First off let’s start off by discussion what type of events can qualify as an unreasonable delay. These can include indemnity payments such as temporary disability or permanent disability benefits, payment of an Award, medical treatment, reimbursement requests, mileage requests, and the list goes on. Most payments in workers’ compensation are controlled by statute, and there are strict limits as to when those payments must be made.
When unreasonable delay penalties are sought, the court first looks to the reason for the delay. The court must consider the totality of the circumstances, which is balancing fairness between the parties, in determining the reasonableness of the delay.
The Labor Code says “when a payment of compensation has been unreasonably delayed or refused, either prior to or subsequent to the issuance of an award, the amount of the payment unreasonably delayed or refused shall be increased up to 25 percent or up to $10,000, whichever is less.”
If the employer/insurance company discovers the delay within 90 days of the date of the discovery and there has been no demand or claim by the employee for a penalty, they may pay a self-imposed penalty in the amount of 10% along with the delayed payment. This self-imposed penalty acts in lieu of the penalty of up to 25% or $10,000.
If the employer/insurance company claims a clerical error for the delay in the payment, this does not preclude them from a claim for penalties by the injured worker. However, on the issue of reasonable delay, this is addressed on a case by case basis. The time limit for claiming a penalty for a delayed or refused payment is two years from the date the payment was due.
If you have questions about delays related to your workers' compensation case and want to talk to an attorney in Fresno, please call 559-408-7436 or fill out the form to the right.
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