Workers' Compensation Legislation

Each year approximately 30 bills are introduced addressing workers’ compensation insurance.  This year the number is a little lower, at 21.  Many of the measures begin as the above-referenced “spot” bills.

Below is a list of the workers’ compensation bills and a short summary:

AB 211 (Cedillo): Existing law, for injuries that cause permanent partial disability and occur on or after January 1, 2004, provides supplemental job displacement benefits in the form of a nontransferable voucher for education-related retraining or skill enhancement for an injured employee who does not return to work for the employer within 60 days of the termination of temporary disability, in accordance with a prescribed schedule based on the percentage of an injured employee's disability.  This bill would provide that the above provisions shall apply to injuries occurring on or after January 1, 2004, and before January 1, 2012.  This bill would provide, for injuries that cause permanent partial disability and occur on or after January 1, 2012, for a supplemental job displacement benefit in the form of a voucher for up to $6,000 to cover various reeducation and skill enhancement expenses, as specified, which would expire 2 years after the date the voucher is furnished to the employee or 5 years after the date of injury, whichever is later.  The bill would exempt employers who make an offer of reemployment or continued employment from providing vouchers.  The bill would require the Administrative Director of the Divisions of Workers’ Compensation to adopt regulations implementing the program.

AB 228 (Fuentes): Existing law exempts positions funded by the State Compensation Insurance Fund from hiring freezes and staff cutbacks otherwise required by law.  This bill would add furloughs to those employee exemptions.

AB 335 (Solorio): This bill would require the Administrative Director of the Division of Workers’ Compensation, in consultation with the Commission on Health, Safety and Workers’ Compensation, to prescribe reasonable rules and regulations for serving certain notices on an injured employee.  This bill would require the Administrative Director, in consultation with the Commission, to develop, make fully accessible on the department's Internet Web site, and make available by mail and at district offices, a booklet written in plain language that describes the overall workers' compensation claims process.  This bill would require each notice to be written in plain language and to reference the booklet to enable employees to understand the context of the notices.  This bill would modify provisions required to be in, and procedures for, specified notices, and would delete a requirement for notice by certified mail, and would make conforming changes.

AB 378 (Solorio): This bill would add pharmacy goods to the list of medical goods or services for which it is unlawful for a physician to refer a person under this provision, except in prescribed circumstances.

AB 397 (Monning): This bill would require, at the time of renewal, an active contractor licensee with an exemption for workers' compensation insurance on file with the board to either recertify the licensee's exemption or to provide a current and valid Certificate of Workers' Compensation Insurance or Certificate of Self-Insurance.  The bill would also provide for retroactive license renewal for otherwise acceptable license renewal applications when the applicant provides the required documentation within 30 days after notification by the board of the renewal rejection.

AB 411 (Pan): Spot bill relative to workers’ compensation.

AB 584 (Fong): This bill would, for the purposes of workers’ compensation, require a psychologist to be licensed by California state law.  This bill would require physician’s completing utilization reviews for workers’ compensation claims to be licensed by California state law.

AB 947 (Solorio): This bill would instead require that any classification system developed by an insurer utilized for determining rates be approved by the Insurance Commissioner prior to its use.

AB 1155 (Alejo): This bill would provide that a workers' compensation claim shall not be denied because the employee's injury or death was related to the employee's race, religious creed, color, national origin, age, gender, marital status, sex, sexual orientation, or genetic characteristics.

AB 1168 (Pan): This bill would require, on or before January 1, 2013, the Administrative Director of the Division of Workers’ Compensation to adopt, after public hearings, a fee schedule that establishes reasonable maximum fees paid for services provided by vocational experts.  This bill would prohibit a vocational expert from being paid, and prohibit the appeals board from allowing, vocational expert fees in excess of those established in the fee schedule.

AB 1263 (Williams): This bill would provide that, notwithstanding any other provision to the contrary, the employment contracts for positions of president, a chief financial officer, a chief operating officer, a chief information technology officer, a chief investment officer, a chief risk officer, and a general counsel at the State Compensation Insurance Fund (the Fund) shall contain employment restrictions prohibiting competition of any kind during the term of contract of employment, and prohibiting a person in any of those positions, for 2 years after terminating his or her employment contract with the Fund, from being employed by a competitor of, consulting with, or lobbying the Fund, if those activities would result in competing with the Fund through the use of the Fund's trade secrets or confidential information or if those activities would constitute engaging in or aiding others in engaging in unfair competition against the Fund, use of the Fund's confidential information, or misappropriating the Fund's proprietary information.  The bill would state the findings, declarations, and intent of the Legislature relating to the need for enactment of this measure.

SB 127 (Emmerson): This bill would require the Administrative Director of the Division of Workers’ Compensation, in order to keep the fee schedule for physician services appropriately updated, to annually adopt the Current Procedural Terminology (CPT) codes, descriptors, and modifiers published by the American Medical Association.

SB 351 (La Malfa): This bill would state the intent of the Legislature to enact legislation relating to workers' compensation in the case of fatal on-the-job accidents.

SB 362 (Berryhill): Spot bill relative to the permanent disability rating schedule.

SB 457 (Calderon): Existing law authorizes a medical provider to file a lien claim with the Workers' Compensation Appeals Board for certain expenses incurred by the provider.  Under existing law, the board is required to allow a lien to the extent of benefits paid or services provided for reimbursement for self-procured medical costs for the effects of an injury or illness arising out of and in the course of employment.  Existing law requires the administrative director, after public hearings, to adopt and revise periodically an official medical fee schedule that establishes reasonable maximum fees paid for medical services, other than prescribed goods and services, in accordance with specified requirements.  This bill would instead, notwithstanding the official medical fee schedule, require the board to allow a lien to the extent of benefits paid for reimbursement for self-procured medical costs.

SB 684 (Corbett): This bill would require that any agreement, other than a settlement agreement resolving a particular dispute, between an employer, whose principal place of business is in California, and a workers' compensation insurer concerning resolution of disputes, including, but not limited to, an arbitration clause arising out of a workers' compensation policy or endorsement, be part of the form or endorsement filed with the rating organization, be provided to the employer contemporaneously with any written quote that offers to provide insurance coverage, and contain provisions to resolve disputes that arise in this state in the California courts and under California law.  The bill would provide, however, that prior to the inception of the policy, employers and workers' compensation insurance companies may, after freely negotiating, expressly agree to a choice of law or a choice of forum other than California.  Failure to observe those requirements would render any dispute resolution provision void and unenforceable.

SB 712 (Committee on Insurance): Spot bill relative to workers’ compensation insurance.

SB 727 (Berryhill): Under existing law, a worker may file a petition with the appeals board when it is alleged that a continuing award for a disability has decreased or terminated.  Existing law prohibits the grant of that petition while the injured worker is pursuing a rehabilitation plan, as specified, in a section of law that is no longer valid.  This bill would remove the prohibition on the granting of the petition.

SB 826 (Leno): This bill would require the Administrative Director of the Division of Workers’ Compensation to assess an administrative penalty against a claims administrator for failing to comply with any data reporting requirement as prescribed.  This bill would require that a penalty not exceed $100 for each violation or $5,000 in any calendar year and would require that the annual maximum penalty be doubled for each consecutive year that the same deficiency results in violations of the same type.  This bill would provide that this penalty is to be deposited in the Workers' Compensation Administration Revolving Fund.

SB 888 (Lieu): Spot bill relative to workers’ compensation fraud.

SB 896 (De Leon): Existing law, operative only until the administrative director adopts a regulation specifying separate reimbursement, if any, for implantable medical hardware or instrumentation for complex spinal surgeries, requires that implantable medical devices, hardware, and instrumentation for specified Diagnostic Related Groups (DRGs) be separately reimbursed in accordance with a prescribed formula.  This bill would instead require that specified spine surgeries be reimbursed to the performing hospital at the rate of 1.8 times the applicable DRG rate, with no separate reimbursement for any implantable devices, hardware, or instrumentation.