benefits from the date of injury, even if retired under either UC retirement system or PERS.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. ) ## 4808. Any such member of the University of California Police Department so disabled is entitled from the date of injury, and regardless of retirement under either the University of California Retirement System or Public Employees’ Retirement System, to the medical, surgical, and hospital benefits prescribed by this division as part of the compensation for persons injured in the course of and arising out of their employment, at the expense of the Regents of the University of California, and such expense shall be charged upon the fund out of which the compensation of the member is paid. (Added by Stats. 1971, Ch. 918.)
  197. 4809.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. )

    Verify source ↗

    If a University of California Police Department member’s disability lasts more than one year, disability indemnity is governed by this division except Section 4806, and the leave of absence continues.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. ) ## 4809. Whenever such disability of such member of the University of California Police Department continues for a period beyond one year, such member shall thereafter be subject, as to disability indemnity, to the provisions of this division other than Section 4806, which refers to temporary disability only, during the remainder of the disability, except that such compensation shall be paid out of funds available for the support of the Regents of the University of California and the leave of absence shall continue. (Added by Stats. 1971, Ch. 918.)
  198. 4810.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. )

    Verify source ↗

    No disability indemnity may be paid to a member of the University of California Police Department for temporary disability when wages or salary payments are being paid at the same time.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. ) ## 4810. No disability indemnity shall be paid to such member of the University of California Police Department as temporary disability concurrently with wages or salary payments. (Added by Stats. 1971, Ch. 918.)
  199. 4811.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. )

    Verify source ↗

    Certain Forestry and Fire Protection employees injured on the job may take paid leave instead of disability payments, for up to one year, or up to three years for a severe burn.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. ) ## 4811. (a) Whenever any member of State Bargaining Unit 8 employed by the Department of Forestry and Fire Protection is disabled by injury arising out of and in the course of their duties, they shall become entitled, regardless of their period of service with the Department of Forestry and Fire Protection, to leave of absence while disabled without loss of salary, in lieu of disability payments under this chapter, for a period not exceeding one year. (b) If the disabling injury described in subdivision (a) is a severe burn as determined by the Director of Forestry and Fire Protection or their designee, the employee shall become entitled, regardless of their period of service, to leave of absence while so disabled without loss of salary, in lieu of disability payments under this chapter, for a period not exceeding three years. (c) An employee shall only receive benefits pursuant to this section during the time period for which they would normally be employed. When this section does not apply, the employee shall be eligible for those benefits that would apply if this section had not been enacted. (d) This section shall not apply to periods of disability that occur subsequent to termination of employment by resignation, retirement, or dismissal. When this section does not apply, the employee shall be eligible for those benefits that would apply if this section had not been enacted. (e) This section shall also apply to an employee related to State Bargaining Unit 8 and employed by the Department of Forestry and Fire Protection who is excepted from the definition of “state employee” in subdivision (c) of Section 3513 of the Government Code. (f) This section shall apply to injuries sustained on or after November 1, 2022. (Added by Stats. 2022, Ch. 250, Sec. 14. (AB 151) Effective September 6, 2022.)
  200. 4816.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. )

    Verify source ↗

    Certain California State University Police Department members in active law enforcement are entitled to enhanced industrial disability leave when injured or ill in the course of duty, but not for psychiatric disabilities or disabilities arising from psychiatric injury.

    ## Labor Code - LAB ## DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. ) ## PART 2. COMPUTATION OF COMPENSATION [4451 - 4856] ( Part 2 enacted by Stats. 1937, Ch. 90. ) ## CHAPTER 2. Compensation Schedules [4550 - 4856] ( Chapter 2 enacted by Stats. 1937, Ch. 90. ) ## ARTICLE 6. Special Payments to Certain Persons [4800 - 4820] ( Heading of Article 6 amended by Stats. 1971, Ch. 918. ) ## 4816. Pursuant to a collective bargaining agreement applicable to members of the California State University Police Department, whenever any member of that police department falling within the “law enforcement” class is disabled by injury or illness arising out of and in the course of his or her duties, he or she shall become entitled, regardless of his or her period of service with the police department, to enhanced industrial disability leave equivalent to the injured employee’s net take home salary on the date of occurrence of the injury. For the purposes of this section, “net take home salary” means the amount of salary received after federal income tax, state income tax, and the employee’s retirement contribution has been deducted from the employee’s gross salary, in lieu of disability payments under this chapter, for a period of not exceeding one year. No benefits shall be paid under this section for any psychiatric disability or any physical disability arising from a psychiatric injury. This section shall apply only to members of the California State University Police Department whose principal duties consist of active law enforcement, and shall not apply to persons employed in the California State University Police Department whose principal duties are those of telephone operator, clerk, stenographer, machinist, mechanic, or otherwise clearly not falling within the scope of active law enforcement service, even though the person is subject to occasional call or is occasionally called upon to perform duties within the scope of active law enforcement service. (Added by Stats. 1994, Ch. 50, Sec. 1. Effective January 1, 1995.)

Provision text is displayed from LexChat’s stored statute record. Use the official source links to verify amendments, commencement, and current legal force.

LexChat organizes source-backed legal information for research. Verify amendments, commencement, and current legal force with the official publisher before relying on it.