Penalties for Late Payment of Workers Compensation Benefits in California
Timely payment of workers compensation benefits is essential for injured workers who rely on them for medical care and wage replacement. In California, strict regulations are in place to make sure that these benefits are paid promptly. When an insurance company or employer fails to make payments on time, they may face penalties. Understanding your rights regarding late payments can help you take action if your workers compensation benefits are delayed.
Timeframes for Workers Compensation Payments
In California, once a workers compensation claim is accepted, temporary disability payments must begin within 14 days of the employer receiving notification of the injury. These payments are meant to replace lost wages during the time the worker is unable to perform their job due to the injury. Medical treatment benefits, such as coverage for doctor visits, hospital stays, or medications, should also be provided promptly so the worker receives necessary care without delay.
What Happens if Payments Are Late?
When workers compensation benefits are not paid on time, California law imposes penalties to hold the insurance company or employer accountable. There are two types of penalties for late payments:
- Automatic Penalty (10%)
If the payment is late without a reasonable excuse, an automatic penalty of 10% of the unpaid amount will be added to the overdue payment. This means that the insurance company or employer is required to pay an additional 10% on top of the original benefit amount that was delayed. - Discretionary Penalty (Up to 25%)
In cases where the delay in payment is unreasonable or without good cause, an injured worker may be entitled to a penalty of up to 25% of the amount due, or $10,000—whichever is less. To receive this higher penalty, the worker must petition for it and prove that the delay was unjustified. If granted, this penalty is meant to further incentivize prompt payments by punishing negligent behavior.
Reasons for Payment Delays
While workers compensation payments are expected to be made on time, there are some situations where delays may occur that are considered reasonable. These can include:
- Disputes over claim validity: If an employer or insurance company disputes the claim, payments may be delayed while the claim is being investigated.
- Missing documentation: Delays may happen if required paperwork, such as medical reports or wage documentation, is incomplete or missing.
- Processing errors: Administrative mistakes or errors in claim processing can lead to payment delays, though these should be resolved quickly once discovered.
Regardless of the reason, communication with your employer or the insurance company is important to resolve delays as soon as possible.
What to Do if Your Workers Compensation Payment Is Late
If your workers compensation benefits are delayed, you do not have to wait indefinitely. Here are steps you can take to address late payments:
- Contact your claims adjuster: The first step is to reach out to your claims adjuster or the insurance company handling your case. They may be able to resolve the issue quickly.
- Consult with an attorney: If the issue is not resolved, or if you believe the delay is unreasonable, speaking with a workers compensation attorney can help. Legal representation can protect your rights and guide you through the process of requesting penalties for delayed payments.
- File a penalty petition: If you believe the delay is unjustified, you can file a petition with the California Workers Compensation Appeals Board to request a penalty. An attorney can assist in building a strong case to prove that the delay warrants a penalty under California law.
The Importance of Timely Payments
Delayed payments can add stress to an already difficult situation, especially when an injury prevents you from working. Penalties for late payments are meant to help injured workers receive the benefits they are entitled to in a timely manner. If you are dealing with late workers compensation payments, you do not have to face it alone.
At the Law Offices of Norman J. Homen, we are committed to helping injured workers in California navigate the workers compensation system. If your benefits have been delayed or denied, we can assist you in understanding your options and taking the necessary steps to get the compensation you need. Contact us today for a free consultation to discuss your case.
