On September 29, 2022, Governor Newsom signed Senate Bill 1127 into law. The rules become effective as of 1/01/2023. SB 1127 changes the California workers’ compensation landscape in three ways:
- Reduces the decision period from 90 days to 75 days for injuries and illness defined under sections 3212 to 3212.85, and 3212.9 to 3213.2 (i.e., presumptive injuries for specified safety officers);
- Increases the maximum number of weeks of disability benefit entitlement from 104 weeks to 240 weeks for presumptive cancer claims for specified firefighters and peace officers as defined in LC 3212.1; and
- Increases the penalty - up to five times the amount of benefits up to $50,000 - for claims of injury or illness as defined in sections 3212 to 3213.2 (i.e., presumptive injuries for specified safety officers and COVID-19 presumptive claims) that are unreasonably denied. (LC 5414.3)
While all three of the above-mentioned provisions have an effective dated of 1/01/2023, the increased penalty provision of newly created LC 5414.3 applies retroactively, regardless of whether the injury occurs before, on, or after the effective date.
The reduced decision period provision affects fewer injuries and illnesses when compared to the increased penalty provision. However, both provisions apply to specified safety officer claims for hernias, heart trouble, pneumonia, cancer, PTSD, tuberculosis, MRSA, biochemical substances, meningitis, skin cancer, Lyme disease and to the low back under the duty belt presumption.
By contrast, the penalty provision covers the three COVID-19 presumptions – 3212.86, 3212.87 and 3212.88 – whereas the reduced decision period provision does not. Thus, the timelines for decision-making specified for COVID presumption claims under SB 1159 still apply: 30 days under LC 3212.86 (essential workers with dates of injury before 7/05/2020); and, for qualified employees with a date of injury after 7/05/2020, LC 3212.87 (certain peace officers, firefighters and specified health care workers) allows for 30 days, whereas a decision must be made within 45 days for COVID claims arising under LC 3212.88 during a period of outbreak (for employees not covered by 3212.87).
As it relates to qualifying school safety officers, SB 1127 would affect qualifying school safety officers falling under Penal Code section 830.32 if the following injuries or illnesses were alleged:
- 3212.15 – PTSD (75 days and penalties)
- 3212.8 – MRSA (75 days and penalties)
- 3212.85 – Biochemicals (75 days and penalties)
- 3212.86 – COVID injuries for essential workers with DOI before 7/05/2020 (penalties)
- 3212.88 – COVID Outbreak (penalties)
Stated differently, qualifying school safety officers would be entitled to both a shorted 75-day decision period and the benefit of the penalty provision if claiming an injury or illness of PTSD, MRSA or biochemicals. Qualifying school safety officers would also be entitled to a shortened 30/45 day decision period and entitled to the increased penalty provision for COVID-19 claims.
Now more than ever, the defense community, and in particular claim examiners, should be cautious when determining if an employee has a qualifying job and qualifying injury.
Hanna Brophy is hosting a Webinar on SB 1127 on Wednesday, October 26, 2022 at 12:00 p.m. To ensure a placement on our invite list, email firstname.lastname@example.org. The author may be contacted at email@example.com.