BILL ANALYSIS Ó
Senate Committee on Labor and Industrial Relations
Ted W. Lieu, Chair
Date of Hearing: June 22, 2011 20011-2012 Regular
Session
Consultant: Gideon L. Baum Fiscal:No
Urgency: No
Bill No: AB 947
Author: Solorio
Version: As Amended April 27, 2011
SUBJECT
Workers' compensation: temporary disability payments.
KEY ISSUE
Should the Legislature extend additional temporary disability
indemnity benefits to injured workers who require additional
medical treatment?
PURPOSE
To increase the cap on the payment of temporary disability
benefits from up to 104 weeks to up to 240 weeks for injured
workers who require additional medical treatment.
ANALYSIS
Existing law establishes a workers' compensation system that
provides benefits to an employee who suffers from an injury or
illness that arises out of and in the course of employment,
irrespective of fault. This system requires all employers to
secure payment of benefits by either securing the consent of the
Department of Industrial Relations to self-insure or by securing
insurance against liability from an insurance company duly
authorized by the state.
Existing law provides for the payment of indemnity benefits if
the occupational injury causes temporary or permanent disability
which prevents the worker from returning to his or her job. In
the case of temporary disability payments, the benefit is
two-thirds of the weekly loss in wages due to disability for up
to 104 weeks within 5 years (Labor Code §§4650, 4653, 4654 and
4656).
Existing law extends up to 240 weeks of temporary disability
benefits for workers who suffer from the following occupational
injuries:
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.
(Labor Code §4656)
This bill provides that, starting January 1, 2012, if an injured
worker requires medical treatment beyond 104 weeks to reach
maximum medical improvement may be extended up to 240 weeks by
the physician to complete treatment.
This bill prohibits the extension of additional temporary
disability benefits if the need for the additional treatment was
caused by the willful failure of the worker to undergo
recommended medical treatment necessary to reach maximum medical
improvement .
COMMENTS
1. Need for this bill?
The author introduced this bill to address circumstances where
medical treatment that is required to cure the injured
worker's injuries takes longer, through no fault of the
injured worker, than the 104 weeks of temporary disability
Hearing Date: June 22, 2011 AB 947
Consultant: Gideon L. Baum Page 2
Senate Committee on Labor and Industrial Relations
(TD) benefits allowed by law. The author's goal is that the
extension of additional TD benefits is for cases involving
substantial injuries where the injured worker is simply not
able to work during the recovery period. Examples could
include cases where conservative treatments are attempted for
an extended period, but ultimately surgery is necessary, or
prolonged pain management challenges due to injury or surgery.
2. Possible Amendments:
The Committee may wish consider three amendments that would
clarify the intent of the bill.
1) On page 3, line 13, the bill references additional TD
benefits for "a single injury". On page 3, line 18,
however, the bill references "an injury". The striking of
"an" on page 3, line 18, and the insertion of "a single"
before injury would make the usage of these two terms
consistent.
2) On page 3, lines 19-20, the bill uses the term "maximum
medical improvement" (MMI). While MMI is the functional
equivalent of "permanent and stationary", the traditional
term for medical stability, it is not used in the Labor
Code--- rather, it comes from the American Medical
Association Guides to the Evaluation of Permanent
Impairment. For the purposes of consistency, the Committee
may wish to strike "maximum medical improvement" on page 3,
lines 19 and 20 and insert "permanent and stationary".
3) On page 3, line 20, the bill references that it would be
a physician which would make the determination of the need
for the extension of TD benefits, but does not clarify
which physician would make that call. This is particularly
important for seriously injured workers, as they may see
several physicians prior to surgery, then specialists.
Therefore, the Committee may wish to strike physician on
page 3, line 20 and insert "primary treating physician, an
agreed medical evaluator, or a qualified medical
evaluator". The amendment would provide specificity and
ensure that any specialists would need to report to the
initial treating doctors for the TD extension.
Hearing Date: June 22, 2011 AB 947
Consultant: Gideon L. Baum Page 3
Senate Committee on Labor and Industrial Relations
3. Proponent Arguments :
Proponents note that since the passage of former Governor
Schwarzenegger's workers' compensation reforms in SB 899
(Poochigian) in 2004, temporary disability benefit awards and
durations have decreased significantly, placing the livelihood
and family life of injured workers in significant jeopardy.
Proponents note that the lack of temporary disability benefits
is particularly difficult for seriously injured workers who
have not been cured within a two year period. These injured
workers, according to the proponents, are left without few
options are frequently must rely on California's safety net,
shifting costs to state and local governments that are more
appropriately absorbed by the workers' compensation system.
4. Opponent Arguments :
Opponents argue that the 104 week cap was one of the major
reforms that have helped control workers' compensation costs.
Opponents also argue that extending the duration of TD
benefits does little to improve medical treatment, but rather
causes cases to be delayed, with negative implications for
both injured workers and employers. Opponents also believe
that the language of the bill is too open-ended and would
allow any physician to extend temporary disability benefits in
most cases. In particular, the California Association of
Joint Powers Authorities (CAJPA) suggests that a study be
conducted to determine whether there are cases that require
extended TD, and to identify those types of cases.
5. Prior Legislation :
AB 2397 (Solorio) of 2010 This bill would have permitted law
enforcement employees to extend paid leave of absence due to
temporary disability by up to an additional year by mutual
agreement with their employer through the collective
bargaining process.
SUPPORT
Hearing Date: June 22, 2011 AB 947
Consultant: Gideon L. Baum Page 4
Senate Committee on Labor and Industrial Relations
California Applicants' Attorneys Association (Sponsor)
California Labor Federation, AFL-CIO
OPPOSITION
Acclamation Insurance Management Services
Allied Managed Care
Alpha Fund
California Association of Joint Powers Authorities
California Special Districts Association
Hearing Date: June 22, 2011 AB 947
Consultant: Gideon L. Baum Page 5
Senate Committee on Labor and Industrial Relations