If you think the health care system in California isn't broken, just ask Joey Palmer. A minor solo motorcycle accident wound up costing him $12,000 in medical bills at a San Francisco hospital... money he didn't have. His saga can be found in the piece by San Francisco Chronicle columnist David Lazarus by clicking here:
http://sfgate.com/cgi-bin/article.cgi?f ... =printable

Tomorrow (Wednesday, April 18), the California Senate Health Committee will hold hearings on Senate Bill SB 840, the so called "single payer" health bill sponsored by State Senator Sheila Kuehl (D-Santa Monica). The hearings will be televised at 1:30 over the internet on the California Channel, which can be accessed by clicking here:
http://www.calchannel.com/

The text and status of SB 840 can be tracked by clicking here:
http://info.sen.ca.gov/cgi-bin/postquer ... p;site=sen

Kuehl's bill is one of several principal proposals for California health care reform. Assembly Speaker Nunez has a plan, as does Senate Pro Tem Perata. And Governor Schwarzenegger has a proposal. The Governor's plan has generated much criticism, since it includes provisions for physicians and hospitals to pay fees (taxes?) on services. That plan would allow the state of California to track down and impose fines on individuals who fail to carry health insurance. For an LA Times analysis of this, see the following:
http://www.latimes.com/news/local/la-me ... california

As I have noted for several months, this is a debate of great interest to many of California's injured workers. Many injured workers lose their health coverage after being off work for an extended time due to injury. Few injured workers can afford to exercise the right to purchase group health coverage under their COBRA rights.

The Kuehl plan, SB 840, offers great promise for California. It deserves serious consideration.

Stay tuned.

Julius Young
www.boxerlaw.com

If you are trying to understand the current situation in California workers' comp... be you a politician, a journalist or an injured worker... I have an excellent idea for you... download the recent study of workers' comp released in March 2007 by the California Labor Federation.

You can download the study by clicking here:
http://www.calaborfed.org/pdfs/Legislat ... .27.07.pdf

The Labor Federation's study is "must reading." It is heartening to see the Labor Federation (and its legislative director Angie Wei) take such an active role in the Sacramento on behalf of the plight of injured workers.

Unfortunately, this was not always the case. When I first began in workers' comp several decades ago, there was a rocky relationship between labor and the advocates of injured workers. Few applicant attorneys maintained substantive relationships with labor leaders over the years. And, there were some bad feelings leading up to and after the passage of SB 899 in 2004. Many applicant attorneys felt that labor could have done more to soften the language in SB 899.

But labor now clearly recognizes that SB 899 has resulted in tremendous unfairness. And for now, it appears that all parties on the boat are rowing in synch.

Rowing in synch will be important over the next few years as labor and injured workers must deal with a popular governor whose signature issue has been workers' comp reform. Victories are likely to be incremental, as a result of negotiations with the governor. But labor
recognizes that the workers left behind are suffering. That's a big start.

Julius Young
www.boxerlaw.com

Will the California legislature address the sharp cuts in permanent disability awards that resulted from Schwarzenegger's workers' comp reform?

If you missed my earlier posts on this issue, check out the following:
http://www.workerscompzone.com/index.ph ... 4e069ef8f9

If there is a bill in 2007, AB 1212, authored by California Assembly Speaker Fabian Nunez (D-Los Angeles), may be the vehicle. You can see the current text of this bill by clicking the following:
http://www.leginfo.ca.gov/pub/07-08/bil ... m_v98.html

The date could change, but currently the Assembly Insurance Committee (chaired by San Jose Democrat Joe Coto) is scheduled to hold hearings on AB 1212 on April 25. I'll be covering that. AB 1212 would require the Schwarzenegger administration's Division of Workers' Compensation (DWC) to revise the permanent disability rating schedule by January 1, 2009.

The hearings should be interesting. But at first blush, the bill's 2009 target date to revise the schedule will please very few advocates of working people. Funny thing... the DWC has already announced that it will be finishing a phase of its study and may be recommending some changes soon. In 2007. On its face, the Nunez bill would appear to take pressure off the Schwarzenegger regulators rather than increase the pressure to revise the schedule. 2009 to amend the schedule?

The task? Setting a fair schedule to provide adequate compensation to workers with permanent impairment and long term wage loss. The context? Insurers over the past several years are paying out as benefits (including medical) less than 40% of premium dollars collected. See my earlier post entitled "Down 64%":
http://www.workerscompzone.com/index.ph ... 4e069ef8f9

Stay tuned.

Julius Young
www.boxerlaw.com

The California Assembly Insurance Committee voted today on Assembly Bill 338. Reversing one of the most harsh features of the 2003-2004 comp reforms, AB 338 would allow TD benefits of up to 156 weeks (instead of the current 104 week maximum). A worker could draw these weeks of TD over a five-year period.

According to the Assembly Daily File, the bill passed on a 6-3 committee vote. This, of course, does not mean that the bill will have smooth sailing from here on out. There are competing ideas for reform of the two-year TD cap, including Assembly Republican John Benoit's AB 1341. And many insurers are happy with the two-year TD cap.

Meanwhile, anecdotes roll in from workers who lose their temporary disability benefits after being disabled for two years. Some of these workers received an additional year of benefits from California EDD's State Disability Insurance program (SDI). The two-year TD cap went into effect in the Spring of 2004. Thus, a number of workers will soon run out of benefits (two years of TD plus one of SDI), only to find that they have no economic safety net.

To see the insurance industry analysis of savings generated by TD limits, click here for the California Workers Compensation Institute's bulletin:
http://www.workcompcentral.com/pdf/2007 ... Dstudy.pdf

Injured workers should applaud Joe Coto for carrying AB 338. After all, why should the family of a worker who is forced to undergo multiple surgeries be forced into poverty due to an arbitrary two-year TD limit?
Keep the big picture in mind. Insurers in California are paying out as benefits less than 40% of premiums collected. For a perspective on this, see my post "The Year of The Pig":
http://www.workerscompzone.com/index.ph ... 4e069ef8f9

Stay tuned.

Julius Young
www.boxerlaw.com

The client appears, x-rays in hand, for a QME exam that will determine numerous issues in her case. Puzzled, she notes that the location of evaluation is actually at a ... tanning salon. It turns out that this is one of many "offices" the QME doctor has... er, rents. Talk about cheesy!

Such is the scam de jour in California workers' comp. A number of medical groups have set up "offices" in pretty much every nook and cranny of the state. Why? This means that they will pop up on many QME panel lists, getting much more business. Many injured workers will pick a panel QME doctor based on how close the doctor's office is to their house (a dumb reason).

The traveling doc may fly in, run a horde of workers through cursory evaluations, and then move on to the next whistle-stop on his QME tour. Another variation on the same theme: some workers receive a panel list of three out-of-town doctors, all evaluating at the same location. By flooding the state QME list with doctors available for particular locations, the doctor's group builds business.

These practices are currently under review as part of a Schwarzenegger administration study of proposed QME regulations. The California Division of Workers Compensation (DWC) has set a Friday April 13 deadline for public comments on proposed QME regulations. To see the DWC website and the discussion forum on regulation of QMEs, click the following:
http://www.dir.ca.gov/dwc/DWCWCABForum/ ... ;RegID=208

Public comments seem to be focused on the need to put some limits on the number of locations any particular QME can list. Respondents are arguing means to address the problem. Is it better to require doctors with multiple offices to limit the number of offices within a certain radius? Or would be better to limit the number of QME locations any doctor could claim? The latter approach seems to make more sense.

A five office limit, for example, might accommodate a doctor who traveled to multiple cities in the Central Valley from Bakersfield to Stockton to do QMEs, but would discourage the LA doctor flying into Oakland to do evals in every East Bay locale from Vallejo to San Jose in addition to his multiple LA area "offices."

The integrity of the QME system is at stake, particularly for unrepresented injured workers who have no knowledge of the QME doctors who they choose.

If you are an injured worker, check out my earlier post "Dumb Reasons to Pick a QME":
http://workerscompzone.com/index.php?d= ... 2f76f29cc5

Julius Young
www.boxerlaw.com