BILL NUMBER: AB 947 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY MARCH 10, 2011
INTRODUCED BY Assembly Member Solorio
FEBRUARY 18, 2011
An act to amend Section 11734 of the Insurance Code,
relating to workers' compensation insurance. An act to
amend Section 4656 of the Labor Code, relating to workers'
compensation.
LEGISLATIVE COUNSEL'S DIGEST
AB 947, as amended, Solorio. Workers' compensation
insurance: rates. : temporary disability payments.
Existing workers' compensation law generally requires employers to
secure the payment of workers' compensation, including medical
treatment, for injuries incurred by their employees that arise out
of, or in the course of, employment. Existing law generally prohibits
aggregate disability payments for a single injury occurring on or
after January 1, 2008, causing temporary disability from extending
for more than 104 compensable weeks within a period of 5 years from
the date of injury. Under existing law, if an employee suffers from
specified injuries or conditions, aggregate disability payments for a
single injury occurring on or after April 19, 2004, causing
temporary disability are prohibited from extending for more than 240
compensable weeks within a period of 5 years from the date of injury.
This bill would add prescribed injuries that require treatment
that cannot medically be completed within 104 weeks to the specified
injuries or conditions that instead prohibit aggregate disability
payments from extending for more than 240 compensable weeks within a
period of 5 years from the date of injury.
Existing law requires workers' compensation insurers to adhere to
a uniform experience rating plan filed with the Insurance
Commissioner by a rating organization designated by the commissioner
and subject to his or her disapproval. Existing law authorizes an
insurer to develop its own classification system upon which a rate
may be made or adopt the classification system developed by the
designated rating organization; provided, however, that any
classification system developed by an insurer be filed with the
commissioner 30 days prior to its use.
This bill would instead require that any classification system
developed by an insurer be approved by the commissioner prior to its
use.
Vote: majority. Appropriation: no. Fiscal committee: no.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 4656 of the Labor
Code is amended to read:
4656. (a) Aggregate disability payments for a single injury
occurring prior to January 1, 1979, causing temporary disability
shall not extend for more than 240 compensable weeks within a period
of five years from the date of the injury.
(b) Aggregate disability payments for a single injury occurring on
or after January 1, 1979, and prior to April 19, 2004, causing
temporary partial disability shall not extend for more than 240
compensable weeks within a period of five years from the date of the
injury.
(c) (1) Aggregate disability payments for a single injury
occurring on or after April 19, 2004, causing temporary disability
shall not extend for more than 104 compensable weeks within a period
of two years from the date of commencement of temporary disability
payment.
(2) Aggregate disability payments for a single injury occurring on
or after January 1, 2008, causing temporary disability shall not
extend for more than 104 compensable weeks within a period of five
years from the date of injury.
(3) Notwithstanding paragraphs (1) and (2), for an employee who
suffers from the following injuries or conditions, aggregate
disability payments for a single injury occurring on or after April
19, 2004, causing temporary disability shall not extend for more than
240 compensable weeks within a period of five years from the date of
the injury:
(A) Acute and chronic hepatitis B.
(B) Acute and chronic hepatitis C.
(C) Amputations.
(D) Severe burns.
(E) Human immunodeficiency virus (HIV).
(F) High-velocity eye injuries.
(G) Chemical burns to the eyes.
(H) Pulmonary fibrosis.
(I) Chronic lung disease.
(J) Injuries to more than one body part requiring a course of
treatment to restore maximal function that cannot medically be
completed within 104 weeks.
(K) Injuries that require multiple stage treatments or procedures
to restore function where the full course of treatment cannot
medically be completed within 104 weeks.
SECTION 1. Section 11734 of the Insurance Code
is amended to read:
11734. (a) Every workers' compensation insurer shall adhere to a
uniform experience rating plan filed with the commissioner by a
rating organization designated by the commissioner and subject to his
or her disapproval.
(b) The commissioner shall designate a rating organization to
assist him or her in gathering, compiling, and reporting relevant
statistical information, and to develop a classification system. An
insurer may develop its own classification system upon which a rate
may be made or adopt the classification system developed by the
designated rating organization; provided, however, that any
classification system developed by an insurer shall be approved by
the commissioner prior to its use. The commissioner shall disapprove
a classification system filed by an insurer pursuant to this section
if the insurer fails to demonstrate that the data thereby produced
can be reported consistent with the uniform statistical plan or the
classification system developed by the rating organization. Every
workers' compensation insurer shall record and report its workers'
compensation experience to the designated rating organization as set
forth in the uniform statistical plan approved by the commissioner.
(c) The designated rating organization shall develop and file
manual rules, subject to the approval of the commissioner, reasonably
related to the recording and reporting of data pursuant to the
uniform statistical plan, uniform experience rating plan, and any
classification systems that may be in effect. Every workers'
compensation insurer shall adhere to the approved manual rules and
experience rating plan in writing and reporting its business. An
insurer shall not agree with any other insurer or with a rating
organization to adhere to manual rules that are not reasonably
related to the recording and reporting of data pursuant to the
uniform statistical plan or classification system developed by the
rating organization.
(d) The designated rating organization shall also develop and file
with the commissioner a weekly premium per employee for each
classification used or proposed for use by that organization. The
weekly premium shall be developed by applying the proposed rate for
each classification to the state average weekly wage. For the purpose
of this section, "state average weekly wage" means the average
weekly wage paid by employers to employees covered by unemployment
insurance as reported by the United States Department of Labor for
California for the 12 months ending March 31 of the calendar year
preceding the year in which the injury occurred.