BILL ANALYSIS Ó
AB 947
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CONCURRENCE IN SENATE AMENDMENTS
AB 947 (Solorio)
As Amended September 2, 2011
Majority vote
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|ASSEMBLY: |46-26|(May 12, 2011) |SENATE: |23-13|(September 8, |
| | | | | |2011) |
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Original Committee Reference: INS.
SUMMARY : Adds certain surgical cases to the list of conditions
that are exceptions to the 104 week cap on temporary disability
(TD) benefits, thereby allowing up to 240 weeks of temporary
disability benefits.
The Senate amendments redraft and narrow the existing provisions
of the bill, as follows:
1)Limit the bill to cases involving injuries that occur on or
after January 1, 2012, where surgery occurs after 104 weeks of
TD benefits have been paid, or where the recovery period for a
surgery extends past the period where 104 weeks of TD benefits
have been paid.
2)Provide that this exception to the 104 week cap applies only
if:
a) The need for the surgery or recovery after 104 weeks
of TD benefits have been paid is not caused by the
willful failure of the employee to undergo recommended
medical treatment;
b) The surgery was delayed as a result of the primary
treating physician's advice to pursue less invasive
treatment; and
c) The surgery was recommended by the primary treating
physician.
EXISTING LAW :
1)Provides for a comprehensive system of workers' compensation
benefits for employees who are injured on the job, including
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TD benefits, which are a partial wage replacement benefit,
during the period of time that an injured worker is unable to
work while recovering from the injury.
2)Specifies that, for injuries on or after April 19, 2004, an
injured worker is entitled to TD benefits for up to 104 weeks
within a two year period commencing with the first payment of
TD benefits.
3)Specifies that, for injuries on or after January 1, 2008, an
injured worker is entitled to TD benefits for up to 104 weeks
within a five year period commencing with the date of injury.
4)Provides that workers with certain listed injuries or
conditions are not subject to the 104 week cap, but instead
may be compensated with TD benefits for up to 240 weeks during
the five year period commencing with the date of injury.
5)Provides that TD benefits are payable until the injured worker
is "permanent and stationary" (P&S), which is the point where
the injured worker's medical condition is not likely to
improve with additional treatment.
AS PASSED BY THE ASSEMBLY , this bill applied to any case where
the primary treating physician determined that treatment was
required beyond the 104 week period, provided it was not due to
the willful refusal of the injured worker to undergo recommended
medical treatment.
FISCAL EFFECT : According to the Senate Appropriations Committee
analysis, unknown, but still likely significant costs to the
General Fund and other Special Funds.
COMMENTS : The purpose of the bill has been to recognize, and
describe, legitimate cases where the existing 104-week cap on
temporary disability benefits is an unfair burden on seriously
injured workers. The effort to draw a circle around the
appropriate class of injuries has proven elusive, and as a
result the bill was narrowed to surgical cases where surgery is
delayed on medical advice, but later determined to be necessary.
If disputes arise, it is intended that the medical treatment
utilization schedule would be relied upon in evaluating
appropriateness of surgery and recovery periods, and that agreed
or qualified medical evaluators would be involved, as
appropriate.
AB 947
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Analysis Prepared by : Mark Rakich / INS. / (916) 319-2086
FN: 0002859