Tell me about penalties in CA workers' comp. What kind of penalties can I get for late payments?
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- Опубликовано: 9 сен 2024
- This video discusses penalties for late payments in California workers' comp cases. If you are an injured worker with a California injury, and don’t have an attorney, this video is intended to help provide an overview of workers’ compensation topics so you can better represent yourself.
Jeremy Lusk is a certified specialist in workers’ compensation with about two decades of experience, and previously served as a Judge at the Fresno District Office of the WCAB. He has worked out of Fresno, but appeared at numerous Boards to represent both injured workers and employers/carriers.
No attorney/client relationship is created or implied by this video. This video is not offering legal advice as to what you should, or should not, do in your workers’ compensation case, but rather offers education/information as to the California workers’ compensation system for unrepresented workers so they can better represent themselves and make more informed decisions.
If you have any questions, let us know at questions@mywcguide.com
Thank you.
Happy to help inform.
Thank you!
Happy to help inform.
What about bad faith (not allowing injured person to seek their own specialized doctor within the MPN) and asking for reimbursement for at home equipment etc?
Bad faith generally would fall under Labor Code section 5813 which pertains to, among other things, bad faith litigation tactics. However, those are not penalties, but rather attorney fees and sanctions that can be awarded.
@@myworkerscompguide What if they do this with an injured party not yet represented? Can I claim I require them to pay lawyer fees due to this?
@@kindredmalise6633 I guess it's conceivable that a defense attorney could file a Petition for Sanctions and Costs against a pro per injured worker based on bad faith litigation tactics, though I don't recall seeing that before. It's probably more likely that the defense would seek to have the applicant declared a vexatious litigant, though I haven't seen that in many, many years.
@@kindredmalise6633 An injured worker without an attorney could seek sanctions and costs, but it would really be an uphill battle as the injured worker would likely have to take it through a MSC and a full trial. Then the injured worker couldn't pursue attorney fees unless they had actually been incurred, I suspect.
@@myworkerscompguide Thank you for that response. I was hoping they would pay the lawyer tax if a reasonable request was made. Such as the insurance representatives trying to take advantage of a person who did not know any better. They literally said in an email, from the adjuster, and the adjuster's supervisor that I could not pick my own PTP, and their own lack of experience is what is delaying my part of recovery. Easy enough to see a swing was taken at me to try and save them money at the cost of myself, and my family.
I seriously hope the judge makes it common for insurance companies to pay for lawyers for making injured parties' lawyer up. From what I am getting at, the process of workman's comp was designed to save California money in court fees.
I think they tried when they said my workman's comp would be delayed (PTP doctor dropped me when the doctor got a rightful complaint when threatening me - did it twice), then they realized it's not good to complain about an injured person asking for things that would clear them for work. EG Psych test for exposed carry work permits.
Then understanding that their gross negligence on not showing up to the doctors' appointments, delaying treatment to an injured party. Whom did not complain when nurses dropped their leg, twisted their leg (within the day of injury), then literally rammed their leg against a wall, while pushing them in an elevator (within one month) would not look good saying that they complain too much. On top of a doctor threatening the injured person in front of their own case manager.
Oh, it gets worse than that but that's the little drama I'm facing alone due to them thinking I am a good person who follows orders without question, or not smart enough to fight back. An evil world I was thrown in on top of an injury.
As far as I'm concerned, this whole process stinks for workman's comp.
AME put me on TTD since March 29th i was on deposition on may 13 , its been 2 months i have not receive any check i call my att. she said the have to send 10% for late payment since March . very stressful
This can be a slow and frustrating system. Your attorney will know best what is happening with your benefits. Best of luck to you.
What if an insurance company agrees to pay for and then months are passing by and they are not sending any payment as agreed. What penalties is that going to be ?
It will depend on if the payments were due or not. Just because an adjuster says they will pay for something does not make them legally liable. If the carrier is required to pay, whether by statute or judicial determination, then there could be unreasonable delays which would be 25%.
What is a self destruction clause?
Sometimes judges will issue an Order that provides that it is only good unless a party objects within twenty days and shows good cause why the Order should not be granted. It's referred to as a self-destruct clause because the Order is good, unless someone objects timely, and then the Order basically self-destructs.
@myworkerscompguide thank you. So the lawyer is skating a fine line of not breaking any actual penalties. Even lied to the judge but cause how rare it is to get penalties granted and I can't record I have 0 proof. But plenty of ethics have been broken and I'm sure she broken some small lesser known rules and regulations. Can you do a video on lesser know rules in the WC system? Also a video on ways to scare the da into acting right?
@@michaelarmstrong9512 A video on keeping evidence, and memorializing conversations would probably be a good idea.
I received a letter from WCAB Notice of Application. What does this mean ? Thanks
It means a case was opened at the WCAB. Either an Application for Adjudication was filed (perhaps if you have an attorney, he or she did this with initial paperwork you signed), or if you signed settlement documents and those were filed for approval. It's basically just the court case number.
What if judge approved C&R 3 months ago, no check has been received, they sent an email May 31 saying check has been issue now with another one with penalties, but as of today June 19 nothing has been received, if asked for a hearing do I have to pay out of settlement for that?
That is certainly very odd. Perhaps the adjuster was sending the checks to the wrong address? Either way, there is no cost to the injured worker to file a DOR and request a hearing to get that figured out.
Thank you, yes unfortunately this whole situation has been! And I don’t know where to go from here, since these are the answers my lawyer is giving me, I wish I knew how I can resolve this
@@jessgo187 Since you have an attorney, he or she knows your case best and what strategy to employ. Best of luck to you.
Can an injured worker or their attorney take an insurance company to trial if they just plainly dont approve anything, if they just deny everything well except for medication like pain pills and stuff of that nature
To go to trial there needs to be a dispute, and in the case of treatment denials it will generally depend on what the denials are based on. Did the insurance company ignore the RFA entirely? Did the insurance company timely go through UR and legally deny the treatment? Did the worker appeal the denial through IMR? Was IMR properly conducted? Were the denials based on other preliminary issues such as denial of a body part, or denial of the entire claim? There are many factors that go into it. Since you have an attorney, you would need to discuss with him or her, as your attorney knows your strategy and case best.
@@myworkerscompguide thank you! I guess my question actually is how can you know or what would be considered bad faith litigation tactics or bad faith in general by ins. company
@@jaliscomx328 It's tough. Attorneys likely can pick those out better, because the system is so darn frustrating and slow. I see treatment denials on my cases virtually every single day, and often times many times per day. But the denials are often based on legal grounds, such as a denied claim, denied body part, or based on UR. I don't think they make sense, but they are legal. To find something that's bad faith or the like, it often needs to be insurance ignoring a request and then refusing to address it, or denying treatment on invalid grounds (the adjuster doesn't think the treatment is necessary, or claiming a body part is denied when it's actually accepted), or the like. But we see those infrequently.
@@myworkerscompguide great info sir! Thanks for making imformation accessible and actually responding!
I’ve had it late due to “holidays” does that count as a penalty?
That's an interesting question. I suspect that if the check should issue on a Monday, but a Monday is a state holiday, then issuing it on Tuesday would be considered "timely." Also, if it was delayed in the mail by a day by the Post Office, I suspect that would not be a penalty. The question will likely boil down to whether the check was "delayed" or not, and why it was delayed.