There may not be much in it for you but there may be for the return-to-work fund if they can show this is a "general business practice" of the employer or carrier.
That may be why he said that, he's trying to establish a pattern of behavior so they can impose administrative penalties
Have to admit, this is the first I've heard of this in California over medical but I found it.
You must first prove the medical was unreasonably delayed or refused.
The law gives the percentage relevant to payment, if the issue is medical the penalty is at the discretion of the judge.
There is a two year statute of limitations, meaning you can only file penalties for offenses two years prior.
Unless the delay or refusal was intentional and grievous I don't see them applying penalties, the courts favor the carrier - I still say you'll need a lawyer, especially if you don't know what you're doing.
If you win the claim for penalties, the court will also award your attorney fees so you have nothing to lose.
LABOR CODE - LAB
DIVISION 4. WORKERS' COMPENSATION AND INSURANCE [3200 - 6002] ( Heading of Division 4 amended by Stats. 1979, Ch. 373. )
PART 4. COMPENSATION PROCEEDINGS [5300 - 6002] ( Part 4 enacted by Stats. 1937, Ch. 90. )
CHAPTER 6. Findings and Awards [5800 - 5816] ( Chapter 6 enacted by Stats. 1937, Ch. 90. )
(a) When 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 ten thousand dollars ($10,000), whichever is less. In any proceeding under this section, the appeals board shall use its discretion to accomplish a fair balance and substantial justice between the parties.
(e) No unreasonable delay in the provision of medical treatment shall be found when the treatment has been authorized by the employer in a timely manner and the only dispute concerns payment of a billing submitted by a physician or medical provider as provided in Section 4603.2.
(g) Notwithstanding any other provision of law, no action may be brought to recover penalties that may be awarded under this section more than two years from the date the payment of compensation was due.
II. Audit penalty: Any employer or insurer that knowingly violates section 5814
with a frequency that indicates a general business practice is liable for administrative
penalties of not to exceed four hundred thousand dollars ($400,000). Penalty
payments shall be imposed by the administrative direction and deposited into the
return-to-work fund established pursuant to section 139.48. The administrative
director may impose a penalty under either this section or subdivision (e) of section
Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.