Section 408.33. Disputed claims; late payment penalty.

(1) On or before the fourteenth day after the employer has notice or knowledge of an alleged injury or death, a carrier and the self-insurers’ security fund shall notify the bureau, on form 107, if the right of the injured or dependent to compensation is disputed. If compensation thereafter is paid, report it on form 701. A copy of form 107, notice of dispute, shall be mailed or given to the injured employee.

(2)    The following subdivisions govern the administration and enforcement of the penalty provisions under section 801 of the act:

(a)    Under section 801(1) of the act, compensation shall be paid promptly and directly to the person entitled to compensation. Weekly benefits become due and payable on the fourteenth day after the employer has notice or knowledge of the disability or death. On that date, all compensation which has accrued shall be paid. If benefits are not paid within 30 days of becoming due and payable, then the carrier shall pay to the employee $50.00 per day for each day after 30 days that the benefits remain unpaid, not to exceed $1,500.00.

(b)   If a case is in litigation and the defendant agrees to pay benefits on a voluntary basis, then the magistrate shall specify the weekly compensation rate, the period of time for which accrued benefits have become  due,  and which medical bills shall be paid by the carrier as a result of the injury or disability. If the benefits agreed to are not paid within 30 days of the date the agreement is formalized by the magistrate, then the carrier shall pay to the employee $50.00 per day for each day after 30 days that the benefits remain unpaid, not to exceed $1,500.00.

(c)   Medical bills become due and payable on the day the carrier receives the bill. If there is a dispute resulting in a delay in paying the medical bills, then the carrier shall advise the employee and doctor of the reasons for the delay in writing. If there is no dispute and the bill remains unpaid after 30 days, then the carrier shall pay to the employee $50.00 for each day after 30 days that the bill remains unpaid, not to exceed

$1,500.00.

(d)         The  travel  allowance   for  medical  examination,    treatment,   or rehabilitation is provided in R 408.45. The employee shall be notified, in writing, of any dispute resulting in a delay in paying  travel  allowance payments. If the expenses are not paid within 30 days of the date of the carrier’s notification, and if the expenses are not disputed, then the carrier shall pay the employee $50.00 for each day after 30 days that the expenses remain unpaid, not to exceed $1,500.00.

(e)   Under section 801(4) of the act, an employer may be liable for all or a portion of the penalty provided in section 801(2) of the act. If there is a dispute between an employer and insurance carrier as to who is liable for the payment of the penalty, the carrier shall be liable for paying the penalties, but may be entitled to reimbursement from the employer.

(f)  Any employee who may be entitled to penalty payments under section 801 of the act and who has not received the payments may apply by notifying the bureau in writing. A copy of the request shall be forwarded to the carrier. In all cases, the bureau of workers’ disability compensation shall respond within a reasonable period of time and shall act, as it deems appropriate, to resolve any disputes involving the penalty provisions of section 801 of the act. If a dispute continues beyond a determination by the bureau or if the director believes there is a question of compliance with the act, then the dispute may be set for a hearing under R 408.35. A party to a dispute may request a formal hearing before a magistrate.

(g)   A carrier shall pay any penalty amounts due an injured employee as a result of the penalty provisions specified in section 801 of the act in a separate check. Penalty amounts are not a part of the basic benefits to which an employee is entitled for the purpose of loss or assessment.

(h)   Benefits, allowances, or bills are presumed paid within 30 days if a check is mailed within 27 days of becoming due and payable under these rules.

History: 1979 AC; 1980 AACS; 1998-2000 AACS.