Workers Comp Law Summary for 2015

Workers Comp Law Summary for 2015

Workers compensation had a difficult year in the State of California. Many bills which would’ve helped injured  workers comp lawsworkers were vetoed by the governor. The following is a summary of the laws that were passed and some of the bills that the governor vetoed regarding workers compensation in the state of California.

Work injury victims are often the targets of adverse legislation however our office will continue the fight to push for fair and just Worker’s Compensation laws and reforms in the state.

Assembly Bill 1124, by Assemblyman Henry Perea, D-Fresno, orders the DWC to adopt an evidence-based list of prescription drugs that will be approved for injured workers. The division must consult with doctors, pharmacists, labor and management when developing the formulary.

AB 1124 requires the formulary be updated on at least a quarterly basis. It creates a pharmacy and therapeutics committee including pharmacists, physicians and the DWC executive medical director to review those updates.

Other workers’ compensation bills passed in 2015 include:

  • AB 438, by Assemblyman David Chiu, D-San Francisco, requiring the DIR and DWC to translate workers’ compensation claim forms, applications for the Return-to-Work Supplement program, the Supplemental Job Displacement Benefit voucher and DWC fact sheets into Chinese, Tagalog, Korean and Vietnamese.
  • AB 822, by Assemblyman Ken Cooley, D-Rancho Cordova, stating a final determination in an insolvent carrier’s liquidation proceedings is not needed before a covered claim can be submitted to the California Insurance Guarantee Association. The bill also gives a person filing a claim one year to challenge a written denial. If the denial is based on failure to exhaust other insurance options to pay benefits, it must be refiled within six months of the time that other insurance has been exhausted.
  • SB 542, by Sen. Tony Mendoza, D-Artesia, which adds the phrase “medical provider network” before references to the independent medical review process established by Labor Code Section 4616.4 in order to clarify and differentiate reviews conducted within an MPN and IMRs that review utilization review decisions. The bill also requires every MPN to post on its website contact information for the network and its medical access assistants. The bill also includes a provision stating approval of a major modification of an MPN extends approval of the network for four years, but approval of a minor modification does not.
  • SB 623, by Sen. Ricardo Lara, D-Bell Gardens, declaring a person can’t be excluded from receiving benefits from the Uninsured Employers Benefits Fund or the Subsequent Injuries Benefits Trust Fund based on citizenship or immigration status.

Gov. Jerry Brown also vetoed three workers’ compensation bills this year.

Brown said AB 305, by Assemblywoman Lorena Gonzalez, would have replaced the American Medical Association’s rating system with an “ill-defined and unscientific standard.” The measure would have mandated the impairment rating for breast cancer be equal to the rating for prostate cancer. And it would have prohibited apportionment decisions based on pregnancy or menopause. Unfortunately this bill is vetoed. Our colleagues at the California applicants attorneys Association were instrumental in getting the bill to the Gov.’s desk and would’ve affected apportionment for thousands of injured workers who have their permanent disability awards apportioned away to nonindustrial fictitious causes.

Brown vetoed AB 1451, by Assemblyman Rocky Chavez, R-Oceanside, which would have extended salary continuation benefits under Labor Code Section 4850 to include lifeguards employed by the city of Oceanside. Brown said the city can negotiate workers’ compensation benefits as part of the collective bargaining process.

Finally, Brown vetoed AB 1542, by Assemblyman Devon Mathis, R-Visalia, and Assemblyman Ken Cooley, which would have required the DWC to reestablish the qualified medical evaluator designation for neuropsychology. The DWC eliminated the designation in September on the grounds that neuropsychology is not a specialty recognized by any licensing board in the state. Brown said the bill undermines the authority of the DWC to apply consistent eligibility standards for QMEs.  Unfortunately neuropsychologists do not have a board specialty which was the basis for the governor’s veto of this bill. Again this takes away a much-needed specialty in neuropsychology for qualified medical evaluators needed by injured workers in the state of California.