Difference between revisions of "California Labor Codes 5402"

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[[California| California]] > [[California_Labor_Codes#5402| Labor Codes]]
 
[[California| California]] > [[California_Labor_Codes#5402| Labor Codes]]
=== § 5402 Knowledge of injury; Limitation on medical liability===
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=== § 5402 Employer's knowledge equivalent to notice; employer's notice to employee or employee's dependents===
  
 
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<tr>
 
<tr>
 
<td width="80%" valign="top">History:  
 
<td width="80%" valign="top">History:  
*[[California_Labor Codes_5402_637| Knowledge of injury; Limitation on medical liability]]
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*[[California_Labor Codes_5402_637| Amended by Stats 2004, CH 34, effective 4/19/04]]
<br><br>(a) Knowledge of an injury, obtained from any source, on the part of an employer, his or her managing agent, superintendent, foreman, or other person in authority, or knowledge of the assertion of a claim of injury sufficient to afford opportunity to the employer to make an investigation into the facts, is equivalent to service under Section [[California_Labor_Codes_5400| 5400]].
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*[[California_Labor Codes_5402_1080| Amended by SB 863; Effective Jan. 1, 2013]]
 
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<br><br>(a)�Knowledge of an injury, obtained from any source, on the part of an employer, his or her managing agent, superintendent, foreman, or other person in authority, or knowledge of the assertion of a claim of injury sufficient to afford opportunity to the employer to make an investigation into the facts, is equivalent to service under Section [[California_Labor_Codes_5400| 5400]].
(b) If liability is not rejected within 90 days after the date the claim form is filed under Section [[California_Labor_Codes_5401| 5401]], the injury shall be presumed compensable under this division. The presumption of this subdivision is rebuttable only by evidence discovered subsequent to the 90-day period.
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(b)�If liability is not rejected within 90 days after the date the claim form is filed under Section [[California_Labor_Codes_5401| 5401]], the injury shall be presumed compensable under this division. The presumption of this subdivision is rebuttable only by evidence discovered subsequent to the 90-day period.
 
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(c)�Within one working day after an employee files a claim form under Section [[California_Labor_Codes_5401| 5401]], the employer shall authorize the provision of all treatment, consistent with Section [[California_Labor_Codes_5307.27| 5307.27]], for the alleged injury and shall continue to provide the treatment until the date that liability for the claim is accepted or rejected. Until the date the claim is accepted or rejected, liability for medical treatment shall be limited to ten thousand dollars ($10,000).
(c) Within one working day after an employee files a claim form under Section [[California_Labor_Codes_5401| 5401]], the employer shall authorize the provision of all treatment, consistent with Section [[California_Labor_Codes_5307.27| 5307.27]] or the American College of Occupational and Environmental Medicine's Occupational Medicine Practice Guidelines, for the alleged injury and shall continue to provide the treatment until the date that liability for the claim is accepted or rejected. Until the date the claim is accepted or rejected, liability for medical treatment shall be limited to ten thousand dollars ($10,000).
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(d)�Treatment provided under subdivision (c) shall not give rise to a presumption of liability on the part of the employer.
 
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(d) Treatment provided under subdivision (c) shall not give rise to a presumption of liability on the part of the employer.
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<td width="3">&nbsp;</td>
 
<td width="3">&nbsp;</td>
 
<td width="20%" valign="top"><b>Relevant Case Law</b>
 
<td width="20%" valign="top"><b>Relevant Case Law</b>
  
[http://www.workcompcentral.com/members/index.php?fa=wiki_redirect&case_no=249106212812491&state=CA Maranian v. WCAB]
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<div id="link1">
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[http://www.workcompcentral.com/members/index.php?fa=wiki_redirect&case_no=249106212812491&state=ca Maranian v. WCAB]
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</div>
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<div id="explanation1" style="display:none">Note: 90-day limitation runs from date of receipt of Claim Form; Order on Recon final re appellate review.</div>
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<div id="link2">
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[http://www.workcompcentral.com/members/index.php?fa=wiki_redirect&case_no=249208212372492&state=ca SCIF v. WCAB (Welcher)]
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</div>
  
Note: 90-day limitation runs from date of receipt of Claim Form; Order on Recon final re appellate review.
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<div id="explanation2" style="display:none">Note: Failure to reject claim within 90 days created presumption of compensability; Testimony inadmissible b/c not identified as witness at MSC.</div>
  
[http://www.workcompcentral.com/members/index.php?fa=wiki_redirect&case_no=249208212372492&state=CA SCIF v. WCAB (Welcher)]
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<div id="link3">
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[http://www.workcompcentral.com/members/index.php?fa=wiki_redirect&case_no=290012212202900&state=ca Honeywell vs. WCAB (Wagner)]
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</div>
  
Note: Failure to reject claim within 90 days created presumption of compensability; Testimony inadmissible b/c not identified as witness at MSC.
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<div id="explanation3" style="display:none">Note: Employer must have actual notice of knowledge of an injury before duty to provide claim form arises.</div>
  
[http://www.workcompcentral.com/members/index.php?fa=wiki_redirect&case_no=290012212202900&state=CA Honeywell vs. WCAB (Wagner)]
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<div id="link4">
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[http://www.workcompcentral.com/members/index.php?fa=wiki_redirect&case_no=290104212662901&state=ca Wagner vs. Allied Signal]
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</div>
  
Note: Employer must have actual notice of knowledge of an injury before duty to provide claim form arises.
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<div id="explanation4" style="display:none">Note: Duty to provide claim form when reasonable certainty of claim of industrial injury.</div>
  
[http://www.workcompcentral.com/members/index.php?fa=wiki_redirect&case_no=290104212662901&state=CA Wagner vs. Allied Signal]
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<div id="link5">
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[http://www.workcompcentral.com/members/index.php?fa=wiki_redirect&case_no=4070721239407&state=ca Kaiser Foundation Hospitals v. WCAB (Daly City)]
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</div>
  
Note: Duty to provide claim form when reasonable certainty of claim of industrial injury.
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<div id="explanation5" style="display:none">Note: Breach of employer's duty to notify employee of rights to benefits tolls limitations period; duty arises if employer has constructive knowledge of injury.</div>
  
[http://www.workcompcentral.com/members/index.php?fa=wiki_redirect&case_no=4070721239407&state=CA Kaiser Foundation Hospitals v. WCAB (Daly City)]
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<div id="link6">
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[http://www.workcompcentral.com/members/index.php?fa=wiki_redirect&case_no=b230q05l2371403st31l10&state=ca Leegin Creative Leather Products, Inc. v. Diaz]
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</div>
  
Note: Breach of employer's duty to notify employee of rights to benefits tolls limitations period; duty arises if employer has constructive knowledge of injury.
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<div id="explanation6" style="display:none">Note: Employer cannot bring civil suit for fraud against claimant.</div>
  
[http://www.workcompcentral.com/members/index.php?fa=wiki_redirect&case_no=b230q05l2371403st31l10&state=CA Leegin Creative Leather Products, Inc. v. Diaz]
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<div id="link7">
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[http://www.workcompcentral.com/members/index.php?fa=wiki_redirect&case_no=b43b05v778313xy3d56rzp&state=ca Honeywell vs. WCAB (Wagner) (Cal Sup Crt)]
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</div>
  
Note: Employer cannot bring civil suit for fraud against claimant.
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<div id="explanation7" style="display:none">Note: Injured worker must actually deliver the Claim Form to the employer before the 90 day limitation on investigations in LC 5402 starts to run.</div>
  
[http://www.workcompcentral.com/members/index.php?fa=wiki_redirect&case_no=b43b05v778313xy3d56rzp&state=CA Honeywell vs. WCAB (Wagner) (Cal Sup Crt)]
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<div id="link8">
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[http://www.workcompcentral.com/members/index.php?fa=wiki_redirect&case_no=l250n07m1724777de5a8ob&state=ca Muna v. WCAB]
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</div>
  
Note: Injured worker must actually deliver the Claim Form to the employer before the 90 day limitation on investigations in LC 5402 starts to run.
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<div id="explanation8" style="display:none">Note: [Unpublished] Employer met its burden of proof in rebutting the presumption of compensability.</div>
  
[http://www.workcompcentral.com/members/index.php?fa=wiki_redirect&case_no=l250n07m1724777de5a8ob&state=CA Muna v. WCAB]
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<div id="link9">
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[http://www.workcompcentral.com/members/index.php?fa=wiki_redirect&case_no=l351z05a1558007jk32n14&state=ca Fleetwood Enterprises, Inc. v. WCAB (Moody)]
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</div>
  
Note: [Unpublished] Employer met its burden of proof in rebutting the presumption of compensability.
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<div id="explanation9" style="display:none">Note: Injury sustained while on pleasure trip is not compensable under the going and coming rule.</div>
  
[http://www.workcompcentral.com/members/index.php?fa=wiki_redirect&case_no=l351z05a1558007jk32n14&state=CA Fleetwood Enterprises, Inc. v. WCAB (Moody)]
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<div id="link10">
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[http://www.workcompcentral.com/members/index.php?fa=wiki_redirect&case_no=o154t10y1571155uv3s23w&state=ca Mendoza v. Huntington Hospital]
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</div>
  
Note: Injury sustained while on pleasure trip is not compensable under the going and coming rule.
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<div id="explanation10" style="display:none">Note: [En Banc] AD Rule 30(d)(3) is invalid because it conflicts with sections 4060(c) and 4062.2 and exceeds the scope of section 5402(b).</div>
  
[http://www.workcompcentral.com/members/index.php?fa=wiki_redirect&case_no=p266y04n1278971ab36w36&state=CA Williams vs. WCAB]
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<div id="link11">
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[http://www.workcompcentral.com/members/index.php?fa=wiki_redirect&case_no=p266y04n1278971ab36w36&state=ca Williams vs. WCAB]
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</div>
  
Note: Presumption of compensability applies even if claim is accepted then denied after 90 days.
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<div id="explanation11" style="display:none">Note: Presumption of compensability applies even if claim is accepted then denied after 90 days.</div>
  
[http://www.workcompcentral.com/members/index.php?fa=wiki_redirect&case_no=x329d04s541238mn0e43zt&state=CA Leinon vs Fishermen's Grotto (#2)]
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<div id="link12">
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[http://www.workcompcentral.com/members/index.php?fa=wiki_redirect&case_no=x329d04s541238mn0e43zt&state=ca Leinon vs Fishermen's Grotto (#2)]
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</div>
  
Note: When indemnity becomes due under 4650 does not depend on whether denial was 'wrong' under 5402.
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<div id="explanation12" style="display:none">Note: When indemnity becomes due under 4650 does not depend on whether denial was 'wrong' under 5402.</div>
  
 
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Latest revision as of 13:12, 19 June 2013

California > Labor Codes

§ 5402 Employer's knowledge equivalent to notice; employer's notice to employee or employee's dependents

History:



(a)�Knowledge of an injury, obtained from any source, on the part of an employer, his or her managing agent, superintendent, foreman, or other person in authority, or knowledge of the assertion of a claim of injury sufficient to afford opportunity to the employer to make an investigation into the facts, is equivalent to service under Section 5400. (b)�If liability is not rejected within 90 days after the date the claim form is filed under Section 5401, the injury shall be presumed compensable under this division. The presumption of this subdivision is rebuttable only by evidence discovered subsequent to the 90-day period. (c)�Within one working day after an employee files a claim form under Section 5401, the employer shall authorize the provision of all treatment, consistent with Section 5307.27, for the alleged injury and shall continue to provide the treatment until the date that liability for the claim is accepted or rejected. Until the date the claim is accepted or rejected, liability for medical treatment shall be limited to ten thousand dollars ($10,000). (d)�Treatment provided under subdivision (c) shall not give rise to a presumption of liability on the part of the employer.

  Relevant Case Law