SECTIONS 4900-4909.1 - California Statutes

LABOR CODE

SECTION 4900-4909.1

4900. No claim for compensation, except as provided in Section 96,
is assignable before payment, but this provision does not affect the
survival thereof.

4901. No claim for compensation nor compensation awarded, adjudged,
or paid, is subject to be taken for the debts of the party entitled
to such compensation except as hereinafter provided.

4902. No compensation, whether awarded or voluntarily paid, shall
be paid to any attorney at law or in fact or other agent, but shall
be paid directly to the claimant entitled thereto unless otherwise
ordered by the appeals board. No payment made to an attorney at law
or in fact or other agent in violation of this section shall be
credited to the employer.

4903. The appeals board may determine, and allow as liens against
any sum to be paid as compensation, any amount determined as
hereinafter set forth in subdivisions (a) through (i). If more than
one lien is allowed, the appeals board may determine the priorities,
if any, between the liens allowed. The liens that may be allowed
hereunder are as follows:
(a) A reasonable attorney's fee for legal services pertaining to
any claim for compensation either before the appeals board or before
any of the appellate courts, and the reasonable disbursements in
connection therewith. No fee for legal services shall be awarded to
any representative who is not an attorney, except with respect to
those claims for compensation for which an application, pursuant to
Section 5501, has been filed with the appeals board on or before
December 31, 1991, or for which a disclosure form, pursuant to
Section 4906, has been sent to the employer, or insurer or
third-party administrator, if either is known, on or before December
31, 1991.
(b) The reasonable expense incurred by or on behalf of the injured
employee, as provided by Article 2 (commencing with Section 4600)
and, to the extent the employee is entitled to reimbursement under
Section 4621, medical-legal expenses as provided by Article 2.5
(commencing with Section 4620) of Chapter 2 of Part 2.
(c) The reasonable value of the living expenses of an injured
employee or of his or her dependents, subsequent to the injury.
(d) The reasonable burial expenses of the deceased employee, not
to exceed the amount provided for by Section 4701.
(e) The reasonable living expenses of the spouse or minor children
of the injured employee, or both, subsequent to the date of the
injury, where the employee has deserted or is neglecting his or her
family. These expenses shall be allowed in the proportion that the
appeals board deems proper, under application of the spouse, guardian
of the minor children, or the assignee, pursuant to subdivision (a)
of Section 11477 of the Welfare and Institutions Code, of the spouse,
a former spouse, or minor children. A collection received as a
result of a lien against a workers' compensation award imposed
pursuant to this subdivision for payment of child support ordered by
a court shall be credited as provided in Section 695.221 of the Code
of Civil Procedure.
(f) The amount of unemployment compensation disability benefits
that have been paid under or pursuant to the Unemployment Insurance
Code in those cases where, pending a determination under this
division there was uncertainty whether the benefits were payable
under the Unemployment Insurance Code or payable hereunder; provided,
however, that any lien under this subdivision shall be allowed and
paid as provided in Section 4904.
(g) The amount of unemployment compensation benefits and extended
duration benefits paid to the injured employee for the same day or
days for which he or she receives, or is entitled to receive,
temporary total disability indemnity payments under this division;
provided, however, that any lien under this subdivision shall be
allowed and paid as provided in Section 4904.
(h) The amount of family temporary disability insurance benefits
that have been paid to the injured employee pursuant to the
Unemployment Insurance Code for the same day or days for which that
employee receives, or is entitled to receive, temporary total
disability indemnity payments under this division, provided, however,
that any lien under this subdivision shall be allowed and paid as
provided in Section 4904.
(i) The amount of indemnification granted by the California
Victims of Crime Program pursuant to Article 1 (commencing with
Section 13959) of Chapter 5 of Part 4 of Division 3 of Title 2 of the
Government Code.
(j) The amount of compensation, including expenses of medical
treatment, and recoverable costs that have been paid by the Asbestos
Workers' Account pursuant to the provisions of Chapter 11 (commencing
with Section 4401) of Part 1.

4903.1. (a) The appeals board, arbitrator, or settlement conference
referee, before issuing an award or approval of any compromise of
claim, shall determine, on the basis of liens filed with it pursuant
to subdivision (b) or (c), whether any benefits have been paid or
services provided by a health care provider, a health care service
plan, a group disability policy, including a loss of income policy, a
self-insured employee welfare benefit plan, or a hospital service
contract, and its award or approval shall provide for reimbursement
for benefits paid or services provided under these plans as follows:
(1) When the referee issues an award finding that an injury or
illness arises out of and in the course of employment, but denies the
applicant reimbursement for self-procured medical costs solely
because of lack of notice to the applicant's employer of his need for
hospital, surgical, or medical care, the appeals board shall
nevertheless award a lien against the employee's recovery, to the
extent of benefits paid or services provided, for the effects of the
industrial injury or illness, by a health care provider, a health
care service plan, a group disability policy, a self-insured employee
welfare benefit plan, or a hospital service contract.
(2) When the referee issues an award finding that an injury or
illness arises out of and in the course of employment, and makes an
award for reimbursement for self-procured medical costs, the appeals
board shall allow a lien, to the extent of benefits paid or services
provided, for the effects of the industrial injury or illness, by a
health care provider, a health care service plan, a group disability
policy, a self-insured employee welfare benefit plan, or a hospital
service contract.
(3) When the referee issues an award finding that an injury or
illness arises out of and in the course of employment and makes an
award for temporary disability indemnity, the appeals board shall
allow a lien as living expense under Section 4903, for benefits paid
by a group disability policy providing loss of time benefits. Such
lien shall be allowed to the extent that benefits have been paid for
the same day or days for which temporary disability indemnity is
awarded and shall not exceed the award for temporary disability
indemnity. No lien shall be allowed hereunder unless the group
disability policy provides for reduction, exclusion, or coordination
of loss of time benefits on account of workers' compensation
benefits.
(4) When the parties propose that the case be disposed of by way
of a compromise and release agreement, in the event the lien
claimant, other than a health care provider, does not agree to the
amount allocated to it, then the referee shall determine the
potential recovery and reduce the amount of the lien in the ratio of
the applicant's recovery to the potential recovery in full
satisfaction of its lien claim.
(b) When a compromise of claim or an award is submitted to the
appeals board, arbitrator, or settlement conference referee for
approval, the parties shall file with the appeals board, arbitrator,
or settlement conference referee any liens served on the parties.
(c) Any lien claimant under Section 4903 or this section shall
file its lien with the appeals board in writing upon a form approved
by the appeals board. The lien shall be accompanied by a full
statement or itemized voucher supporting the lien and justifying the
right to reimbursement and proof of service upon the injured worker,
or if deceased, upon the worker's dependents, the employer, the
insurer, and the respective attorneys or other agents of record.
(d) The appeals board shall file liens required by subdivision (c)
immediately upon receipt. Numbers shall be assigned pursuant to
subdivision (c) of Section 5500.

4903.2. Where a lien claimant is reimbursed pursuant to subdivision
(f) or (g) of Section 4903 or Section 4903.1, for benefits paid or
services provided, the appeals board may award an attorney's fee to
the applicant's attorney out of the lien claimant's recovery if the
appeals board determines that all of the following occurred:
(a) The lien claimant received notice of all hearings following
the filing of the lien and received notice of intent to award the
applicant's attorney a fee.
(b) An attorney or other representative of the lien claimant did
not participate in the proceedings before the appeals board with
respect to the lien claim.
(c) There were bona fide issues respecting compensability, or
respecting allowability of the lien, such that the services of an
attorney were reasonably required to effectuate recovery on the claim
of lien and were instrumental in effecting the recovery.
(d) The case was not disposed of by compromise and release.
The amount of the attorney's fee out of the lien claimant's
recovery shall be based on the extent of applicant's attorney's
efforts on behalf of the lien claimant. The ratio of the amount of
the attorney's fee awarded against the lien claimant's recovery to
that recovery shall not exceed the ratio of the amount of the
attorney's fee awarded against the applicant's award to that award.

4903.3. The director, as administrator of the Uninsured Employers
Fund, may, in his discretion, provide compensation, including medical
treatment, from the Uninsured Employers Fund in cases to which the
director is a party before the issuance of any award, if such
compensation is not being provided to the applicant.
The appeals board shall determine and allow as a first lien
against any sum to be paid as compensation the amount of
compensation, including the cost of medical treatment, provided by
the director pursuant to this section.

4903.4. When a dispute arises concerning a lien for expenses
incurred by or on behalf of the injured employee as provided by
Article 2 (commencing with Section 4600) of Chapter 2 of Part 2, the
appeals board may resolve the dispute in a separate proceeding, which
may include binding arbitration upon agreement of the employer, lien
claimant, and the employee, if the employee remains a party to the
dispute, according to the rules of practice and procedure.

4903.5. (a) No lien claim for expenses as provided in subdivision
(b) of Section 4903 may be filed after six months from the date on
which the appeals board or a workers' compensation administrative law
judge issues a final decision, findings, order, including an order
approving compromise and release, or award, on the merits of the
claim, after five years from the date of the injury for which the
services were provided, or after one year from the date the services
were provided, whichever is later.
(b) Notwithstanding subdivision (a), any health care provider,
health care service plan, group disability insurer, employee benefit
plan, or other entity providing medical benefits on a nonindustrial
basis, may file a lien claim for expenses as provided in subdivision
(b) of Section 4903 within six months after the person or entity
first has knowledge that an industrial injury is being claimed.
(c) The injured worker shall not be liable for any underlying
obligation if a lien claim has not been filed and served within the
allowable period. Except when the lien claimant is the applicant as
provided in Section 5501, a lien claimant shall not file a
declaration of readiness to proceed in any case until the
case-in-chief has been resolved.
(d) This section shall not apply to civil actions brought under
the Cartwright Act (Chapter 2 (commencing with Section 16700) of Part
2 of Division 7 of the Business and Professions Code), the Unfair
Practices Act (Chapter 4 (commencing with Section 17000) of Part 2 of
Division 7 of the Business and Professions Code), or the federal
Racketeer Influenced and Corrupt Organization Act (Chapter 96
(commencing with Section 1961) of Title 18 of the United States Code)
based on concerted action with other insurers that are not parties
to the case in which the lien or claim is filed.

4903.6. (a) Except as necessary to meet the requirements of Section
4903.5, no lien claim or application for adjudication shall be filed
under subdivision (b) of Section 4903 until the expiration of one of
the following:
(1) Sixty days after the date of acceptance or rejection of
liability for the claim, or expiration of the time provided for
investigation of liability pursuant to subdivision (b) of Section
5402, whichever date is earlier.
(2) The time provided for payment of medical treatment bills
pursuant to Section 4603.2.
(3) The time provided for payment of medical-legal expenses
pursuant to Section 4622.
(b) No declaration of readiness to proceed shall be filed for a
lien under subdivision (b) of Section 4903 until the underlying case
has been resolved or where the applicant chooses not to proceed with
his or her case.
(c) The appeals board shall adopt reasonable regulations to ensure
compliance with this section, and shall take any further steps as
may be necessary to enforce the regulations, including, but not
limited to, impositions of sanctions pursuant to Section 5813.
(d) The prohibitions of this section shall not apply to lien
claims, applications for adjudication, or declarations of readiness
to proceed filed by or on behalf of the employee, or to the filings
by or on behalf of the employer.

4904. (a) If notice is given in writing to the insurer, or to the
employer if uninsured, setting forth the nature and extent of any
claim that is allowable as a lien, the claim is a lien against any
amount thereafter payable as compensation, subject to the
determination of the amount and approval of the lien by the appeals
board. When the Employment Development Department has served an
insurer or employer with a lien claim, the insurer or employer shall
notify the Employment Development Department, in writing, as soon as
possible, but in no event later than 15 working days after commencing
disability indemnity payments. When a lien has been served on an
insurer or an employer by the Employment Development Department, the
insurer or employer shall notify the Employment Development
Department, in writing, within 10 working days of filing an
application for adjudication, a stipulated award, or a compromise and
release with the appeals board.
(b) (1) In determining the amount of lien to be allowed for
unemployment compensation disability benefits under subdivision (f)
of Section 4903, the appeals board shall allow the lien in the amount
of benefits which it finds were paid for the same day or days of
disability for which an award of compensation for any permanent
disability indemnity resulting solely from the same injury or illness
or temporary disability indemnity, or both, is made and for which
the employer has not reimbursed the Employment Development Department
pursuant to Section 2629.1 of the Unemployment Insurance Code.
(2) In determining the amount of lien to be allowed for
unemployment compensation benefits and extended duration benefits
under subdivision (g) of Section 4903, the appeals board shall allow
the lien in the amount of benefits which it finds were paid for the
same day or days for which an award of compensation for temporary
total disability is made.
(3) In determining the amount of lien to be allowed for family
temporary disability insurance benefits under subdivision (h) of
Section 4903, the appeals board shall allow the lien in the amount of
benefits that it finds were paid for the same day or days for which
an award of compensation for temporary total disability is made and
for which the employer has not reimbursed the Employment Development
Department pursuant to Section 2629.1 of the Unemployment Insurance
Code.
(c) In the case of agreements for the compromise and release of a
disputed claim for compensation, the applicant and defendant may
propose to the appeals board, as part of the compromise and release
agreement, an amount out of the settlement to be paid to any lien
claimant claiming under subdivision (f), (g), or (h) of Section 4903.
If the lien claimant objects to the amount proposed for payment of
its lien under a compromise and release settlement or stipulation,
the appeals board shall determine the extent of the lien claimant's
entitlement to reimbursement on its lien and make and file findings
on all facts involved in the controversy over this issue in
accordance with Section 5313. The appeals board may approve a
compromise and release agreement or stipulation which proposes the
disallowance of a lien, in whole or in part, only where there is
proof of service upon the lien claimant by the defendant, not less
than 15 days prior to the appeals board action, of all medical and
rehabilitation documents and a copy of the proposed compromise and
release agreement or stipulation. The determination of the appeals
board, subject to petition for reconsideration and to the right of
judicial review, as to the amount of lien allowed under subdivision
(f), (g), or (h) of Section 4903, whether in connection with an award
of compensation or the approval of a compromise and release
agreement, shall be binding on the lien claimant, the applicant, and
the defendant, insofar as the right to benefits paid under the
Unemployment Insurance Code for which the lien was claimed. The
appeals board may order the amount of any lien claim, as determined
and allowed by it, to be paid directly to the person entitled, either
in a lump sum or in installments.
(d) Where unemployment compensation disability benefits, including
family temporary disability insurance benefits, have been paid
pursuant to the Unemployment Insurance Code while reconsideration of
an order, decision, or award is pending, or has been granted, the
appeals board shall determine and allow a final amount on the lien as
of the date the board is ready to issue its decision denying a
petition for reconsideration or affirming, rescinding, altering or
amending the original findings, order, decision, or award.
(e) The appeals board may not be prohibited from approving a
compromise and release agreement on all other issues and deferring to
subsequent proceedings the determination of a lien claimant's
entitlement to reimbursement if the defendant in any of these
proceedings agrees to pay the amount subsequently determined to be
due under the lien claim.

4904.1. The payment of liens as provided in Section 4904, shall in
no way affect the commencement of immediate payments on any balance
of the award to the injured claimant where an installment payment for
his disability has been determined.

4905. Where it appears in any proceeding pending before the appeals
board that a lien should be allowed if it had been duly requested by
the party entitled thereto, the appeals board may, without any
request for such lien having been made, order the payment of the
claim to be made directly to the person entitled, in the same manner
and with the same effect as though the lien had been regularly
requested, and the award to such person shall constitute a lien
against unpaid compensation due at the time of service of the award.

4906. (a) No charge, claim, or agreement for the legal services or
disbursements mentioned in subdivision (a) of Section 4903, or for
the expense mentioned in subdivision (b) of Section 4903, is
enforceable, valid, or binding in excess of a reasonable amount. The
appeals board may determine what constitutes a reasonable amount.
(b) No attorney or agent shall demand or accept any fee from an
employee or dependent of an employee for the purpose of representing
the employee or dependent of an employee in any proceeding of the
division, appeals board, or any appellate procedure related thereto
until the amount of the fee has been approved or set by the appeals
board.
(c) Any fee agreement shall be submitted to the appeals board for
approval within 10 days after the agreement is made.
(d) In establishing a reasonable attorney's fee, consideration
shall be given to the responsibility assumed by the attorney, the
care exercised in representing the applicant, the time involved, and
the results obtained.
(e) At the initial consultation, an attorney shall furnish the
employee a written disclosure form promulgated by the administrative
director which shall clearly and prominently describe the procedures
available to the injured employee or his or her dependents. The
disclosure form shall describe this section, the range of attorney's
fees customarily approved by the appeals board, and the attorney's
fees provisions of Section 4064 and the extent to which an employee
may receive compensation without incurring attorney's fees. The
disclosure form shall include the telephone number of the
administrative director together with the statement that the employee
may receive answers at that number to questions concerning
entitlement to compensation or the procedures to follow to receive
compensation. A copy of the disclosure form shall be signed by the
employee and the attorney and sent to the employer, or insurer or
third-party administrator, if either is known, by the attorney within
15 days of the employee's and attorney's execution thereof.
(f) The disclosure form set forth in subdivision (e) shall
contain, prominently stated, the following statement:
"Any person who makes or causes to be made any knowingly false or
fraudulent material statement or representation for the purpose of
obtaining or denying worker's compensation benefits or payments is
guilty of a felony."
(g) The employee, the insurer, the employer, and the attorneys for
each party shall sign and file with the board a statement, with the
application or answer, under penalty of perjury that they have not
violated Section 139.3 and that they have not offered, delivered,
received, or accepted any rebate, refund, commission, preference,
patronage dividend, discount, or other consideration, whether in the
form of money or otherwise, as compensation or inducement for any
referred examination or evaluation.

4907. The privilege of any person, including attorneys admitted to
practice in the Supreme Court of the state to appear in any
proceeding as a representative of any party before the appeals board,
or any of its referees, may, after a hearing, be removed, denied, or
suspended by the appeals board for a violation of this chapter or
for other good cause.

4908. A claim for compensation for the injury or death of any
employee, or any award or judgment entered thereon, has the same
preference over the other debts of the employer, or his estate and of
the insurer which is given by the law to claims for wages. Such
preference is for the entire amount of the compensation to be paid.
This section shall not impair the lien of any previous award.

4909. Any payment, allowance, or benefit received by the injured
employee during the period of his incapacity, or by his dependents in
the event of his death, which by the terms of this division was not
then due and payable or when there is any dispute or question
concerning the right to compensation, shall not, in the absence of
any agreement, be an admission of liability for compensation on the
part of the employer, but any such payment, allowance, or benefit may
be taken into account by the appeals board in fixing the amount of
the compensation to be paid. The acceptance of any such payment,
allowance, or benefit shall not operate as a waiver of any right or
claim which the employee or his dependents has against the employer.

4909.1. Authorized representatives of the Department of
Corrections, and the Department of the Youth Authority may request
the State Compensation Insurance Fund to provide any payment,
allowance, or benefit as described in Section 4909. When requested by
an authorized representative, the State Compensation Insurance Fund
shall administer the benefits in a timely fashion.