Grinberg: Sacramento Strikes to Shorten WC Investigation Interval| Staff Compensation Information

By Gregory Grinberg

Tuesday, May 18, 2021 | 0

Have a nice Monday, dear readers! We’re going through 2021 right now, aren’t we?

Gregory Grinberg

So, pop quiz for you, dear readers. How many days does an employer have after receiving the DWC-1 application form to reject an application? If you look at Labor Act 5402, you will find that an employer has 90 days to issue a rejection. But if you look to the future, the answer might be different … very different.

Senate Bill 335 would amend Section 5402 of the Labor Code to shorten the investigation period from 90 days to 45 days. The bill would also reduce the COVID-related investigation periods to 30 days (down from 45 in some cases). Ultimately, employers would be liable for the first $ 17,000 (up from $ 10,000) of medical treatment prior to the claim being denied.

Let’s just do some basic arithmetic (come on, dear readers, it’s going to be fun!)

An employee who has had back problems in the past that occurred before the start of the employment relationship applies for an employee compensation claim for a back injury. The employer is skeptical of the cause of the damage and plans to request a panel. A notification of delay will be issued approximately 10 days after the application form has been received and the Pro employee will request a panel by mail. The panel arrives approximately 20 days later and the first available appointment is within 45 days. The report will not be published for another 30 days thereafter.

In order to receive a QME opinion on the cause of the damage, the expected waiting time is 105 days from the time the application form is made available to the employer. Mind you, dear readers, all of this is very optimistic about the timeline. The typical time from the application form to the QME opinion is much longer and often requires replacement panels as the available QMEs cannot be determined in a timely manner.

It is difficult enough to get a thorough exam within 90 days. What should the employer investigate in 45 days? In fact, in most cases, a deposit is not available within 45 days, which means more and more employers are having to issue a rejection because an investigation cannot be completed on time.

Hopefully SB335 goes its way to all other bad legislative ideas and becomes a footnote rather than a law. However, this is another example of the worrying trend from Sacramento, which appears determined to make employee compensation an intolerable burden on remaining California employers. With other states wooing California businesses by offering lower taxes and fewer regulations, the cost of employee compensation insurance per $ 100 payroll will certainly be an added incentive to move out.

Gregory Grinberg is the managing partner of Gale, Sutow & Associates’ SF Bay South office and a certified employee compensation law specialist. This post was reprinted with permission from Grinberg’s WCDefenseCA blog.