WC Regulations
The regulations listed here are a small sub-section of the entire work comp code. The code is available in its entirety at the Division of Workers' Compensation web site.
| Labor Code (LC) |
| California Code of Regulations (CCR) |
| Insurance Code (IC) |
Labor Code (LC)
132a. It is the declared
policy of this state that there should not be discrimination against workers
who are injured in the course and scope of their employment.
(1) Any employer who discharges, or threatens to discharge, or in any manner
discriminates against any employee because he or she has filed or made known
his or her intention to file a claim for compensation with his or her employer
or an application for adjudication, or because the employee has received a
rating, award, or settlement, is guilty of a misdemeanor and the employee's
compensation shall be increased by one-half, but in no event more than ten
thousand dollars ($10,000), together with costs and expenses not in excess
of two hundred fifty dollars ($250). Any such employee shall also be entitled
to reinstatement and reimbursement for lost wages and work benefits caused
by the acts of the employer.
(2) Any insurer that advises, directs, or threatens an insured under penalty
of cancellation or a raise in premium or for any other reason, to discharge
an employee because he or she has filed or made known his or her intention
to file a claim for compensation with his or her employer or an application
for adjudication, or because the employee has received a rating, award, or
settlement, is guilty of a misdemeanor and subject to the increased compensation
and costs provided in paragraph (1).
(3) Any employer who discharges, or threatens to discharge, or in any manner
discriminates against any employee because the employee testified or made
known his or her intentions to testify in another employee's case before the
appeals board, is guilty of a misdemeanor, and the employee shall be entitled
to reinstatement and reimbursement for lost wages and work benefits caused
by the acts of the employer.
(4) Any insurer that advises, directs, or threatens an insured employer under
penalty of cancellation or a raise in premium or for any other reason, to
discharge or in any manner discriminate against an employee because the employee
testified or made known his or herintention to testify in another employee's
case before the appeals board, is guilty of a misdemeanor.
Proceedings for increased compensation as provided in paragraph (1), or for
reinstatement and reimbursement for lost wages and work benefits, are to be
instituted by filing an appropriate petition with the appeals board, but these
proceedings may not be commenced more than one year from the discriminatory
act or date of termination of the employee. The appeals board is vested with
full power, authority, and jurisdiction to try and determine finally all matters
specified in this section subject only to judicial review, except that the
appeals board shall have no jurisdiction to try and determine a misdemeanor
charge. The appeals board may refer and any worker may complain of suspected
violations of the criminal misdemeanor provisions of this section to the Division
of Labor Standards Enforcement, or directly to the office of the public prosecutor.
132a(4). Any insurer that
advises, directs, or threatens an insured employer under penalty of cancellation
or a raise in premium or for any other reason, to discharge or in any manner
discriminate against an employee because the employee testified or made known
his or her intention to testify in another employee's case before the appeals
board, is guilty of a misdemeanor.
3202. This division and Division 5 (commencing with Section 6300) shall be liberally construed by the courts with the purpose of extending their benefits for the protection of persons injured in the course of their employment.
3202.5. Nothing contained in Section 3202 shall be construed as relieving a party or a lien claimant from meeting the evidentiary burden of proof by a preponderance of the evidence. "Preponderance of the evidence" means such evidence as, when weighed with that opposed to it, has more convincing force and the greater probability of truth. When weighing the evidence, the test is not the relative number of witnesses, but the relative convincing force of the evidence.
3208. "Injury" includes any injury or disease arising out of the employment, including injuries to artificial members, dentures, hearing aids, eyeglasses and medical braces of all types; provided, however, that eyeglasses and hearing aids will not be replaced, repaired, or otherwise compensated for, unless injury to them is incident to an injury causing disability.
3209.3. (a) "Physician" includes physicians and surgeons holding an M.D. or D.O. degree, psychologists, acupuncturists, optometrists, dentists, podiatrists, and chiropractic practitioners licensed by California state law and within the scope of their practice as defined by California state law.
3550. (a) Every employer
subject to the compensation provisions of this division shall post and keep
posted in a conspicuous location frequented by employees, and where the notice
may be easily read by employees during the hours of the workday, a notice
which shall state the name of the current compensation insurance carrier of
the employer, or when such is the fact, that the employer is self-insured,
and who is responsible for claims adjustment.
(b) Failure to keep any notice required by this section conspicuously posted
shall constitute a misdemeanor, and shall be prima facie evidence of noninsurance.
(c) This section shall not apply with respect to the employment of employees
as defined in subdivision (d) of Section 3351.
(d) The form and content of the notice required by this section shall be prescribed
by the administrative director and shall advise employees that all injuries
should be reported to their employer. The notice shall also include, in nontechnical
language, advice as to the injured employee's right to receive medical care,
to select or change the treating physician pursuant to the provisions of Section
4600, and the right to receive temporary disability indemnity, permanent disability
indemnity, vocational rehabilitation services, and death benefits, as appropriate.
The notice shall also identify to whom injuries should be reported, and the
location and telephone number of the nearest information and assistance officer.
(e) Failure of an employer to provide the notice required by this section
shall automatically permit the employee to be treated by his or her personal
physician with respect to an injury occurring during that failure.
(f) The notice required to be posted by this section may be made available
to self-insured employers and insurers by the administrative director. Insurers
shall provide this notice to each of their policyholders, with advice concerning
the requirements of this section and the penalties for failure to post this
notice.
3551. Every employer subject to the compensation provisions of this code, except employers of employees defined in subdivision (d) of Section 3351, shall give every new employee, either at the time the employee is hired or by the end of the first pay period, written notice of the information contained in Section 3550.
3552. Upon the request of an employee, an employer shall provide the employee with an appropriate form on which the employee may indicate the name of his or her "personal physician," as defined by Section 4600.
3600. (a) Liability for
the compensation provided by this division, in lieu of any other liability
whatsoever to any person except as otherwise specifically provided in Sections
3602, 3706, and 4558, shall, without regard to negligence, exist against an
employer for any injury sustained by his or her employees arising out of and
in the course of the employment and for the death of any employee if the injury
proximately causes death, in those cases where the following conditions of
compensation concur:
(1) Where, at the time of the injury, both the employer and the employee are
subject to the compensation provisions of this division.
(2) Where, at the time of the injury, the employee is performing service growing
out of and incidental to his or her employment and is acting within the course
of his or her employment.
(3) Where the injury is proximately caused by the employment, either with
or without negligence.
(4) Where the injury is not caused by the intoxication, by alcohol or the
unlawful use of a controlled substance, of the injured employee. As used in
this paragraph, "controlled substance" shall have the same meaning
as prescribed in Section 11007 of the Health and Safety Code.
(5) Where the injury is not intentionally self-inflicted.
(6) Where the employee has not willfully and deliberately caused his or her
own death.
(7) Where the injury does not arise out of an altercation in which the injured
employee is the initial physical aggressor.
(8) Where the injury is not caused by the commission of a felony, or a crime
which is punishable as specified in subdivision (b) of Section 17 of the Penal
Code, by the injured employee, for which he or she has been convicted.
(9) Where the injury does not arise out of voluntary participation in any
off-duty recreational, social, or athletic activity not constituting part
of the employee's work-related duties, except where these activities are a
reasonable expectancy of, or are expressly or impliedly required by, the employment.
The administrative director shall promulgate reasonable rules and regulations
requiring employers to post and keep posted in a conspicuous place or places
a notice advising employees of the provisions of this subdivision. Failure
of the employer to post the notice shall not constitute an expression of intent
to waive the provisions of this subdivision.
(10) Except for psychiatric injuries governed by subdivision (e) of Section
3208.3, where the claim for compensation is filed after notice of termination
or layoff, including voluntary layoff, and the claim is for an injury occurring
prior to the time of notice of termination or layoff, no compensation shall
be paid unless the employee demonstrates by a preponderance of the evidence
that one or more of the following conditions apply:
(A) The employer has notice of the injury, as provided under Chapter 2 (commencing
with Section 5400), prior to the notice of termination or layoff.
(B) The employee's medical records, existing prior to the notice of termination
or layoff, contain evidence of the injury.
(C) The date of injury, as specified in Section 5411, is subsequent to the
date of the notice of termination or layoff, but prior to the effective date
of the termination or layoff.
(D) The date of injury, as specified in Section 5412, is subsequent to the
date of the notice of termination or layoff. For purposes of this paragraph,
an employee provided notice pursuant to Sections 44948.5, 44949, 44951, 44955,
44955.6, 72411, 87740, and 87743 of the Education Code shall be considered
to have been provided a notice of termination or layoff only upon a district'
s final decision not to reemploy that person. A notice of termination or layoff
that is not followed within 60 days by that termination or layoff shall not
be subject to the provisions of this paragraph, and this paragraph shall not
apply until receipt of a later notice of termination or layoff. The issuance
of frequent notices of termination or layoff to an employee shall be considered
a bad faith personnel action and shall make this paragraph inapplicable to
the employee.
(b) Where an employee, or his or her dependents, receives the compensation
provided by this division and secures a judgment for, or settlement of, civil
damages pursuant to those specific exemptions to the employee's exclusive
remedy set forth in subdivision (b) of Section 3602 and Section 4558, the
compensation paid under this division shall be credited against the judgment
or settlement, and the employer shall be relieved from the obligation to pay
further compensation to, or on behalf of, the employee or his or her dependents
up to the net amount of the judgment or settlement received by the employee
or his or her heirs, or that portion of the judgment as has been satisfied.
3700. Every employer except
the state shall secure the payment of compensation in one or more of the following
ways:
(a) By being insured against liability to pay compensation in one or more
insurers duly authorized to write compensation insurance in this state.
(b) By securing from the Director of Industrial Relations a certificate of
consent to self-insure either as an individual employer, or as one employer
in a group of employers, which may be given upon furnishing proof satisfactory
to the Director of Industrial Relations of ability to self-insure and to pay
any compensation that may become due to his or her employees.
(c) For any county, city, city and county, municipal corporation, public district,
public agency, or any political subdivision of the state, including each member
of a pooling arrangement under a joint exercise of powers agreement (but not
the state itself), by securing from the Director of Industrial Relations a
certificate of consent to self-insure against workers' compensation claims,
which certificate may be given upon furnishing proof satisfactory to the director
of ability to administer workers' compensation claims properly, and to pay
workers' compensation claims that may become due to its employees. On or before
March 31, 1979, a political subdivision of the state which, on December 31,
1978, was uninsured for its liability to pay compensation, shall file a properly
completed and executed application for a certificate of consent to self-insure
against workers' compensation claims. The certificate shall be issued and
be subject to the provisions of Section 3702.
3751. (a) No employer shall
exact or receive from any employee any contribution, or make or take any deduction
from the earnings of any employee, either directly or indirectly, to cover
the whole or any part of the cost of compensation under this division. Violation
of this subdivision is a misdemeanor.
(b) If an employee has filed a claim form pursuant to Section 5401, a provider
of medical services shall not, with actual knowledge that a claim is pending,
collect money directly from the employee for services to cure or relieve the
effects of the injury for which the claim form was filed, unless the medical
provider has received written notice that liability for the injury has been
rejected by the employer and the medical provider has provided a copy of this
notice to the employee. Any medical provider who violates this subdivision
shall be liable for three times the amount unlawfully collected, plus reasonable
attorney's fees and costs.
4050. Whenever the right to compensation under this division exists in favor of an employee, he shall, upon the written request of his employer, submit at reasonable intervals to examination by a practicing physician, provided and paid for by the employer, and shall likewise submit to examination at reasonable intervals by any physician selected by the administrative director or appeals board or referee thereof.
4060. (a) This section shall
apply to disputes over the compensability of any injury. This section shall
not apply where injury to any part or parts of the body is accepted as compensable
by the employer.
(b) Neither the employer nor the employee shall be liable for any comprehensive
medical-legal evaluation performed by other than the treating physician either
in whole or in part on behalf of the employee prior to the filing of a claim
form and prior to the time the claim is denied or becomes presumptively compensable
under Section 5402. However, reports of treating physicians shall be admissible.
(c) If a medical evaluation is required to determine compensability at any
time after the period specified in subdivision (b), and the employee is represented
by an attorney, each party may select a qualified medical evaluator to conduct
a comprehensive medical-legal evaluation. Neither party may obtain more than
one comprehensive medical-legal report, provided, however, that any party
may obtain additional reports at their own expense. The parties may, at any
time, agree on one medical evaluator to evaluate the issues in dispute.
(d) If a medical evaluation is required to determine compensability at any
time after the period specified in subdivision
(b), and the employee is not represented by an attorney, the employer shall
not seek agreement with the employee on a physician to prepare a comprehensive
medical-legal evaluation. The employee may select a qualified medical evaluator
to prepare a comprehensive medical-legal evaluation. The division shall assist
unrepresented employees, and shall make available to them the list of medical
evaluators compiled under Section 139.2. Neither party may obtain more than
one comprehensive medical-legal report, provided, however, that any party
may obtain additional reports at their own expense. If an employee has received
a comprehensive medical-legal evaluation under this subdivision, and he or
she later becomes represented by an attorney, he or she shall not be entitled
to an additional evaluation at the employer's expense.
(e) Evaluations performed under this section shall not be limited to the issue
of the compensability of the injury, but shall address all medical issues
in dispute.
4061.5. The treating physician primarily responsible for managing the care of the injured worker or the physician designated by that treating physician shall, in accordance with rules promulgated by the administrative director, render opinions on all medical issues necessary to determine eligibility for compensation. In the event that there is more than one treating physician, a single report shall be prepared by the physician primarily responsible for managing the injured worker's care that incorporates the findings of the various treating physicians.
4600. Medical, surgical, chiropractic, acupuncture, and hospital treatment, including nursing, medicines, medical and surgical supplies, crutches, and apparatus, including orthotic and prosthetic devices and services, that is reasonably required to cure or relieve from the effects of the injury shall be provided by the employer. In the case of his or her neglect or refusal seasonably to do so, the employer is liable for the reasonable expense incurred by or on behalf of the employee in providing treatment. After 30 days from the date the injury is reported, the employee may be treated by a physician of his or her own choice or at a facility of his or her own choice within a reasonable geographic area. However, if an employee has notified his or her employer in writing prior to the date of injury that he or she has a personal physician, the employee shall have the right to be treated by that physician from the date of injury. If an employee requests a change of physician pursuant to Section 4601, the request may be made at any time after the injury, and the alternative physician, chiropractor, or acupuncturist shall be provided within five days of the request as required by Section 4601. For the purpose of this section, "personal physician" means the employee's regular physician and surgeon, licensed pursuant to Chapter 5 (commencing with Section 2000) of Division 2 of the Business and Professions Code, who has previously directed the medical treatment of the employee, and who retains the employee's medical records, including his or her medical history. Where at the request of the employer, the employer's insurer, the administrative director, the appeals board, or a workers' compensation judge, the employee submits to examination by a physician, he or she shall be entitled to receive in addition to all other benefits herein provided all reasonable expenses of transportation, meals, and lodging incident to reporting for the examination, together with one day of temporary disability indemnity for each day of wages lost in submitting to the examination. Regardless of the date of injury, "reasonable expenses of transportation" includes mileage fees from the employee's home to the place of the examination and back at the rate of twenty-one cents ($0.21) a mile or the mileage rate adopted by the Director of the Department of Personnel Administration pursuant to Section 19820 of the Government Code, whichever is higher, plus any bridge tolls. The mileage and tolls shall be paid to the employee at the time he or she is given notification of the time and place of the examination. Where at the request of the employer, the employer's insurer, the administrative director, the appeals board, a workers' compensation judge, an employee submits to examination by a physician and the employee does not proficiently speak or understand the English language, he or she shall be entitled to the services of a qualified interpreter in accordance with conditions and a fee schedule prescribed by the administrative director. These services shall be provided by the employer. For purposes of this section, "qualified interpreter" means a language interpreter certified, or deemed certified, pursuant to Article 8 (commencing with Section 11435.05) of Chapter 4.5 of Part 1 of Division 3 of Title 2 of, or Section 68566 of, the Government Code.
4601. (a) If the employee
so requests, the employer shall tender the employee one change of physician.
The employee at any time may request that the employer tender this one-time
change of physician. Upon request of the employee for a change of physician,
the maximum amount of time permitted by law for the employer or insurance
carrier to provide the employee an alternative physician or, if requested
by the employee, a chiropractor, or an acupuncturist shall be five working
days from the date of the request. Notwithstanding the 30-day time period
specified in Section 4600, a request for a change of physician pursuant to
this section may be made at any time. The employee is entitled, in any serious
case, upon request, to the services of a consulting physician, chiropractor,
or acupuncturist of his or her choice at the expense of the employer. The
treatment shall be at the expense of the employer.
(b) If an employee requesting a change of physician pursuant to subdivision
(a) has notified his or her employer in writing prior to the date of injury
that he or she has a personal chiropractor, the alternative physician tendered
by the employer to the employee, if the employee so requests, shall be the
employee's personal chiropractor. For the purpose of this article, "personal
chiropractor" means the employee's regular chiropractor licensed pursuant
to Chapter 2 (commencing with Section 1000) of Division 2 of the Business
and Professions Code, who has previously directed treatment of the employee,
and who retains the employee's chiropractic treatment records, including his
or her chiropractic history.
(c) If an employee requesting a change of physician pursuant to subdivision
(a) has notified his or her employer in writing prior to the date of injury
that he or she has a personal acupuncturist, the alternative physician tendered
by the employer to the employee, if the employee so requests, shall be the
employee's personal acupuncturist. For the purpose of this article, "personal
acupuncturist" means the employee's regular acupuncturist licensed pursuant
to Chapter 12 (commencing with Section 4935) of Division 2 of the Business
and Professions Code, who has previously directed treatment of the employee,
and who retains the employee's acupuncture treatment records, including his
or her acupuncture history.
4603. If the employer desires a change of physicians or chiropractor, he may petition the administrative director who, upon a showing of good cause by the employer, may order the employer to provide a panel of five physicians, or if requested by the employee, four physicians and one chiropractor competent to treat the particular case, from which the employee must select one.
5401. (a) Within one working
day of receiving notice or knowledge of injury under Section 5400 or 5402,
which injury results in lost time beyond the date of injury or which results
in medical treatment beyond first aid, the employer shall provide, personally
or by first-class mail, a claim form and a notice of potential eligibility
for benefits under this division to the injured employee, or in the case of
death, to his or her dependents. As used in this subdivision, "first
aid" means any one-time treatment of minor scratches, cuts, burns, splinters,
or other minor industrial injury. "Minor industrial injury" shall
not include serious exposure to a
hazardous substance as defined in subdivision (i) of Section 6302. The claim
form shall request the injured employee's name and address, social security
number, the time and address where the injury occurred, and the nature of
and part of the body affected by the injury. The notice shall include a description
of the procedures and assistance available to the employee on his or her own
behalf, the procedure to be used to commence proceedings for the collection
of compensation for the purposes of this chapter, the telephone number of
the division's information and assistance services, and a statement that the
employee has a right to consult an attorney or information and assistance
officer, or both, for assistance. Claims forms shall be available at district
offices of the Employment Development Department and the division. Claims
forms may be made available to the employee from any other source. (b) The
completed claim form shall be filed with the employer by the injured employee,
or, in the case of death, by a dependent of the injured employee, or by an
agent of the employee or dependent. Except as provided in subdivision (c),
a claim form is deemed filed when it is personally delivered to the employer
or received by the employer by first-class or certified mail. A dated copy
of the completed form shall be provided by the employer to the employer's
insurer and to the employee, dependent, or agent who filed the claim form.
(c) The claim form shall be filed with the employer prior to the injured employee's
entitlement to late payment supplements under subdivision (d) of Section 4650,
or prior to the injured employee's request for a medical evaluation under
Section 4060, 4061, or 4062. Filing of the claim form with the employer shall
toll, for injuries occurring on or after January 1, 1994, the time limitations
set forth in Sections 5405 and 5406 until the claim is denied by the employer
or the injury becomes presumptively compensable pursuant to Section 5402.
For purposes of this subdivision, a claim form is deemed filed when it is
personally delivered to the employer or mailed to the employer by first-class
or certified mail.
5412. The date of injury in cases of occupational diseases or cumulative injuries is that date upon which the employee first suffered disability therefrom and either knew, or in the exercise of reasonable diligence should have known, that such disability was caused by his present or prior employment.
5450. The Division of Workers' Compensation shall make available to employees, employers and other interested parties information, assistance, and advice to assure the proper and timely furnishing of benefits and to assist in the resolution of disputes on an informal basis.
5451. Any party may consult with, or seek the advice of, an information and assistance officer within the Division of Workers' Compensation as designated by the administrative director. If no application is filed, if the employee is not represented, or upon agreement of the parties, the information and assistance officer shall consider the contentions of the parties and may refer the matter to the appropriate bureau or unit within the Division of Workers' Compensation for review and recommendations. The information and assistance officer shall advise the employer and the employee of their rights, benefits, and obligations under this division. Upon making a referral, the information and assistance officer shall arrange for a copy of any pertinent material submitted to be served upon the parties or their representatives, if any. The procedures to be followed by the information and assistance officer shall be governed by the rules and regulations of the administrative director adopted after public hearings.