California Labor Codes 5402
§ 5402 Knowledge of injury; Limitation on medical liability
(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 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).
(d) Treatment provided under subdivision (c) shall not give rise to a presumption of liability on the part of the employer.
Note: 90-day limitation runs from date of receipt of Claim Form; Order on Recon final re appellate review.
Note: Failure to reject claim within 90 days created presumption of compensability; Testimony inadmissible b/c not identified as witness at MSC.
Note: Employer must have actual notice of knowledge of an injury before duty to provide claim form arises.
Note: Duty to provide claim form when reasonable certainty of claim of industrial injury.
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.
Note: Employer cannot bring civil suit for fraud against claimant.
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.
Note: [Unpublished] Employer met its burden of proof in rebutting the presumption of compensability.
Note: Injury sustained while on pleasure trip is not compensable under the going and coming rule.
Note: Presumption of compensability applies even if claim is accepted then denied after 90 days.
Note: When indemnity becomes due under 4650 does not depend on whether denial was 'wrong' under 5402.