California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 4.5 - Division of Workers' Compensation › Subchapter 1.5 - Injuries on or After January 1, 1990 › Article 5 - Administrative Penalties › Section 10111 - Schedule of Administrative Penalties for Injuries on or After January 1, 1990, but Before January 1, 1994

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The administrative penalties set forth in subsections (a)
						through (d) of this section will be imposed for injuries occurring on or after
						January 1, 1990, but before January 1, 1994, subject to any applicable
						mitigation or exacerbation under subsection (e) of this section.
(a) A penalty of up to $100 for each
					 violation shall be assessed when there is:
(1)
					 Failure to make full payment of 10% self-imposed increase when temporary
					 disability indemnity or permanent disability indemnity is overdue. The penalty
					 for this violation is:
If the self-imposed increase was not paid or was only
						partially paid, the audit penalty is based on the amount of the underlying
						indemnity and is as follows:
$25 if the late-paid indemnity totals not more than 3
						days;
$50 if the late-paid indemnity totals more than 3 but not
						more than 7 days;
$75 if the late-paid indemnity totals more than 7 but not
						more than 14 days;
$100 if the late paid indemnity totals more than 14
						days.
(2) Failure to provide
					 first permanent disability payment when due and/or within 14 days after
					 temporary disability payments are terminated. The penalty for this violation
					 is:
$25 if the first payment was made 1 to 2 days
						late;
$50 if the first payment was made 3 to 7 days
						late;
$75 if the first payment was made 8 to 14 days
						late;
$100 if the first payment was made more than 14 days
						late.
(3) Failure to respond
					 to a written request for medical treatment of injured worker within 20 days of
					 the date of request. The penalty for this violation is:
$25 for a response made from 1 to 7 days late;
$50 for a response made from 8 to 15 days late;
$75 for a response made from 16 to 34 days late;
$100 for failure to respond for more than 35
						days.
(4) Failure to
					 provide, upon request, any transportation costs when due to injured worker for
					 medical care. The penalty for this violation is:
$25 for $10 or less in expense;
$50 for more than $10, to $20, in expense;
$75 for more than $20, to $40, in expense;
$100 for more than $40 in expense.
(5) Failure to document average weekly
					 earnings if temporary disability indemnity is being paid at less than the
					 maximum rate. The penalty for this violation is $100.
(6) Failure to make the first payment of
					 temporary disability indemnity not later than 14 days after the date of the
					 employer's knowledge of injury and disability pursuant to Labor Code Section
					 4650(a).
					 The penalty for this violation is:
$25 if the first payment was made 1 to 2 days
						late;
$50 if the first payment was made 3 to 7 days
						late;
$75 if the first payment was made 8 to 14 days late,
						and/or if all indemnity then due was not paid but was paid with a subsequent
						payment;
$100 if the first payment was made more than 14 days
						late, and/or if all indemnity then due was not paid with the first payment and
						remains unpaid at the time of audit.
(7) Failure to follow the Rules and
					 Regulations established by the Administrative Director for the purpose of
					 carrying out the workers' compensation provisions in Labor Code Section
					 3200 through
					 Section 6002. The penalty for this
					 violation is:
[i] For each failure to include
					 in a claim file a copy of the Employee's Claim for Worker's Compensation
					 Benefits, DWC Form 1, showing the date the form was provided to and received
					 from the employee, or documentation of the date the claim form was provided to
					 the employee if the employee did not return the form, the penalty is:
$100 if there were any late indemnity payments, or if
						notice of acceptance of the claim was not issued within 90 days after the
						employer's date of knowledge of injury and disability, or if the claim was
						denied.
[ii] For each
					 failure to issue a notice of benefits as required by Title 8, California Code
					 of Regulations, Division 1, Chapter 4.5, Subchapter 1, Article 8, beginning
					 with Section
					 9810, or by Title 8, California
					 Code of Regulations, Division 1, Chapter 4.5, Subchapter 1.5, Article 7,
					 beginning with Section
					 10122, unless penalties apply and
					 are assessed under Section
					 10111(b)(2) of
					 these regulations, the penalty is $100.
[iii] For each notice of benefits which was
					 not issued timely as provided in Title 8, California Code of Regulations,
					 Division 1, Chapter 4.5, Subchapter 1, Article 8, beginning with Section
					 9810, or as provided in Title 8,
					 California Code of Regulations, Division 1, Chapter 4.5, Subchapter 1.5,
					 Article 7, beginning with Section
					 10122, the penalty is:
$25 for each notice of first, resumed, changed or final
						payment of temporary disability indemnity, wage continuation, death benefits,
						permanent disability indemnity, or VRMA which was issued from 1 to 7 days
						late;
$50 for each notice of first, resumed, changed or final
						payment of temporary disability indemnity, wage continuation, death benefits,
						permanent disability indemnity, or VRMA which was issued more than 7 days late,
						and for each delay in decision notice or denial notice which was issued from 1
						to 7 days late;
$75 for each delay in decision notice or denial notice
						which was issued more than 7 days late.
[iv] For each Notice of Benefits required by
					 Title 8, California Code of Regulations, Division 1, Chapter 4.5, Subchapter 1,
					 Article 8, beginning with Section
					 9810, or by Title 8, California
					 Code of Regulations, Division 1, Chapter 4.5, Subchapter 1.5, Article 7,
					 beginning with Section
					 10122, which was materially
					 inaccurate or incomplete, except an inaccurate or incomplete denial notice, the
					 penalty is $25. For a materially inaccurate or incomplete denial notice the
					 penalty is $100.
[v] For each
					 failure to include in a claim file, or document attempts to obtain, any of the
					 required contents specified in Section
					 10101, the penalty is
					 $100.
[vi] For each failure to
					 comply with any regulation of the Administrative Director, not otherwise
					 assessed in these Regulations, the penalty is $100.
(8) Failure to pay or object to all
					 documented Medical-Legal expenses within 60 days of receipt of billing and any
					 required reports as provided for in Labor Code 4622. The penalty for this
					 violation is:
$50 for each bill which was paid more than 60 days from
						receipt with interest and a 10% increase;
$75 for each bill which was paid more than 60 days from
						receipt where either interest or a 10% increase was not included;
$100 for each bill which was paid more than 60 days from
						receipt where neither interest nor a 10% increase was paid;
$100 for each bill which was not paid where no timely
						objection was sent.
(9)
					 Failure to pay or object to expenses for medical treatment within 60 days of
					 receipt of the bill and any required reports. The penalty for this violation
					 is:
$25 for each bill of $100 or less, excluding interest and
						penalty;
$50 for each bill of more than $100, but no more than
						$200, excluding interest and penalty;
$75 for each bill of more than $200, but no more than
						$300, excluding interest and penalty;
$100 for each bill of more than $300, excluding interest
						and penalty.
(10) Failure to
					 pay within ten days any indemnity due, which is not specified in subsections
					 (a)(1) through (a)(9). The penalty for this violation is:
$25 for late payment of 3 days of indemnity or
						less;
$50 for late payment of more than 3 but no more than 7
						days of indemnity;
$75 for late payment of more than 7 days of indemnity, or
						failure to pay 3 days of indemnity or less;
$100 for failure to pay more than 3 days of
						indemnity.