A twenty year old employee is injured at work but does not report it as required by work procedures. The TPA is told to pay benefits. What should the TPA do?

• A. Deny benefits
• B. Report to the WCAB
• C. Report to the Administrative Director
• D. Pay benefits in accordance with the Labor Code

Answer: (D)

The key idea is that workers’ compensation benefits in California are governed by the Labor Code, and once an injury is compensable, benefits must be paid in accordance with those statutory provisions, even if the employee did not follow internal reporting procedures. The TPA should proceed to pay the benefits owed under the code because denying or delaying benefits would deprive the employee of the statutory entitlement.

Late or missed reporting can trigger separate penalties or enforcement actions under the Labor Code, but that outcome is handled separately from the ongoing obligation to provide benefits to which the employee is entitled. Reporting to a regulatory body like the WCAB or the Administrative Director isn’t the correct course of action for initiating or continuing benefit payments; those bodies become involved in disputes, orders, or penalties, not the routine payment of benefits. The correct approach is to pay benefits in accordance with the Labor Code while compliance issues related to reporting are handled through the proper channels.