Workers' compensation: liability.

Existing law establishes a workers' compensation system, administered by the Administrative Director of the Division of Workers' Compensation, to compensate an employee for injuries arising out of and in the course of their employment. Existing law prohibits a claim for workers' compensation from being maintained unless within 30 days after the occurrence of the injury, the injured person, or in case of the death, a dependent, or someone on the injured person's or dependent's behalf, serves notice of the injury upon the employer. Existing law also requires an injured employee, or in the case of death, a dependent, or an agent of the employee or dependent, to file a claim form with the employer. Under existing law, except for specified injuries, if liability is not rejected within 90 days after the date the claim form is filed with the employer, the injury is presumed compensable and the presumption is rebuttable only by evidence discovered subsequent to the 90-day period. This bill would reduce those 90-day time periods to 45 days and, for certain injuries or illnesses, including hernia, heart trouble, pneumonia, or tuberculosis, among others, sustained in the course of employment of a specified member of law enforcement or a specified first responder, would reduce those time periods to 30 days. Existing law requires an employer, one working day after an employee files a claim form, to authorize the provision of all treatment, as specified, for the alleged injury and to continue to provide the treatment until the date that liability for the claim is accepted or rejected. Existing law limits liability for medical treatment to $10,000 until the date the claim is accepted or rejected. This bill would increase that amount from $10,000 to $17,000. Existing law requires that certain proceedings, including proceedings for the enforcement against the employer or an insurer of any liability for compensation, be instituted before the Workers' Compensation Appeals Board. Existing law authorizes the appeals board to fix and determine, in its award, the total amount of compensation to be paid and specify the manner of payment, or may fix and determine the weekly disability payment to be made and order payment during the continuance of disability. Existing law requires that when payment of compensation has been unreasonably delayed or refused, either prior to or subsequent to the issuance of an award, the amount of the unreasonably delayed or refused payment be increased up to 25% or up to $10,000, whichever is less. Existing law requires the appeals board to use its discretion to accomplish a fair balance and substantial justice between the parties. This bill would require, if payment of compensation has been unreasonably delayed or refused, either prior to or subsequent to the issuance of an award, for specified claims of injury or illness, including hernia, heart trouble, pneumonia, or tuberculosis, among others, sustained in the course of employment of a specified member of law enforcement or a specified first responder, the full amount of the order, decision, or award to be increased by 10%. The bill would prohibit multiple increases from being awarded for repeated delays in making a series of payments due for the same type or specie of benefit unless there has been a legally significant event between the delay and the subsequent delay in payments of the same type or specie of benefit that establishes the employer's or insurance carrier's liability. The bill would apply to all injuries, without regard to whether the injury occurs before, on, or after the operative date of the bill. The bill would make other conforming changes.