What Is California Labor Code §3751: Doctor Billing and Insurance Costs?

If an employee has filed a claim form pursuant to Section 5401, a provider of medical services shall not, with actual knowledge that a claim is pending, collect money directly from the employee for services to cure or relieve the effects of the injury for which the claim form was filed, unless the medical provider has received written notice that liability for the injury has been rejected by the employer and the medical provider has provided a copy of this notice to the employee. Any medical provider who violates this subdivision shall be liable for three times the amount unlawfully collected, plus reasonable attorney's fees and costs.

What does Labor Code 3751 do?

It keeps the cost of a work injury off the worker in two ways: no paycheck deduction for insurance, and no direct bill while a claim is open.

Workers' compensation is supposed to cost the injured worker nothing out of pocket. California backs up that idea with two separate rules in this one statute. Subsection (a) stops an employer from charging any part of the insurance premium back to an employee's wages. Subsection (b) stops a treating doctor, hospital, or clinic from billing an injured worker directly once a claim form has been filed, as long as the provider knows about the claim and the employer has not rejected it in writing.

Neither rule depends on the size of the employer, the worker's wage, or how long the person has been on the job. Both apply to any California employee covered by workers' compensation.

Can my employer deduct the cost of workers' comp insurance from my paycheck?

No. Labor Code 3751(a) makes that a crime, no matter what the deduction is called on a pay stub.

No employer shall exact or receive from any employee any contribution, or make or take any deduction from the earnings of any employee, either directly or indirectly, to cover the whole or any part of the cost of compensation under this division. Violation of this subdivision is a misdemeanor.

Buying workers' compensation insurance, or qualifying to self-insure, is the employer's own duty under Labor Code 3700. This statute makes sure that duty cannot be passed back to the workforce through a payroll deduction, a so-called safety fee, or a line item on a check stub. If something like this shows up on your pay, ask about it in writing and keep a copy of the stub.

What happens if a medical bill still reaches me while my claim is open?

A provider that knows about your pending claim is not supposed to bill you for that injury, and one that does can owe three times what it collected.

The billing protection starts once you file the claim form described in Labor Code 5401, the form your employer must hand or mail you within one working day of learning about a work injury that needs more than first aid. From that point, a doctor, hospital, or other provider with actual knowledge of the pending claim should not collect money from you for treating the injury. The exception is narrow: your employer rejected the claim in writing, and the provider has a copy of that written rejection. Outside that exception, a provider that collects from you anyway is liable for three times the amount it took, plus your attorney's fees and costs, under the same subsection quoted above.

Does the protection change once a claim is accepted, denied, or still pending?

The protection is strongest while a claim is open, whether that means accepted or simply undecided. It stops once a written denial reaches the provider.

While your claim is accepted, or waiting on a decision, this rule should keep a bill from landing on your doorstep for that injury. The picture changes once your employer has rejected the claim in writing and the provider holds a copy of that notice. At that point the provider may be allowed to collect from you, and the real dispute usually shifts to whether the claim itself should have been denied in the first place. See what to do after a denied workers' comp claim if that is where things stand for you.

How is this different from the billing rules between my doctor and the insurer?

A different law controls how a provider bills the claims administrator. This statute is the one that keeps that process away from your own wallet.

Labor Code 4603.2 sets the paperwork and deadlines between your treating provider and the claims administrator, including a 90 day window for the provider to dispute a paid amount. None of that back and forth is supposed to turn into a bill addressed to you. The two statutes work as a pair. One keeps the provider and the claims administrator talking to each other on price. The other keeps that conversation from reaching your mailbox while the claim is open.

What should I do if a bill or collection notice still shows up?

Keep the notice, confirm your claim number with the provider's billing office, and send a copy to your claims administrator instead of paying it right away.

A bill does not automatically mean you owe the money, and it is not something to ignore either. Write down the date it arrived. Call the provider's billing office, give your claim number, and ask whether the office has a record of your open claim. Send a copy of the bill to your claims administrator so the file shows you reported it. If the provider says your claim was rejected in writing, ask for a copy of that rejection. That is the one situation where this statute stops protecting you, and it usually means the underlying claim decision needs its own review.

Getting help with a billing problem on your claim

A bill that should not have been sent is worth asking a lawyer about, especially if it keeps happening or a collection agency gets involved.

Yazdchi Law P.C. reviews billing and collection problems tied to open California workers' compensation claims. Call (661) 273-1780 or use the contact form for a free consultation. The firm serves injured workers across California from its office in Palmdale and reviews each matter individually before deciding whether to take it on.