Lead Opinion
Opinion
When a worker suffers an industrial injury, the employer is required by law to provide workers’ compensation benefits. This obligation to provide benefits arises shortly after the injury has been incurred. When, upon a worker’s application, the Workers’ Compensation Appeals Board (WCAB) issues an order or award, it includes benefits that the employer already has or should have paid, as well as benefits the employer is to pay in the future. (See, e.g., Lab. Code, §§ 4600, 4650; all further statutory citations are to the Labor Code.) If the employer has unreasonably delayed or refused payment of benefits, section 5814 requires that the WCAB, as a penalty for the employer’s improper conduct, increase by 10 percent “the full amount of the order, decision or award.”
The issue in this case concerns the computation of the section 5814 penalty. More specifically, it is whether payments that were made by the
Facts
On January 9, 1988, petitioner Grant David Rhiner was injured when he fell off a roof at work. Because his employer
Petitioner received orthopedic treatment from Dr. Malcolm Lesavoy at the University of California at Los Angeles (UCLA). Dr. Lesavoy recommended that petitioner be examined by Dr. Kimberly McCallum, a psychiatrist at the UCLA Neuropsychiatric Institute. Dr. McCallum prescribed medication for petitioner, and recommended that petitioner continue to receive psychotherapy from a clinical psychologist, Dr. Laurie Reifsnyder, near his home in Arroyo Grande.
Dr. Reifsnyder provided petitioner psychotherapy from August 1988 through January 1990. Petitioner’s employer refused to pay for this treatment, claiming, erroneously so, that it was duplicative of psychiatric treatment petitioner was receiving at UCLA. Invoking section 5814, petitioner applied for the imposition of a penalty against his employer.
The workers’ compensation judge judicially noticed that petitioner’s home was approximately 200 miles from UCLA, and found that the employer had acted unreasonably by insisting that petitioner be required to travel to UCLA to receive psychotherapy. Citing Gallamore, supra,
The WCAB affirmed the finding by the workers’ compensation judge that the employer had unreasonably refused to pay for Dr. Reifsnyder’s treatment
Petitioner sought review in the Court of Appeal. That court accepted review and concluded that the workers’ compensation judge had calculated the section 5814 statutory penalty correctly, as 10 percent of the entire medical treatment award, and that the WCAB had calculated the penalty incorrectly, as 10 percent of what remained of the medical treatment award after deducting the employer’s preaward payments. In arriving at its conclusion, the Court of Appeal followed Toccalino v. Workers’ Comp. Appeals Bd., supra,
Discussion
The resolution of the appropriate means of computing the penalty against the employer for unreasonable delay in payment to the injured employee centers on the construction of section 5814. As in all problems of statutory interpretation, it is appropriate to begin with the words of the provision to be construed, as these words are generally “the best indicator of legislative intent.” (Adoption of Kelsey S. (1992)
Section 5814 says: “When payment of compensation has been unreasonably delayed or refused, either prior to or subsequent to the issuance of an award, the full amount of the order, decision or award shall be increased by
Section 5814 expressly requires that the penalty be calculated as a 10 percent increase of the “full amount of the order, decision or award.” It makes no provision for any deductions or credits, nor does it distinguish between benefits payable before and after the award. Thus, it is clear from the plain wording of the statute that the Legislature intended the penalty to be applied against the total amount of the award, without a deduction or credit for the employer’s timely preaward payments.
Additional support for this conclusion is found in the statute’s legislative history. Section 5814 was enacted in 1945. (Stats. 1945, ch. 802, § 2, p. 1497.) Before 1945, the subject of an employer’s unreasonable delay in payment of benefits to the injured employee was addressed in section 5811. As originally enacted in 1917, section 5811 granted the Industrial Accident Commission (the predecessor of the WCAB) discretionary authority to award interest on the amounts of compensation unreasonably delayed, at the rate of 1.5 percent per month during the period of delay.
In 1945, the Legislature enacted section 5814 (Stats. 1945, ch. 802, § 2, p. 1497) and transferred the interest provisions from former section 5811 to section 5800 (Stats. 1945, ch. 695, § 1, p. 1380).
Gallamore, a unanimous decision of this court, held that “the penalty [under section 5814] is to be computed by assessing 10 percent of the entire amount ultimately awarded for the particular class of benefit which has been Unreasonably delayed or withheld.” (Gallamore, supra,
Nevertheless, subsequent to Gallamore, supra,
The division of authority centers on this court’s decision in Gallamore, supra,
1. Our Decision in Gallamore
In Gallamore, supra,
We addressed the issue presented in this case—whether any of the employer’s prior payments should be excluded in assessing the 10 percent
In a single paragraph, we disposed of the claim that prior payments should be deducted from the award before assessing the 10 percent increase. Because of its obvious importance, we quote this paragraph from Gallamore in full:
“Carrier argues that the penalty should be applied to the net amount of benefits remaining unpaid, thereby permitting credit to the employer or carrier for amounts previously paid without delay on the specific benefit awarded. (See Adams v. Workers’ Comp. Appeals Bd. [(1976)]
In the final part of the Gallamore opinion, entitled “Summary,” this court reiterated the holding that the penalty is to be computed on “the entire amount ultimately awarded for the particular class of benefit which has been unreasonably delayed or withheld.” (
First, the carrier’s contention, as recited in our Gallamore opinion, was that “the penalty should be applied to the net amount of benefits remaining unpaid, thereby permitting credit to the employer or carrier for amounts previously paid without delay on the specific benefit awarded.” (Gallamore, supra,
Second, in Gallamore we cited Ramsey v. Workmen’s Comp. App. Bd. (1969)
Third, Gallamore’s summary of the holding on this issue—that the WCAB is to compute the penalty on “the entire amount ultimately awarded for the particular class of benefit which has been unreasonably delayed or withheld” (Gallamore, supra,
Finally, to read into Gallamore an approval of deductions for preaward payments by the employer renders the disposition in Gallamore inconsistent. The facts of the case, as recited in the opinion, were that the carrier had delayed in reimbursing the employee for travel expenses, but had made the reimbursement before the hearing and award. The employee had requested three separate section 5814 penalties, one being for the delay in reimbursing travel expenses. The WCAB had imposed only one of the requested penalties, and it had imposed no penalty for delay in travel expense reimbursement. (Gallamore, supra, 23 Cal.3d at pp. 820-821.) We remanded the matter to the WCAB to reconsider the employee’s two additional penalty claims. In particular, we stated that unreasonable delay in reimbursing travel expenses, if proved, “would justify another 10 percent penalty, applied to the total amount of travel expenses for which reimbursement was proper.” (Id. at p. 827.) This language can only mean that the carrier’s belated but preaward reimbursement of travel expenses was not exempt from the penalty assessment.
2. Court of Appeal’s Decisions in Crowe and Kaminski
The first case to consider our holding in Gallamore, supra,
The Crowe court justified this conclusion by reading two ptt-Gallamore Court of Appeal decisions—Daniels v. Workmen’s Comp. Appeals Bd. (1972)
Although the Crowe court’s reasoning might be questioned on other grounds as well,
The Court of Appeal’s decision in Crowe, supra,
In Toccalino, supra,
The issue again arose in Consani, supra, 221 Cal.App.3d 12. The court in Consani, like the court in Toccalino, supra,
The Court of Appeal in Consani rejected the employer’s argument. The court correctly noted that Gallamore made no reference to the Garcia footnote, that the footnote was unnecessary to the decision in Garcia, and that the cases cited in the Garcia footnote did not support Gallamore’s conclusion. (Consani, supra, 221 Cal.App.3d at pp. 18-20.) Accordingly, the Consani court concluded that our opinion in Gallamore did not adopt the Garcia footnote.
As this discussion confirms, the Courts of Appeal in Toccalino, supra,
4. Payments made Under “Compulsion of an Award”
In this case, the employer argues that our decision in Gallamore, supra,
The sentence in Gallamore, supra, upon which the employer relies reads: “The statutory language [of section 5814], referring to the ‘full’ amount of an award makes no provision for credit for any partial payments made under compulsion of an award.” (
More important, the context of the sentence in Gallamore, supra, negates the employer’s contention. The sentence immediately preceding the sentence on which the employer relies says: “Carrier argues that the penalty should be applied to the net amount of benefits remaining unpaid, thereby permitting credit to the employer or carrier for amounts previously paid without delay on the specific benefit awarded.” (
5. WCAB Discretion
In the second to last paragraph of our Gallamore opinion, we admonished the WCAB to strike “a fair balance between the right of the employee to prompt payment of compensation benefits, and the avoidance of imposition
What the employer overlooks or ignores is that the Gallamore statement at issue immediately followed one in which we declined to express an opinion as to whether certain acts of the carrier had been unreasonable. (Gallamore, supra, 23 Cal.3d at pp. 827-828.) Read in context, the statement in question pertains to the WCAB’s authority to decide whether a penalty should be assessed at all, not to the calculation of the penalty. Elsewhere, the Gallamore opinion indicates that the board does not have discretion to ignore de minimis delinquencies (id. at pp. 822-823), holds that the penalty is imposed against the entirety of the benefit of which any part was unreasonably delayed or withheld (id. at p. 827), and notes that once the determination to assess a penalty has been made, the amount “can be readily computed” (id. at p. 822).
By limiting the penalty to the class of benefits in which the employer’s delinquency occurred, and by precluding all deductions for the employer’s previous payments of benefits to the injured worker, Gallamore established a method of penalty computation that is relatively simple and vests no discretion in the WCAB.
6. Policy Considerations
The employer argues that policy considerations support its view that a section 5814 penalty should be calculated without including timely payments that the employer made before the formal issuance of an award. The employer asserts that the potential harshness of imposing a 10 percent penalty on the full amount of the award when the amount delayed or refused is small militates against including preaward payments in the penalty calculation.
The express language of the statute, however, compels the conclusion we reached in Gallamore, supra, that the penalty must be assessed on “the entire amount ultimately awarded for the particular class of benefit which has been unreasonably delayed or withheld.” (
ft ]s true, as the employer argues, that under section 5814 the employer’s unreasonable delay or refusal to pay a small amount of benefits to the injured employee may result in a large penalty.
The employer and amici curiae argue that the enactment of the Margolin-Bill Greene Workers’ Compensation Reform Act of 1989 (Stats. 1989, ch. 892, p. 2982; id., ch. 893, p. 3040) is an intervening circumstance that makes this court’s decision in Gallamore “ripe for reconsideration.” (See Moradi-Shalal v. Fireman’s Fund Ins. Companies (1988)
The legislation in question, which applies only to injuries occurring on or after January 1, 1990 (Stats. 1989, ch. 893, § 6, p. 3045), made a number of
Contrary to the assertions of the employer and amici curiae, the new legislation supports this court’s decision in Gallamore, supra,
Conclusion
We reaffirm our holding in Gallamore, supra,
The judgment of the Court of Appeal is affirmed.
Lucas, C. J., Mosk, J., Panelli, J., Baxter, J., and George, J., concurred.
Notes
The employer, Ted Jones, and the employer’s workers’ compensation insurance carrier, MSI Insurance Company, are both parties in this case. For convenience, they are referred to collectively as “employer.”
Here, the workers’ compensation judge’s “Findings and Award and Order” and the WCAB’s “Opinion and Order Granting Reconsideration and Decision After Reconsideration” do not clearly state that preaward medical benefits as well as future medical benefits have been awarded. As we said in Mercer-Fraser Co. v. Industrial Acc. Com. (1953)
When it was enacted in 1917, section 5811 provided in pertinent part: “. . . the commission may, in its discretion, where payments of compensation have been unreasonably delayed, allow the beneficiary thereof interest thereon, at not to exceed one and one-half per cent per month, during such period of delay.” (Stats. 1917, ch. 586, § 23, p. 851.)
As amended in 1937, section 5811 read: “Where payments of compensation have been unreasonably delayed, the commission may allow the beneficiary thereof interest thereon, at not to exceed one and one-half per cent per month, during such period of delay.” (Stats. 1937, ch. 90, § 5811, p. 302.)
The 1945 amendments also modified the nature of the interest calculations. Instead of imposing interest as a penalty based on unreasonable delay in providing compensation, the Legislature directed that WCAB awards would accrue interest at the same rate as judgments in civil actions.
For example, the Court of Appeal in Crowe, supra, referred to payments made by the employer before the actual issuance of an award as “voluntarily” made. (
The employer also argues that imposing the section 5814 penalty against the full amount of the award for the class of benefits unreasonably delayed encourages employers to delay future payments, because the penalty will be the same no matter how long or how often the employer delays payment. We disagree: successive delinquencies require the imposition of multiple penalties. (Gallamore, supra, 23 Cal.3d at pp. 823-824.)
The employer has not challenged the penalty imposed in this case on the ground that, in relation to the detriment to the injured worker, it is so excessive as to violate due process. (See Hale v. Morgan (1978)
The following cases, to the extent they are inconsistent with this holding, are disapproved: Kaminski v. Workers’ Comp. Appeals Bd., supra,
Concurrence Opinion
I concur in the judgment.
In the past a number of courts, including our own, have elected to avoid the harsh and inequitable consequences of a literal application of Labor Code section 5814 (section 5814). The majority here, with little concern for these prior decisions, have decided that sound policy shall prevail over plain language no longer; regardless of common sense or fairness, the penalty for late payments of workers’ compensation benefits shall apply to the “full amount of the . . . award” without exception for timely preaward payments.
The majority’s devotion to text is difficult to fault. Yet candor compels that we acknowledge a departure from precedent when it occurs, and recognize that the laudable imperatives which informed such decisions as Gallamore v. Workers’ Comp. Appeals Bd. (1979)
Discussion
Section 5814 provides, in pertinent part, as follows: “When payment of compensation has been unreasonably delayed or refused, either prior to or subsequent to the issuance of an award, the full amount of the order, decision or award shall be increased by 10 percent. The question of delay and reasonableness of the cause therefor shall be determined by the appeals board in accordance with the facts.”
Section 5814 is thus comprised of two parts: one relating to the question whether payment of compensation has been unreasonably delayed, in which
As a result, this and other courts have consistently declined to adopt a literal construction of the statute. Although the text provides that the “full amount of the order, decision or award shall be increased by 10 percent,” we have nevertheless held that some benefits timely provided should be excluded from the penalty assessment. In Garcia v. Workmen’s Comp. Appeals Bd., supra,
Gallamore, supra,
The majority make much of our subsequent observation in Gallamore that, “if any part of a specific benefit has been delayed or withheld, the penalty is imposed against the entirety of that benefit.” (
Clearly the courts in Gallamore and Garcia elected to transcend the literal language of section 5814 in favor of “achieving a fair balance between the right of the employee to prompt payment of compensation benefits, and the avoidance of imposition upon the employer or carrier of harsh and unreasonable penalties.” (Gallamore, supra,
Two early decisions in this line are Langer v. Workmen’s Comp. App. Bd., supra,
This rule was subsequently adopted and applied in Ramsey v. Workmen’s Comp. App. Bd. (1969)
As explained in Vogh v. Workmen’s Comp. App. Bd., supra,
The rule urged herein is not only sound from a policy perspective, as noted above, but also strikes the “fair balance” mandated in Gallamore between the employee’s right to prompt payment and the employer’s interest in the “avoidance of. . . harsh and unreasonable penalties.” (
Nevertheless, as the majority correctly observe, when the language of a statute is clear and unambiguous its meaning should be strictly observed. Although we departed from this rule in Gallamore, supra,
