CHAPTER 2. Compensation Schedules [4550. - 4856.]
Chapter 2 enacted by Stats. 1937, Ch. 90.
§§ 4550–4856 · 152 sections
ARTICLE 1. General Provisions §§ 4550–4558 · 11 sections
- § 4550 Where liability for compensation exists under this division, such compensation shall be furnished or paid by the employer and shall be as provided in this…
- § 4551 Where the injury is caused by the serious and willful misconduct of the injured employee, the compensation otherwise recoverable therefor shall be reduced…
- § 4552 The reduction of compensation because of the serious and willful misconduct of an employee is not enforceable, valid, or binding in any respect until the…
- § 4553 The amount of compensation otherwise recoverable shall be increased one-half, together with costs and expenses not to exceed two hundred fifty dollars ($250),…
- § 4553.1 In order to support a holding of serious and willful misconduct by an employer based upon violation of a safety order, the appeals board must specifically find…
- § 4554 In case of the willful failure by an employer to secure the payment of compensation, the amount of compensation otherwise recoverable for injury or death as…
- § 4555 In case of failure by an employer to secure the payment of compensation, the appeals board may award a reasonable attorney’s fee in addition to the amount of…
- § 4555.5 Whenever a petition to reduce an award, based upon a permanent disability rating which has become final, is denied, the appeals board may order the petitioner…
- § 4556 The increases provided for by this article shall not be limited by the provisions of Chapter 1 of this part relating to maximum amounts in the computation of…
- § 4557 Where the injury is to an employee under 16 years of age and illegally employed at the time of injury, the entire compensation otherwise recoverable shall be…
- § 4558 (a) As used in this section: (1) “Employer” means a named identifiable person who is, prior to the time of the employee’s injury or death, an owner or…
ARTICLE 2. Medical and Hospital Treatment §§ 4600–4615 · 34 sections
- § 4600 (a) Medical, surgical, chiropractic, acupuncture, licensed clinical social worker, and hospital treatment, including nursing, medicines, medical and surgical…
- § 4600.05 (a) An employer, as defined in Section 3300, shall provide immediate support from a nurse case manager for employees injured by an act of domestic terrorism,…
- § 4600.1 (a) Subject to subdivision (b), any person or entity that dispenses medicines and medical supplies, as required by Section 4600, shall dispense the generic…
- § 4600.2 (a) Notwithstanding Section 4600, if a self-insured employer, group of self-insured employers, insurer of an employer, or group of insurers contracts with a…
- § 4600.3 (a) (1) Notwithstanding Section 4600, when a self-insured employer, group of self-insured employers, or the insurer of an employer contracts with a health care…
- § 4600.35 Any entity seeking to reimburse health care providers for health care services rendered to injured workers on a capitated, or per person per month basis, shall…
- § 4600.4 (a) A workers’ compensation insurer, third-party administrator, or other entity that requires, or pursuant to regulation requires, a treating physician to…
- § 4600.5 (a) Any health care service plan licensed pursuant to the Knox-Keene Health Care Service Plan Act, a disability insurer licensed by the Department of…
- § 4600.6 Any workers’ compensation insurer, third-party administrator, or other entity seeking certification as a health care organization under subdivision (e) of…
- § 4600.7 (a) The Workers’ Compensation Managed Care Fund is hereby created in the State Treasury for the administration of Sections 4600.3 and 4600.5 by the Division of…
- § 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…
- § 4602 If the employee so requests, the employer shall procure certification by either the administrative director or the appeals board as the case may be of the…
- § 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,…
- § 4603.2 (a) (1) Upon selecting a physician pursuant to Section 4600, the employee or physician shall notify the employer of the name and address, including the name of…
- § 4603.3 (a) Upon payment, adjustment, or denial of a complete or incomplete itemization of medical services, an employer shall provide an explanation of review in the…
- § 4603.4 (a) The administrative director shall adopt rules and regulations to do all of the following: (1) Ensure that all health care providers and facilities submit…
- § 4603.5 The administrative director shall adopt rules pertaining to the format and content of notices required by this article; define reasonable geographic areas for…
- § 4603.6 (a) If the only dispute is the amount of payment and the provider has received a second review that did not resolve the dispute, the provider may request an…
- § 4604 Controversies between employer and employee arising under this chapter shall be determined by the appeals board, upon the request of either party, except as…
- § 4604.5 (a) The recommended guidelines set forth in the medical treatment utilization schedule adopted by the administrative director pursuant to Section 5307.27 shall…
- § 4605 Nothing contained in this chapter shall limit the right of the employee to provide, at his or her own expense, a consulting physician or any attending…
- § 4606 Any county, city and county, city, school district, or other public corporation within the state which was a self-insured employer under the “Workmen’s…
- § 4607 Where a party to a proceeding institutes proceedings to terminate an award made by the appeals board to an applicant for continuing medical treatment and is…
- § 4608 No workers’ compensation insurer, self-insured employer, or agent of an insurer or self-insured employer, shall refuse to pay pharmacy benefits solely because…
- § 4609 (a) In order to prevent the improper selling, leasing, or transferring of a health care provider’s contract, it is the intent of the Legislature that every…
- § 4610 (a) For purposes of this section, “utilization review” means utilization review or utilization management functions that prospectively, retrospectively, or…
- § 4610.1 An employee shall not be entitled to an increase in compensation under Section 5814 for unreasonable delay in the provision of medical treatment for periods of…
- § 4610.3 (a) Regardless of whether an employer has established a medical provider network pursuant to Section 4616 or entered into a contract with a health care…
- § 4610.5 (a) This section applies to the following disputes: (1) Any dispute over a utilization review decision regarding treatment for an injury occurring on or after…
- § 4610.6 (a) Upon receipt of a case pursuant to Section 4610.5, an independent medical review organization shall conduct the review in accordance with this article and…
- § 4611 (a) When a contracting agent sells, leases, or transfers a health provider’s contract to a payor, the rights and obligations of the provider shall be governed…
- § 4614 (a) (1) Notwithstanding Section 5307.1, where the employee’s individual or organizational provider of health care services rendered under this division and…
- § 4614.1 Notwithstanding subdivision (f) of Section 1345 of the Health and Safety Code, a health care service plan licensed pursuant to the Knox-Keene Health Care…
- § 4615 (a) Upon the filing of criminal charges against a physician, practitioner, or provider for any crime described in subparagraph (A) of paragraph (1) of…
ARTICLE 2.3. Medical Provider Networks §§ 4616–4616.7 · 8 sections
- § 4616 (a) (1) An insurer, employer, or entity that provides physician network services may establish or modify a medical provider network for the provision of…
- § 4616.1 (a) An insurer, employer, or entity that provides physician network services that offers a medical provider network under this division and that uses economic…
- § 4616.2 (a) A medical provider network shall file a written continuity of care policy with the administrative director. (b) If approved by the administrative director,…
- § 4616.3 (a) If the injured employee notifies the employer of the injury or files a claim for workers’ compensation with the employer, the employer shall arrange an…
- § 4616.4 (a) (1) The administrative director shall contract with individual physicians, as described in paragraph (2), or an independent medical review organization to…
- § 4616.5 (a) For purposes of this article, “employer” means a self-insured employer, joint powers authority, or the state. (b) For purposes of this article, “entity…
- § 4616.6 No additional examinations shall be ordered by the appeals board and no other reports shall be admissable to resolve any controversy arising out of this…
- § 4616.7 (a) A health care organization certified pursuant to Section 4600.5 shall be deemed approved pursuant to this article if the requirements of this article are…
ARTICLE 2.5. Medical-Legal Expenses §§ 4620–4628 · 7 sections
- § 4620 (a) For purposes of this article, a medical-legal expense means any costs and expenses incurred by or on behalf of any party, the administrative director, or…
- § 4621 (a) In accordance with the rules of practice and procedure of the appeals board, the employee, or the dependents of a deceased employee, shall be reimbursed…
- § 4622 All medical-legal expenses for which the employer is liable shall, upon receipt by the employer of all reports and documents required by the administrative…
- § 4625 (a) Effective for services provided on or after January 1, 2017, all bills for medical-legal evaluation or medical-legal expense shall be submitted to the…
- § 4626 All charges for X-rays, laboratory services, and other diagnostic tests provided in connection with an industrial medical-legal evaluation shall be billed in…
- § 4627 The board and the administrative director may promulgate such reasonable rules and regulations as may be necessary to interpret this article and compel…
- § 4628 (a) Except as provided in subdivision (c), no person, other than the physician who signs the medical-legal report, except a nurse performing those functions…
ARTICLE 3. Disability Payments §§ 4650–4664 · 25 sections
- § 4650 (a) If an injury causes temporary disability, the first payment of temporary disability indemnity shall be made not later than 14 days after knowledge of the…
- § 4650.5 Notwithstanding Section 4650, in the case of state civil service employees, employees of the Regents of the University of California, and employees of the…
- § 4651 (a) (1) A disability indemnity payment shall not be made by any written instrument unless it is immediately negotiable and payable in cash, on demand, without…
- § 4651.1 Where a petition is filed with the appeals board concerning a continuing award of such appeals board, in which it is alleged that the disability has decreased…
- § 4651.2 No petitions filed under Section 4651.1 shall be granted while the injured workman is pursuing a rehabilitation plan under Section 139.5 of this code.
- § 4651.3 Where a petition is filed with the appeals board pursuant to the provisions of Section 4651.1, and is subsequently denied wholly by the appeals board, the…
- § 4652 Except as otherwise provided by Section 4650.5, no temporary disability indemnity is recoverable for the disability suffered during the first three days after…
- § 4653 If the injury causes temporary total disability, the disability payment is two-thirds of the average weekly earnings during the period of such disability,…
- § 4654 If the injury causes temporary partial disability, the disability payment is two-thirds of the weekly loss in wages during the period of such disability.…
- § 4655 If the injury causes temporary disability which is at times total and at times partial, the weekly disability payment during the period of each total or…
- § 4656 (a) Aggregate disability payments for a single injury occurring prior to January 1, 1979, causing temporary disability shall not extend for more than 240…
- § 4657 In case of temporary partial disability the weekly loss in wages shall consist of the difference between the average weekly earnings of the injured employee…
- § 4658 (a) For injuries occurring prior to January 1, 1992, if the injury causes permanent disability, the percentage of disability to total disability shall be…
- § 4658.1 As used in this article, the following definitions apply: (a) “Regular work” means the employee’s usual occupation or the position in which the employee was…
- § 4658.5 (a) This section shall apply to injuries occurring on or after January 1, 2004, and before January 1, 2013. (b) Except as provided in Section 4658.6, if the…
- § 4658.6 The employer shall not be liable for the supplemental job displacement benefit pursuant to Section 4658.5 if the employer meets either of the following…
- § 4658.7 (a) This section shall apply to injuries occurring on or after January 1, 2013. (b) If the injury causes permanent partial disability, the injured employee…
- § 4659 (a) If the permanent disability is at least 70 percent, but less than 100 percent, 1.5 percent of the average weekly earnings for each 1 percent of disability…
- § 4660 This section shall only apply to injuries occurring before January 1, 2013. (a) In determining the percentages of permanent disability, account shall be taken…
- § 4660.1 This section applies to injuries occurring on or after January 1, 2013. (a) In determining the percentages of permanent partial or permanent total disability,…
- § 4661 Where an injury causes both temporary and permanent disability, the injured employee is entitled to compensation for any permanent disability sustained by him…
- § 4661.5 Notwithstanding any other provision of this division, when any temporary total disability indemnity payment is made two years or more from the date of injury,…
- § 4662 (a) Any of the following permanent disabilities shall be conclusively presumed to be total in character: (1) Loss of both eyes or the sight thereof. (2) Loss…
- § 4663 (a) Apportionment of permanent disability shall be based on causation. (b) A physician who prepares a report addressing the issue of permanent disability due…
- § 4664 (a) The employer shall only be liable for the percentage of permanent disability directly caused by the injury arising out of and occurring in the course of…
ARTICLE 4. Death Benefits §§ 4700–4709 · 13 sections
- § 4700 The death of an injured employee does not affect the liability of the employer under Articles 2 (commencing with Section 4600) and 3 (commencing with Section…
- § 4701 If an injury causes death, either with or without disability, the employer shall be liable, in addition to any other benefits provided by this division, for…
- § 4702 (a) Except as otherwise provided in this section and Sections 4553, 4554, 4557, and 4558, and notwithstanding any amount of compensation paid or otherwise…
- § 4703 Subject to the provisions of Section 4704, this section shall determine the right to a death benefit. If there is any person wholly dependent for support upon…
- § 4703.5 (a) In the case of one or more totally dependent children, as defined in Section 3501, after payment of the amount specified in Section 4702, and…
- § 4703.6 The provisions of Section 4703.5 shall also apply to a totally dependent minor child of a local safety member as defined in Article 4 (commencing with Section…
- § 4704 The appeals board may set apart or reassign the death benefit to any one or more of the dependents in accordance with their respective needs and in a just and…
- § 4705 The person to whom the death benefit is paid for the use of the several beneficiaries shall apply it in compliance with the findings and directions of the…
- § 4706 (a) If a dependent beneficiary of any deceased employee dies and there is no surviving dependent, the payments of the death benefit accrued and payable at the…
- § 4706.5 (a) Whenever any fatal injury is suffered by an employee under circumstances that would entitle the employee to compensation benefits, but for their death, and…
- § 4707 (a) Except as provided in subdivision (b), no benefits, except reasonable expenses of burial not exceeding one thousand dollars ($1,000), shall be awarded…
- § 4708 Upon application of any party in interest for a death benefit provided by this division on the death of an employee member of the Public Employees’ Retirement…
- § 4709 (a) Notwithstanding any other law, a dependent of a peace officer, as defined in Section 830.1, 830.2, 830.3, 830.31, 830.32, 830.33, 830.34, 830.35, 830.36,
ARTICLE 4.5. Public Official Death Benefits §§ 4720–4728 · 9 sections
- § 4720 As used in this article: (a) “Elected public official” means any person other than the President or Vice President of the United States who holds any federal,…
- § 4721 The surviving spouse or dependent minor children of an elected public official who is killed by assassination shall be entitled to a special death benefit…
- § 4722 If the deceased elected public official is survived by a spouse with or without dependent minor children, such special death benefit shall be payable to the…
- § 4723 The person or persons to whom the special death benefit is payable pursuant to Section 4722 shall, within one year of the date of death of the elected public…
- § 4724 The person or persons to whom the special death benefit is payable pursuant to Section 4722 shall file a claim therefor with the Department of General…
- § 4725 The State Compensation Insurance Fund shall be the disbursing agent for payments made pursuant to this article and shall receive a fee for its services to be…
- § 4726 The Department of General Services and the Administrative Director of the Division of Workers’ Compensation shall jointly adopt rules and regulations as may be…
- § 4727 Any person who is convicted of any crime in connection with the assassination of an elected public official shall not be eligible for any benefits pursuant to…
- § 4728 (a) A dependent of an elected public official, who was intentionally killed while holding office, in retaliation for, or to prevent the performance of, an…
ARTICLE 5. Subsequent Injuries Payments §§ 4750–4758 · 13 sections
- § 4750 For the purposes of this article, the following terms have the following meanings: (a) “Administrative director” means the Administrative Director of the…
- § 4751 (a) If an employee who is permanently partially disabled receives a subsequent compensable injury resulting in additional permanent partial disability so that…
- § 4753 (a) (1) SIBTF benefits are not in addition to but shall be reduced to the extent of any monetary payments received by the employee, from any source whatsoever,…
- § 4753.5 In any hearing, investigation, or proceeding, the state shall be represented by the Attorney General, or the attorneys of the Department of Industrial…
- § 4754 (a) The appeals board shall fix and award the amounts of SIBTF benefits to be paid under this article, and shall direct the director, as trustee or…
- § 4754.1 (a) This section shall apply to all compensable subsequent injuries for which there has not been a final determination of SIBTF liability as of the date this…
- § 4754.2 An application for SIBTF benefits under this article shall be made five years from the date of the subsequent industrial injury described in subdivision (a) of…
- § 4754.3 (a) SIBTF shall not be liable for the payment of interest on any awards or order for payment of attorney’s fees. (b) SIBTF shall not be liable for any…
- § 4754.5 Nothing in this article shall impair the right of the Attorney General or the Department of Industrial Relations to release by compromise any claims brought…
- § 4755 (a) The director may draw from the State Treasury out of the Subsequent Injuries Benefits Trust Fund for the purposes specified in Section 4751, without at the…
- § 4756 (a) The Legislature finds and declares that it is in the best interest of the State of California to provide a person, regardless of their citizenship or…
- § 4757 (a) The Legislature finds and declares that the changes made by the act that added this section are procedural and shall apply to all claims for SIBTF…
- § 4758 (a) This section applies to a claim for SIBTF benefits that meets any of the following criteria: (1) Prior to June 1, 2026, the Workers’ Compensation Appeals…
ARTICLE 6. Special Payments to Certain Persons §§ 4800–4820 · 21 sections
- § 4800 (a) Whenever any member of the Department of Justice falling within the “state peace officer/firefighter” class is disabled by injury arising out of and in the…
- § 4800.5 (a) Whenever any sworn member of the Department of the California Highway Patrol is disabled by a single injury, excluding disabilities that are the result of…
- § 4801 It shall be the duty of the appeals board to determine in the case of members of the California Highway Patrol, upon request of the Department of the…
- § 4802 Any such member of the California Highway Patrol or Department of Justice, or any such harbor policeman, so disabled is entitled from the date of injury and…
- § 4803 Whenever such disability of such member of the California Highway Patrol, or Department of Justice, or of such harbor policeman, continues for a period beyond…
- § 4804 No disability indemnity shall be paid to said member of the California Highway Patrol or harbor policeman as temporary disability concurrently with wages or…
- § 4804.1 Whenever any member of a University of California fire department specified in Section 3212.4 falling within the active “firefighting and prevention service”…
- § 4804.2 It shall be the duty of the appeals board to determine in the case of members of a University of California fire department specified in Section 4804. 1, upon…
- § 4804.3 Any such member of a University of California fire department specified in Section 4804.1, so disabled is entitled from the date of injury and regardless of…
- § 4804.4 Whenever such disability of such member of a University of California fire department, specified in Section 4804.1, continues for a period beyond one year,…
- § 4804.5 No disability indemnity shall be paid to said member of a University of California fire department, specified in Section 4804.1, as temporary disability…
- § 4806 Whenever any member of the University of California Police Department falling within the “law enforcement” class is disabled by injury arising out of and in…
- § 4807 It shall be the duty of the appeals board to determine, in the case of members of the University of California Police Department, upon the request of the…
- § 4808 Any such member of the University of California Police Department so disabled is entitled from the date of injury, and regardless of retirement under either…
- § 4809 Whenever such disability of such member of the University of California Police Department continues for a period beyond one year, such member shall thereafter…
- § 4810 No disability indemnity shall be paid to such member of the University of California Police Department as temporary disability concurrently with wages or…
- § 4811 (a) Whenever any member of State Bargaining Unit 8 employed by the Department of Forestry and Fire Protection is disabled by injury arising out of and in the…
- § 4816 Pursuant to a collective bargaining agreement applicable to members of the California State University Police Department, whenever any member of that police…
- § 4817 It shall be the duty of the appeals board to determine, in the case of members of the California State University Police Department, upon the request of the…
- § 4819 Whenever the disability of a member of the California State University Police Department continues for a period beyond one year, that member shall thereafter…
- § 4820 No disability indemnity shall be paid to a member of the California State University Police Department as temporary disability concurrently with wages or…
ARTICLE 7. City Police and Firemen, Sheriffs, and Others §§ 4850–4856 · 11 sections
- § 4850 (a) Whenever any person listed in subdivision (b), who is employed on a regular, full-time basis, and is disabled, whether temporarily or permanently, by…
- § 4850.3 A city, county, special district, or harbor district that is a member of the Public Employees’ Retirement System, is subject to the County Employees Retirement…
- § 4850.4 (a) A city, county, special district, or harbor district that is a member of the Public Employees’ Retirement System, is subject to the County Employees…
- § 4850.5 Any firefighter employed by the County of San Luis Obispo, and the sheriff or any officer or employee of the sheriff’s office of the County of San Luis Obispo,…
- § 4850.7 (a) Any firefighter employed by a dependent or independent fire district may be entitled to the benefits of this article, if otherwise entitled to these…
- § 4851 The governing body of any city, county, or city and county, in addition to anyone else properly entitled, including the Public Employees’ Retirement System,…
- § 4852 The provisions of this article do not diminish or affect the right of any such officer or employee to the medical, surgical, and hospital benefits prescribed…
- § 4853 Whenever such disability of any such officer or employee continues for a period beyond one year, such member shall thereafter be subject as to disability…
- § 4854 No disability indemnity shall be paid to any such officer or employee concurrently with wages or salary payments.
- § 4855 This article shall not be applicable to individuals who are appointed as reserve public safety employees and are deemed to be employees of a county, city, town…
- § 4856 (a) Whenever any local employee who is a firefighter, peace officer as described in Chapter 4.5 (commencing with Section 830) of Title 3 of Part 2 of the Penal…