After a claim is filed, what is the maximum time the insurer has to either accept or deny the claim before the law presumes the injury is compensable?
Explanation
Labor Code §5402(b) creates a 90-day presumption: if the claim is not denied within 90 days after the claim form is filed with the employer, the injury is presumed compensable, and that presumption is rebuttable only by evidence that could not have been discovered with reasonable diligence within the 90 days. (Initial medical treatment up to $10,000 must also be authorized during the investigation.)
Law Reference: Cal. Labor Code §5402This topic, taught in full in the California Property & Casualty Broker-Agent guide. California Property & Casualty Broker-Agent Study Guide — 2026 Edition — PDF + EPUB, $24.99 · 14-day refund →
Practice all 531 questions free — no signup required.
Own the complete California Property & Casualty Broker-Agent guide — PDF + EPUB, $24.99 →
Related questions on this topic
- An injured employee unable to work while recovering from a workplace injury is entitled to temporary disability (TD) benefits. How is the TD rate generally calculated?
- Permanent disability (PD) benefits in California are paid based on what factor?
- Under California law, how soon must an employer provide a DWC-1 claim form to an employee after receiving notice of a workplace injury?
- Under California's ABC test (Labor Code §2775), a worker is classified as an employee — and therefore must be covered by workers' compensation — unless the hiring entity proves all three of which conditions?
- A California corporation has one shareholder who is also its sole officer. Which statement about that owner's workers' compensation coverage is correct?
- A licensed general contractor hires an unlicensed framer who has no workers' compensation insurance, and the framer is injured on the job. Who is most likely responsible for providing workers' compensation benefits?
Last reviewed: · editorial process