Industry Watchers Weigh-in on ‘Concerning’ California Workers’ Comp Bills

A handful of workers’ compensation bills make their way through state Legislature every year that catch the attention of those watching the space — for better or worse.

A few bills this year have a pair of industry watchers more than a bit concerned.

Mark Walls, vice president, communications and strategic analysis for Safety National, has already been sounding the alarm over Assembly Bill 1465, which would require the administrative director of the state’s workers’ compensation system to establish a statewide medical provider network, called the California Medical Provider Network, and give employees the choice to treat within their employer’s MPN or the CAMPN.

John Norwood with Norwood Associates, an industry lobbyist, called it a “terrible bill.”

He said there have been no discussions regarding this issue, and there are no studies or other information supporting the need for this change.

“Implementation of something like this will likely adversely affect medical care received by injured workers and substantially increase costs to the state and employers,” Norwood said.

Next in line on Walls’ list of worries is Senate Bill 213, which creates presumptions for any healthcare worker involved in direct patient care and broadly defines “injury.”

“It’s a rebuttable presumption,” Walls said.

The bill as worded may apply to infectious diseases, cancer, musculoskeletal injuries, post-traumatic distress, respiratory diseases and of course COVID-19.

“The problem with presumptions is that they change the ground rules on workers’ compensation,” Walls said.

Walls said the bill would create another “class of worker,” requiring employers to bear the burden of proof if they want to refute a claim, which Walls believes would increase costs for employers.

Norwood had similar feelings on SB 213. “It’s another bad bill that will start the state down the road of enacting presumptions for workers’ comp in the private sector,” Norwood said.

Another bill on Walls’ watchlist is Senate Bill 335. The bill would reduce the timeframe to dispute claims from 90 to 45 days, and 30 days for certain conditions.

“It’s a significant reduction in the time allowed for disputing a claim,” Walls said.

The bill allows up to $17,000 in medical treatment to be authorized until a claim is accepted or denied, up from the $10,000 the law currently allows.

“California’s the only state that I know of that mandates that workers’ comp pays for unauthorized medical treatment before a claim is accepted,” Walls said.

He said the reduction in the timeframe makes it difficult to get a worker in to be seen and evaluated.

“It’s not possible to get an exam that quickly,” he said. “What we foresee that doing is forcing employers and carriers to deny more claims,” he said, adding that there’s a double-edged sword, because there are penalties in the bill for excessive denials.

Senate Bill 788 would “prohibit consideration of race, religious creed, color, national origin, age, gender, marital status, sex, sexual identity, sexual orientation, or genetic characteristics to determine the approximate percentage of the permanent disability caused by other factors,” and would express the Legislature’s intent to eliminate bias and discrimination in the workers’ comp system.

Walls said over the last several years in California some legislators have been attempting to undermine permanent disability apportionment in the guise of ending discriminatory practices in the workers’ comp system, and he views this as the latest attempt to do just that.

“What they’re actually trying to do is eliminate apportionment,” Walls said. “Ultimately, what this does is reduce legitimate apportionment.”

He explained that if, for example, an older worker has a preexisting condition that would lead to PD apportionment, that wouldn’t be allowed because would be considered age discrimination, he said.

“SB 788 is just another attempt to undermine PD apportionment,” Walls said.