Tuesday, March 27, 2012, 10:16 PM - Political developmentsOn Wednesday March 28 a hearing on workers' comp is scheduled in Sacramento at the Capitol.
The hearing, held by the Senate Industrial Relations Committee and the Assembly Insurance Committee, will focus on the impact of SB 899.
The hearing is slated to start at 9:30 Wednesday.
It will be viewable online in realtime via the following link (choose Senate Committee Room 2040):
http://senate.ca.gov/listentorooms?utm_ ... dium=email
If you can't catch the realtime broadcast you will also probably be able to find it on the California Channel website .Here is that link:
With rumors about further reform efforts swirling around the system, it will be interesting to see some researchers and commentators reflect on where we are now and what solutions might be advanced.
Friday, March 23, 2012, 09:14 AM - Political developmentsIn the 1980s and 1990s workers' comp legislative changes sometimes occurred as stakeholder groups ganged up on other stakeholder groups to push bills through.
The interests of employers and insurers sometimes collided, and deals were cut with labor and applicant attorneys.
I'll never forget a lunch several years ago with a leading employer-side figure in the comp industry. He told me that efforts were underway to keep employers and insurers together, and that the divisions that emerged in earlier decades were not likely to be repeated.
It's complicated, though.
In a down economy as premiums have dropped and as investment income opportunities have become somewhat less lucrative, insurers need more revenue.
On the other hand, business looks at increases in workers' comp costs as a constant threat. Whether we are talking small business or global enterprises, workers comp may be a small part of overall costs, but cost margins are critical for many employers.
And for cities and counties and school districts, increased workers comp costs can determine whether clinics and schools remain open and whether public safety positions can be funded. California has cities, including Stockton, teetering on the edge of bankruptcy. PERS and municipal pension funding remains a problem.
All of this becomes more critical as the drumbeat of a new round of comprehensive comp reforms is faintly heard in the background.
And that's why an e-blast yesterday from the Workers' Comp Executive caught my attention. The piece by the Executive notes that:
"The California Workers' Compensation Institute at its 48th annual meeting votes in a new slate of board members for 2012-2013. In addition to electing 15 insurer members, CWCI for the first time ever has elected two self-insureds-one private and one public-to serve as board members. CWCI President Michael Nolan says the idea originated with CWCI's Executive Committee and Board of Directors both of whom want a stronger relationship and greater input from the self-insured community."
According to the Workers' Comp Executive the two non-insurer associate members are Sean McNally of Grimmway Farms and Martin Brady of Schools Insurance Authority. McNally is of course a member of CHWSC and was involved in the talks over a grand-bargain reform that surfaced several years ago but stalled.
It's another example of how employers and insurers are reaching out to coordinate their interests in a way that wasn't done in prior years.
I'm sure these folks are crunching their numbers.
Doctors and applicant attorneys had better get busy crunching theirs. Benefits need to go up. The question is, who will pay?
Tuesday, March 20, 2012, 10:08 PM - Political developmentsVarious workers' comp bills have ben introduced in the legislature. I'll be covering them soon, and following them as the legislative season progresses.
But today is the time to shine a spotlight on a deserving bill that might just help unemployed injured workers and victims of the economic downturn alike.
It's AB 1450.
Sponsored by Assemblyman Michaell Allen (D-Santa Rosa), the bill would prohibit discrimination against the unemployed.
The bill seeks to address the sort of discrimination which arises when employers discourage the unemployed from applying for jobs. There have been a number of reports of hiring companies requiring that applicants currently have a job.
These sorts of policies obviously add to the burden of seeking employment and disadvantage those who stopped working because of an injury, a pregnancy, a family emergency, or who were laid off due to the down economy.
Employment status would be added to other criteria (such as race, gender, religion etc) which are protected criteria in hiring decisions.
A number of other states have adopted such laws, including New Jersey.
Business groups will likely oppose the legislation, and it's not currently clear whether the Brown Administration will support the concept.
Writing in the Riverside Press-Enterprise, staff writer Jack Katzanek notes that:
"A paper published in July 2011 by the National Employment Law Project, an advocacy group that supports employment rights for lower-wage workers, researched four of the most common-used job-search web sites and found 150 listings that expressly ruled out applicants based on their current employment status. Most used phrases such as ďmust be currently employed.Ē Some said they or the companies they were headhunting for would accept someone who was recently employed.Most of the listings NELP cited were employment agencies but also included companies such as Allstate Insurance, investment and asset management company Greenstreet Real Estate Partners and Johns Hopkins University. CareerBuilder.com and Indeed.com were the locations of three-quarters of these listings, NELP found."
Here is the legislative counsel's digest of the current version of the bill (note that amendments are likely):
"AB 1450, as amended, Allen. Employment: discrimination: status as unemployed.
Existing law contains provisions that define unlawful discrimination and employment practices by employers and employment agencies.
This bill would make it unlawful, unless based on a bona fide occupational qualification or any other provision of law, for an employer to knowingly or intentionally refuse to consider for employment or refuse to offer employment to an individual because of the individualís status as unemployed, publish, an employment agency, or a person who operates an Internet Web site for posting jobs in this state to take specified employment actions relating to employment status, as defined, including, among other things, refusing to hire a person because of that personís employment status and publishing an advertisement orannouncement for any job that includes provisions pertaining to an individualís current employment or employment status as unemployed, as specified, or direct or request that an employment agency take an individualís status as unemployed into account in screening or referring applicants for employment, as specified.
The bill would also make it unlawful, unless based on a bona fide occupational qualification or any other provision of law, for an employment agency to knowingly or intentionally refuse to consider or refer an individual for employment because of the individualís status as unemployed, limit, segregate, or classify individuals in any manner that may limit their access to information about jobs or referral for consideration of jobs because of their status as unemployed, or publish an advertisement or announcement, as described above with respect to employers.
This bill would subject an employer or, an employment agency, or a person who operates an Internet Web Site for posting jobs in this state who violates the above provisions to civil penalties that increase as the number of violations increase. The bill would state that it shall not be construed to create a private cause of action, as specified.
The State Contract Act governs contracting between state agencies and private contractors, and sets forth requirements for the procurement of materials, supplies, equipment, and services by state agencies.
This bill would provide that failure to comply with the requirements of the bill would constitute a breach of the contract and may be grounds for canceling, terminating, or suspending the contract, as specified, and debarring the contractor from eligibility for an award of future state agency contracts for a period not to exceed 3 years, as specified.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no."
Unless there is a change, there will be a hearing on the bill March 28 at the Assembly Labor and Employment Committee at the Capitol.
Friday, March 16, 2012, 09:43 PM - Medical treatment under WCThis was a week where I personally learned one of the obstacles injured workers face.
I was lucky. The malady was not industrial. Between my persuasive powers and the fact I knew the doctor, a thirty day wait for an appointment was reduced to one-half day.
There was no UR hoop to navigate. My bleeding and swollen finger would be addressed.
What did I learn in the process that relates to workers' comp?
That even a minor injury can sometimes knock a worker-off task.
In this instance it was minor knuckle surgery. Surgery that was in and out at an ambulatory surgery center.
Surgery at 8 am, under a light general anesthetic, and back to work by lunchtime. No post surgical pain meds given, and none requested.
But it was interesting to experience the effect of having even one digit immobilized and anesthetized.
For several days it's been hard to type. Keyboard usage is fundamental to modern lawyering. Answering e mails. Sending instant messaging to staff.
Holding a briefcase and an umbrella.
So it's been hunt and peck at a keyboard. Productivity slowed.
I also got a glimpse of the disruptive effect the medical system can have on an individual. Schedules are disrupted. Other tasks-or pleasures-get canceled or delayed.
Suddenly there are consultations. Pre-op appointments. Trips to the lab for pre-op blood panels. Trips to get an EKG before the doctor will do a simple surgery under anesthesia. Surgery itself.
And the family is affected. The spouse misses work to provide a ride home.
And then post op appointments.
For a number of workers this becomes the steady routine, sometimes for years on end.
Frankly, it's exhausting. It's easy to see how ambition gets sapped, and attitudes can deteriorate. And it's no surprise that employers would sometimes get cranky if a worker's productivity dropped off as a result.
Then there's the humbling aspect of it all.
You may feel healthy overall striding into the surgery center in blue jeans and boots.
But suddenly you're wearing a gown that barely ties in the back. You're wearing little paper booties with faint rubber no-slip strips. And you're told to put on a blue hair net. An iv is in your arm.
Told to avoid drinking any liquids, you are in caffeine withdrawal as you await the event.
No wonder you feel vulnerable.
My point is that even where one is grateful for having excellent doctors and the most efficient care, entanglement with the medical system is a psychic drain.
Not enough attention is paid to this in our comp system. With lives disrupted, work habits and routines get disrupted. It can all run downhill.
Thursday, March 15, 2012, 10:29 PM - Medical treatment under WCOne of the emerging successes of the Division of Workers' Compensation under Jerry Brown is that the Medical Unit appears to be whittling down the backlog of requests for QME panels for both represented and unrepresented workers.
DWC Administrative Director was recently quoted in an article by Greg Jones of workcompcentral.com on the topic of medical panels. According to Jones, "When she started as administrative director in July, the unit was almost 10 months behind in issuing panels. Moran said Monday that the unit is now working on requests dating back to December 27, 2011." This progress was also hailed by Jim Fisher of the DWC Medical Unit in recent remarks at the Los Angeles and Oakland DWC conference.
But will this progress be crushed by a potential tsunami that lurks on the horizon?
Huh, you say. What?
The tsunami could be triggered if the WCAB clarifies the law on whether represented workers must appeal utilization review treatment denials by going through the QME process.
Although some of my readers may have strong opinions about what procedures the law does or does not require, the fact is that there many judges and attorneys who believe that the QME process is permitted but not mandatory where a represented worker seeks to appeal a UR non-certification of a treatment request.
Since the 2003/2004 reforms, many a treatment dispute has been resolved by settlement or trial where the attorney challenged the utilization review physician denial by filing a declaration of readiness, relying on a report by the treating physician.
In some of those instances there were issues regarding whether the defendant had met statutory requirements for a valid utilization review:
-was the UR physician competent to evaluate the treatment request
(see Labor Code 4610(e))?
-was the treatment request within the scope of the physician's practice (see labor Code 4610(e)?
-was the UR review timely (see 4610(g)(1))?
-would delay be detrimental to the employee's health, triggering stricter timeframes (see 4610(g)(2)?
TO BE CONTINUED IN PART 2.........