Tuesday, April 24, 2007, 10:36 PM - Understanding the CA WC systemIt happens two or three times a month. I go to my mail slot at Boxer & Gerson. Buried along with the incoming mail and subpoenaed medical records is a VHS tape or a DVD.
And will I soon be getting just a notice of a clickable link to see my client on video on You Tube? Here in Web 2.0, we are a long way past Betamax.
In the brave new world of surveillance, there are cameras everywhere. Today's cameraphones, mini videocams and hidden microphones make it much easier for investigators.
Investigations are big business in California workers' comp. Yet, in over 20 years of handling workers' comp cases, I have had only one client indicted for workers' comp fraud. And I have had very few cases where
my client's testimony was rejected by a judge (or agreed medical examiner) due to the content of "films" (er... videos).
Perhaps that's due in part to client preparation. I try to remind my clients: don't lie and don't exaggerate. If you are going back to work, announce it. Be careful with the words you use in deposition and with doctors. Never means never, ever, ever. Sometimes is not never. Occasionally is not never.
Assume that you may be watched or followed. Don't apologize for living your life, but recognize that when you make a claim your privacy is at risk. Don't be arrogant. Assume that the facts will come out. Your home may be your castle, but areas viewable from public spaces are fair game.
Statements you give to investigators, claims examiners, lawyers, doctors and other people may be used against you. Histories you give to doctors will be read by other doctors.
I tell my clients: don't let yourself be a film star. It's not a workers' comp fantasy you want to fulfill. And I'd just as soon munch on popcorn with my friends.
Monday, April 23, 2007, 10:24 PM - Political developmentsIt's a week of hearings and studies:
The Assembly Insurance Committee holds hearings at 9 am in Sacramento this Wednesday on various workers' comp issues:
The Commission on Health Safety and Workers' Compensation (CHSWC) meets in Oakland on Friday at 9. Among other issues, CHSWC will be hearing reports on apportionment in workers' comp and employer premium fraud. The agenda is noted here:
http://www.dir.ca.gov/CHSWC/Meetings/20 ... 72007.html
Meanwhile, the DWC continues work on its study of long-term wage losses. And its QME regs are in the early draft stage. Doctor groups such as CSIMS are weighing in on regs that would determine how many offices a QME can have and how far apart the offices need to be:
A lot happening. Or maybe very little.
And applicant attorneys and insurers continue to wait for the Supreme Court decision in the Welcher, Brodie and Dykes cases, interpreting apportionment under SB 899, Schwarzenegger's comp reform. That decision may set the tone for judicial interpretation of scores of cases.
Monday, April 23, 2007, 09:08 AM - Political developmentsAs I continue to note, the debate in Sacramento over health care reform is critical to many injured workers since so many of them lose their group health coverage.
Last week, the Senate Health Committee voted favorably on the single payer plan sponsored by State Senator Sheila Kuehl. The single payer concept is still alive for now. My blog post last week, "The $12,000 Broken Rib," covers the single-payer issue.
But most Capitol observers don't believe it has enough political traction to survive as the legislature's plan, let alone get the support of Governor Schwarzenegger.
I frequently disagree with fellow blogger Bill Bradley (not the former basketball player-turned U.S. Senator!), but his blog, New West Notes, is often worthwhile reading for its take on California politics. You may find it interesting to read the following blog post on "Prognosis For Schwarzencare":
http://billbradley.pajamasmedia.com/200 ... rzcare.php
Saturday, April 21, 2007, 10:21 AM - Political developmentsHappy Birthday?
April 19 was the 3rd birthday of SB 899, Schwarzenegger's workers' comp reform. Dueling press releases were issued by employer groups and injured worker groups, including Voters Injured at Work.
The California Labor Federation study can be accessed here:
http://www.calaborfed.org/pdfs/Legislat ... .27.07.pdf
WCAN (the Workers' Compensation Information Network) is a coalition of large employer groups, trade associations, cities and counties which advocate for lower workers' comp costs. To see the WCAN home page. click here:
You can find WCAN's press release on the 2004 reforms by clicking here:
http://www.fixworkerscompnow.org/pdf/an ... 041907.pdf
Voters Injured at Work is a statewide organization of workers fighting for worker justice. You can find their press release here:
http://www.viaw.org/board.php?b_code=bl ... c=list#491
Happy birthday? Depends on who you are. Big winners: insurers, big self-insured employers, large public entities. Big losers: injured workers, doctors, small employers who have not seen large savings, lawyers.
But, given the continuing exodus of manufacturing jobs to offshore locales, has the reform actually made California business more competitive? And can insurers continue to justify a system that pays out in benefits only around 30% of premium dollar collected? What are socially adequate levels of long term wage-loss replacement?
This blog will continue to analyze the effects of SB 899 and developments in California workers' comp law. Stay tuned.
Thursday, April 19, 2007, 10:02 PM - Political developmentsThis week... the week of the Virginia Tech massacres, has been a traumatic week for many Americans. Once again, a certain mythic innocence has been lost. Our culture seems coarser. The university... an idealized place of learning... a site for the rites of passage to adulthood... has been stained by a crazed act.
I wish I could say this isn't a concern in California's workers' comp system. But that would be a lie. Here's an example why.
In February 2006, a disgruntled claimant took a concealed, loaded handgun to the Oakland Workers' Compensation Appeals Board, intending to vent his frustration by shooting people. Although the individual decided not to shoot anyone, he was turned in by his roommate and arrested with the gun in his posession after leaving the WCAB. A link to the story is at the bottom of this post.
I'm sure there have been other scary examples. But 2006 was a big wake-up call.
Violence is a hard thing to predict. Many of us in the Bay Area legal community remember the horrible massacre at 101 California. But the confluence of anger, financial stress and medical desperation many injured workers feel leaves California's workers' comp boards particularly vulnerable to the possibility of violence. Although a few district offices of the California Workers' Comp Appeals Board have metal detectors (including the San Francisco building housing the California Supreme Court), most do not. Contrast this to county Superior Courts, most of which have metal detectors.
The State has been slow to act. Boxer and Gerson has written to a number of politicians and officials pointing out the need for metal detectors at the Oakland WCAB. Despite promises, any action appears mired in bureaucratic maze.
It is time for the Division of Workers' Compensation to come up with a plan.
To see a link to the story on the 2006 event in Oakland, click here:
http://findarticles.com/p/articles/mi_q ... _n16459649
After the 1993 massacre at 101 California in San Francisco, many Bay Area lawyers worked hard to form the Legal Community Against Violence. To see the site of the Legal Community Against Violence, click the following: