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Workers’ Comp Claim Investigations May Shorten in California

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One of the biggest frustrations workers in California experience when seeking workers’ compensation benefits is the wait between filing and getting the final word about whether their claim is approved or denied. Claims administrators have 90 days to investigate the case and reach a final decision, which means that many claimants feel like they are in a state of claim limbo for 3 full months.

In an effort to expedite workers’ compensation claims and eliminate unnecessary delays that can negatively impact injured workers, the proposed Senate Bill 335 would shorten the investigation time period from 90 days to just 45 days. SB 335 would also increase employer liability for an injured worker’s medical costs while the investigation is pending to $17,000, up from $10,000. During the current 90-day investigation period, employers only have to provide up to $10,000 in medical treatment cost coverage in most cases, which means that injured workers could be left without necessary medical care for months.

The California Workers’ Compensation Institute (CWCI) is analyzing SB 335 to get a better understanding of what its proposed changes might mean for workers’ compensation in the state as a whole. For example, it is studying data sets from the last 5 years or so to see how many cases even involved hitting the $10,000 medical liability cap within the first 90 days after a workplace accident.

Altered Penalties for Noncompliant Insurers

SB 335 will also change how insurance companies can be penalized for unreasonably delaying payments to a workers’ compensation claimant. Under the current system, a claimant can be paid another 25% of the amount that was delayed, up to $10,000. For example, if $4,000 in benefits were delayed unjustly, then the claimant could be paid another $1,000.

The proposed changes under SB 335 would instead penalize an insurance company in an amount equal to 10% of all benefits owed to the claimant. For example, if a claimant should be provided $100,000 worth of benefits by the time the workers’ comp case concludes, then any delay at any point during it could result in the claimant being paid an additional $10,000. In most situations, this claim would mean that a claimant receives a larger award for the misconduct carried out by an insurer.

To learn more about SB 335 and how it could impact workers’ compensation programs in California, you can click here to access a PDF file from the official CWCI website of the group’s analysis of the bill. If you live in Newport Beach, Corona, or Bakersfield, and you need assistance with a workers’ compensation claim, then contact Alvandi Law Group, P.C. right away to speak with experienced attorneys.



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