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3208.3.
(a) A psychiatric injury shall be compensable if it is a mental disorder
which causes disability or need for medical treatment, and it is diagnosed
pursuant to procedures promulgated under paragraph (4) of subdivision
(j) of Section 139.2 or, until these procedures are promulgated, it is
diagnosed using the terminology and criteria of the American Psychiatric
Association's Diagnostic and Statistical Manual of Mental Disorders, Third
Edition-Revised, or the terminology and diagnostic criteria of other psychiatric
diagnostic manuals generally approved and accepted nationally by practitioners
in the field of psychiatric medicine.
(b)
(1) In order to establish
that a psychiatric injury is compensable, an employee shall demonstrate
by a preponderance of the evidence that actual events of employment were
predominant as to all causes combined of the psychiatric injury.
(2) Notwithstanding
paragraph (1), in the case of employees whose injuries resulted from being
a victim of a violent act or from direct exposure to a significant violent
act, the employee shall be required to demonstrate by a preponderance
of the evidence that actual events of employment were a substantial cause
of the injury.
(3) For the purposes
of this section, "substantial cause" means at least 35 to 40 percent of
the causation from all sources combined.
(c) It is the intent
of the Legislature in enacting this section to establish a new and higher
threshold of compensability for psychiatric injury under this division.
(d) Notwithstanding
any other provision of this division, no compensation shall be paid pursuant
to this division for a psychiatric injury related to a claim against an
employer unless the employee has been employed by that employer for at
least six months.
The six months of
employment need not be continuous. This subdivision shall not apply if
the psychiatric injury is caused by a sudden and extraordinary employment
condition. Nothing in this subdivision shall be construed to authorize
an employee, or his or her dependents, to bring an action at law or equity
for damages against the employer for a psychiatric injury, where those
rights would not exist pursuant to the exclusive remedy doctrine set forth
in Section 3602 in the absence of the amendment of this section by the
act adding this subdivision.
(e) Where the claim
for compensation is filed after notice of termination of employment or
layoff, including voluntary layoff, and the claim is for an injury occurring
prior to the time of notice of termination or layoff, no compensation
shall be paid unless the employee demonstrates by a preponderance of the
evidence that actual events of employment were predominant as to all causes
combined of the psychiatric injury and one or more of the following conditions
exist:
(1) Sudden and extraordinary
events of employment were the cause of the injury.
(2) The employer
has notice of the psychiatric injury under Chapter 2 (commencing with
Section 5400) prior to the notice of termination or layoff.
(3) The employee's
medical records existing prior to notice of termination or layoff contain
evidence of treatment of the psychiatric injury.
(4) Upon a finding
of sexual or racial harassment by any trier of fact, whether contractual,
administrative, regulatory, or judicial.
(5) Evidence that
the date of injury, as specified in Section 5411 or 5412, is subsequent
to the date of the notice of termination or layoff, but prior to the effective
date of the termination or layoff.
(f) For purposes
of this section, an employee provided notice pursuant to Sections 44948.5,
44949, 44951, 44955, 44955.6, 72411, 87740, and 87743 of the Education
Code shall be considered to have been provided a notice of termination
or layoff only upon a district' s final decision not to reemploy that
person.
(g) A notice of termination
or layoff that is not followed within 60 days by that termination or layoff
shall not be subject to the provisions of this subdivision, and this subdivision
shall not apply until receipt of a later notice of termination or layoff.
The issuance of frequent notices of termination or layoff to an employee
shall be considered a bad faith personnel action and shall make this subdivision
inapplicable to the employee.
(h) No compensation
under this division shall be paid by an employer for a psychiatric injury
if the injury was substantially caused by a lawful, nondiscriminatory,
good faith personnel action. The burden of proof shall rest with the party
asserting the issue.
(i) When a psychiatric
injury claim is filed against an employer, and an application for adjudication
of claim is filed by an employer or employee, the division shall provide
the employer with information concerning psychiatric injury prevention
programs.
(j) An employee who
is an inmate, as defined in subdivision (e) of Section 3351, or his or
her family on behalf of an inmate, shall not be entitled to compensation
for a psychiatric injury except as provided in subdivision (d) of Section
3370.
3600.
(a) Liability for
the compensation provided by this division, in lieu of any other liability
whatsoever to any person except as otherwise specifically provided in
Sections 3602, 3706, and 4558, shall, without regard to negligence, exist
against an employer for any injury sustained by his or her employees arising
out of and in the course of the employment and for the death of any employee
if the injury proximately causes death, in those cases where the following
conditions of compensation concur:
(1) Where, at the
time of the injury, both the employer and the employee are subject to
the compensation provisions of this division.
(2) Where, at the
time of the injury, the employee is performing service growing out of
and incidental to his or her employment and is acting within the course
of his or her employment.
(3) Where the injury
is proximately caused by the employment, either with or without negligence.
(4) Where the injury
is not caused by the intoxication, by alcohol or the unlawful use of a
controlled substance, of the injured employee. As used in this paragraph,
"controlled substance" shall have the same meaning as prescribed in Section
11007 of the Health and Safety Code.
(5) Where the injury
is not intentionally self-inflicted.
(6) Where the employee
has not willfully and deliberately caused his or her own death.
(7) Where the injury
does not arise out of an altercation in which the injured employee is
the initial physical aggressor.
(8) Where the injury
is not caused by the commission of a felony, or a crime which is punishable
as specified in subdivision (b) of Section 17 of the Penal Code, by the
injured employee, for which he or she has been convicted.
(9) Where the injury
does not arise out of voluntary participation in any off-duty recreational,
social, or athletic activity not constituting part of the employee's work-related
duties, except where these activities are a reasonable expectancy of,
or are expressly or impliedly required by, the employment. The administrative
director shall promulgate reasonable rules and regulations requiring employers
to post and keep posted in a conspicuous place or places a notice advising
employees of the provisions of this subdivision. Failure of the employer
to post the notice shall not constitute an expression of intent to waive
the provisions of this subdivision.
(10) Except for psychiatric
injuries governed by subdivision (e) of Section 3208.3, where the claim
for compensation is filed after notice of termination or layoff, including
voluntary layoff, and the claim is for an injury occurring prior to the
time of notice of termination or layoff, no compensation shall be paid
unless the employee demonstrates by a preponderance of the evidence that
one or more of the following conditions apply:
(A) The employer
has notice of the injury, as provided under Chapter 2 (commencing with
Section 5400), prior to the notice of termination or layoff.
(B) The employee's
medical records, existing prior to the notice of termination or layoff,
contain evidence of the injury.
(C) The date of injury,
as specified in Section 5411, is subsequent to the date of the notice
of termination or layoff, but prior to the effective date of the termination
or layoff.
(D) The date of injury,
as specified in Section 5412, is subsequent to the date of the notice
of termination or layoff. For purposes of this paragraph, an employee
provided notice pursuant to Sections 44948.5, 44949, 44951, 44955, 44955.6,
72411, 87740, and 87743 of the Education Code shall be considered to have
been provided a notice of termination or layoff only upon a district'
s final decision not to reemploy that person. A notice of termination
or layoff that is not followed within 60 days by that termination or layoff
shall not be subject to the provisions of this paragraph, and this paragraph
shall not apply until receipt of a later notice of termination or layoff.
The issuance of frequent notices of termination or layoff to an employee
shall be considered a bad faith personnel action and shall make this paragraph
inapplicable to the employee.
(b) Where an employee,
or his or her dependents, receives the compensation provided by this division
and secures a judgment for, or settlement of, civil damages pursuant to
those specific exemptions to the employee's exclusive remedy set forth
in subdivision (b) of Section 3602 and Section 4558, the compensation
paid under this division shall be credited against the judgment or settlement,
and the employer shall be relieved from the obligation to pay further
compensation to, or on behalf of, the employee or his or her dependents
up to the net amount of the judgment or settlement received by the employee
or his or her heirs, or that portion of the judgment as has been satisfied.
5500.5. (a)
Except as otherwise provided in Section 5500.6, liability for occupational
disease or cumulative injury claims filed or asserted on or after January
1, 1978, shall be limited to those employers who employed the employee
during a period of four years immediately preceding either the date of
injury, as determined pursuant to Section 5412, or the last date on which
the employee was employed in an occupation exposing him or her to the
hazards of the occupational disease or cumulative injury, whichever occurs
first. Commencing January 1, 1979, and thereafter on the first day of
January for each of the next two years, the liability period for occupational
disease or cumulative injury shall be decreased by one year so that liability
is limited in the following manner:
For claims filed
or asserted on or after: The period shall be:
January 1, 1979 .....................
three years
January 1, 1980 .....................
two years
January 1, 1981 and
thereafter ...... one year
In the event that
none of the employers during the above referenced periods of occupational
disease or cumulative injury are insured for workers' compensation coverage
or an approved alternative thereof, liability shall be imposed upon the
last year of employment exposing the employee to the hazards of the occupational
disease or cumulative injury for which an employer is insured for workers'
compensation coverage or an approved alternative thereof. Any employer
held liable for workers' compensation benefits as a result of another
employer's failure to secure the payment of compensation as required by
this division shall be entitled to reimbursement from the employers who
were unlawfully uninsured during the last year of the employee's employment,
and shall be subrogated to the rights granted to the employee against
the unlawfully uninsured employers under the provisions of Article 1 (commencing
with Section 3700) of Chapter 4 of Part 1 of Division 4. If, based upon
all the evidence presented, the appeals board or workers' compensation
judge finds the existence of cumulative injury or occupational disease,
liability for the cumulative injury or occupational disease shall not
be apportioned to prior or subsequent years; however, in determining the
liability, evidence of disability due to specific injury, disability due
to nonindustrial causes, or disability previously compensated for by way
of a findings and award or order approving compromise and release, or
a voluntary payment of disability, may be admissible for purposes of apportionment.
(b) Where a claim
for compensation benefits is made on account of an occupational disease
or cumulative injury which may have arisen out of more than one employment,
the application shall state the names and addresses of all employers liable
under subdivision (a), the places of employment, and the approximate periods
of employment where the employee was exposed to the hazards of the occupational
disease or cumulative injury. If the application is not so prepared or
omits necessary and proper employers, any interested party, at or prior
to the first hearing, may request the appeals board to join as defendant
any necessary or proper party. If the request is made prior to the first
hearing on the application, the appeals board shall forthwith join the
employer as a party defendant and cause a copy of the application together
with a notice of the time and place of hearing to be served upon the omitted
employer; provided, the notice can be given within the time specified
in this division. If the notice cannot be timely given or if the motion
for joinder is made at the time of the first hearing, then the appeals
board or the workers' compensation judge before whom the hearing is held,
if it is found that the omitted employer named is a necessary or proper
party, may order a joinder of the party and continue the hearing so that
proper notice may be given to the party or parties so joined. Only one
continuance shall be allowed for the purpose of joining additional parties.
Subsequent to the first hearing the appeals board shall join as a party
defendant any additional employer when it appears that the employer is
a proper party, but the liability of the employer shall not be determined
until supplemental proceedings are instituted.
(c) In any case involving
a claim of occupational disease or cumulative injury occurring as a result
of more than one employment within the appropriate time period set forth
in subdivision (a), the employee making the claim, or his or her dependents,
may elect to proceed against any one or more of the employers. Where such
an election is made, the employee must successfully prove his or her claim
against any one of the employers named, and any award which the appeals
board shall issue awarding compensation benefits shall be a joint and
several award as against any two or more employers who may be held liable
for compensation benefits. If, during the pendency of any claim wherein
the employee or his or her dependents has made an election to proceed
against one or more employers, it should appear that there is another
proper party not yet joined, the additional party shall be joined as a
defendant by the appeals board on the motion of any party in interest,
but the liability of the employer shall not be determined until supplemental
proceedings are instituted. Any employer joined as a defendant subsequent
to the first hearing or subsequent to the election provided herein shall
not be entitled to participate in any of the proceedings prior to the
appeal board's final decision, nor to any continuance or further proceedings,
but may be permitted to ascertain from the employee or his or her dependents
such information as will enable the employer to determine the time, place,
and duration of the alleged employment.
On supplemental proceedings,
however, the right of the employer to full and complete examination or
cross-examination shall not be restricted.
(d) (1) In the event
a self-insured employer which owns and operates a work location in the
State of California, sells or has sold the ownership and operation of
the work location pursuant to a sale of a business or all or part of the
assets of a business to another self-insured person or entity after January
1, 1974, but before January 1, 1978, and all the requirements of subparagraphs
(A) to (D), inclusive, exist, then the liability of the employer-seller
and employer-buyer, respectively, for cumulative injuries suffered by
employees employed at the work location immediately before the sale shall,
until January 1, 1986, be governed by the provisions of this section which
were in effect on the date of that sale.
(A) The sale constitutes
a material change in ownership of such work location.
(B) The person or
entity making the purchase continues the operation of the work location.
(C) The person or
entity becomes the employer of substantially all of the employees of the
employer-seller.
(D) The agreement
of sale makes no special provision for the allocation of liabilities for
workers' compensation between the buyer and the seller.
(2) For purposes
of this subdivision:
(A) "Work location"
shall mean any fixed place of business, office, or plant where employees
regularly work in the trade or business of the employer.
(B) A "material change
in ownership" shall mean a change in ownership whereby the employer-seller
does not retain, directly or indirectly, through one or more corporate
entities, associations, trusts, partnerships, joint ventures, or family
members, a controlling interest in the work location.
(3) This subdivision
shall have no force or effect on or after January 1, 1986, unless otherwise
extended by the Legislature prior to that date, and it shall not have
any force or effect as respects an employee who, subsequent to the sale
described in paragraph (1) and prior to the date of his or her application
for compensation benefits has been filed, is transferred to a different
work location by the employer-buyer.
(4) If any provision
of this subdivision or the application thereof to any person or circumstances
is held invalid, that invalidity shall not affect other provisions or
applications of this subdivision which can be given effect without the
invalid provision or application, and to this end the provisions of this
subdivision are severable.
(e) At any time within
one year after the appeals board has made an award for compensation benefits
in connection with an occupational disease or cumulative injury, any employer
held liable under the award may institute proceedings before the appeals
board for the purpose of determining an apportionment of liability or
right of contribution. The proceeding shall not diminish, restrict, or
alter in any way the recovery previously allowed the employee or his or
her dependents, but shall be limited to a determination of the respective
contribution rights, interest or liabilities of all the employers joined
in the proceeding, either initially or supplementally; provided, however,
if the appeals board finds on supplemental proceedings for the purpose
of determining an apportionment of liability or of a right of contribution
that an employer previously held liable in fact has no liability, it may
dismiss the employer and amend its original award in such manner as may
be required.
(f) If any proceeding
before the appeals board for the purpose of determining an apportionment
of liability or of a right of contribution where any employee incurred
a disability or death resulting from silicosis in underground metal mining
operations, the determination of the respective rights and interests of
all of the employers joined in the proceedings either initially or supplementally
shall be as follows:
(1) All employers
whose underground metal mining operations resulted in a silicotic exposure
during the period of the employee's employment in those operations shall
be jointly and severally liable for the payment of compensation and of
medical, surgical, legal and hospital expense which may be awarded to
the employee or his or her estate or dependents as the result of disability
or death resulting from or aggravated by the exposure.
(2) In making its
determination in the supplemental proceeding for the purpose of determining
an apportionment of liability or of a right of contribution of percentage
liabilities of the various employers engaged in underground metal mining
operations the appeals board shall consider as a rebuttal presumption
that employment in underground work in any mine for a continuous period
of more than three calendar months will result in a silicotic exposure
for the employee so employed during the period of employment if the underground
metal mine was driven or sunk in rock having a composition which will
result in dissemination of silica or silicotic dust particles when drilled,
blasted, or transported.
(g) Any employer
shall be entitled to rebut the presumption by showing to the satisfaction
of the appeals board, or the workers' compensation judge, that the mining
methods used by the employer in the employee's place of employment did
not result during his or her employment in the creation of silica dust
in sufficient amount or concentration to constitute a silicotic hazard.
Dust counts, competently made, at intervals and in locations as meet the
requirements of the Division of Occupational Safety and Health for safe
working conditions may be received as evidence of the amount and concentration
of silica dust in the workings where the counts have been made at the
time when they were made. The appeals board may from time to time, as
its experience may indicate proper, promulgate orders as to the frequency
with which dust counts shall be taken in different types of workings in
order to justify their acceptance as evidence of the existence or nonexistence
of a silicotic hazard in the property where they have been taken.
(h) The amendments
to this section adopted at the 1959 Regular Session of the Legislature
shall operate retroactively, and shall apply retrospectively to any cases
pending before the appeals board or courts. From and after the date this
section becomes effective no payment shall be made out of the fund used
for payment of the additional compensation provided for in Section 4751,
or out of any other state funds, in satisfaction of any liability heretofore
incurred or hereafter incurred, except awards which have become final
without regard to the continuing jurisdiction of the appeals board on
that effective date, and the state and its funds shall be without liability
therefor. This subdivision shall not in any way effect a reduction in
any benefit conferred or which may be conferred upon any injured employee
or his dependents.
(i) The amendments
to this section adopted at the 1977 Regular Session of the Legislature
shall apply to any claims for benefits under this division which are filed
or asserted on or after January 1, 1978, unless otherwise specified in
this section.
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