BILL ANALYSIS                                                                                                                                                                                                    Ó






                 Senate Committee on Labor and Industrial Relations
                              William W. Monning, Chair

          Date of Hearing: June 25, 2013               2013-2014 Regular  
          Session                              
          Consultant: Gideon L. Baum                   Fiscal:Yes
                                                       Urgency: No
          
                                  Bill No: AB 1373
                            Author: Speaker John A. Perez
                      As Introduced/Amended: February 22, 2013
          

                                       SUBJECT
          
               Workers' compensation: firefighters and peace officers.


                                      KEY ISSUE

          Should the Legislature extend the timelines that limit a  
          dependent from filing for workers' compensation death benefits  
          if the deceased worker died of Cancer, Tuberculosis,  
          Methicillin-Resistant Staphylococcus aureus (MRSA) skin  
          infections, or a bloodborne infectious disease?
          
          Should the Legislature extend the timelines for a dependent  
          specified above to file for workers' compensation death benefits  
          for an undefined and indeterminate period of time?


                                      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  creates a series of disputable presumptions of an  
          occupational injury for peace and safety officers for the  
          purposes of the workers' compensation system.  These  
          presumptions include:










                 Heart disease;
                 Hernias;
                 Pneumonia;
                 Cancer;
                 Meningitis;
                 Tuberculosis;
                 Methicillin-resistant Staphylococcus aureus (MRSA) skin  
               infections; and
                 Bloodborne infectious disease.

          The compensation awarded for these injuries must include full  
          hospital, surgical, medical treatment, disability indemnity, and  
          death benefits, as provided by workers compensation law.  These  
          presumptions tend to run for 5 to 10 years commencing on their  
          last day of employment, depending on the injury and the peace  
          officer classification involved.  (Labor Code §§3212 to 3213.2)

           Existing law  provides that the presumptions listed above are  
          disputable and may be controverted by evidence.  However, unless  
          controverted, the Workers' Compensation Appeals Board must find  
          is accordance with the presumption.  (Labor Code §§3212 to  
          3213.2)

           Existing law  provides for the payment of a workers' compensation  
          indemnity death benefit.  The amount of the benefit is  
          determined by the date of injury, the number dependents, and if  
          those dependents are partially dependent or wholly dependent on  
          the deceased worker.  
          (Labor Code §§ 4700 to 4709)

           Existing law  provides that no person is a dependent of any  
          deceased employee unless in good faith a member of the family or  
          household of the employee, or unless the person bears to the  
          employee the relation of husband or wife, child, posthumous  
          child, adopted child or stepchild, grandchild, father or mother,  
          father-in-law or mother-in-law, grandfather or grandmother,  
          brother or sister, uncle or aunt, brother-in-law or  
          sister-in-law, nephew or niece.  (Labor Code §3503)
           
          Existing law  requires,  with certain exceptions  , that the  
          collection of workers' compensation death benefits must be  
          Hearing Date:  June 26, 2013                             AB 1373  
          Consultant: Gideon L. Baum                               Page 2

          Senate Committee on Labor and Industrial Relations 
          








          commenced one year from:

             1)   The date of death where death occurs within one year  
               from date of injury; or
             2)   The date of last furnishing of any benefits where death  
               occurs more than one year from the date of injury; or
             3)   The date of death, where death occurs more than one year  
               after the date of injury and compensation benefits have  
               been furnished.

          No such proceedings may be commenced more than one year after  
          the date of death, nor more than 240 weeks from the date of  
          injury. 

          (Labor Code §5405)
           
          The exceptions to the above timelines are as follows:  

             a)   In the case of the death of an asbestos worker or  
               firefighter from asbestosis, the period within which  
               proceedings may be commenced for the collection of workers'  
               compensation death benefits is one year from the date of  
               death;

             b)   In the case of the death of a healthcare worker,  
               firefighter, peace officer, or correctional officer from  
               HIV-related disease, the period within which proceedings  
               may be commenced for the collection of workers'  
               compensation death benefits is one year from the date of  
               death, provided they meet certain requirements.
           
           (Labor Code §§ 5406.5 and 5406.6)
           
          Existing law  defines the "date of injury",  in cases of  
          occupational diseases  or cumulative injuries is that date upon  
           which the employee first suffered disability therefrom and  
          either knew, or in the exercise of reasonable diligence should  
          have known  , that such disability was caused by his present or  
          prior employment.  

          (Labor Code §5412)
          
          Hearing Date:  June 26, 2013                            AB 1373  
          Consultant: Gideon L. Baum                               Page 3

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          This bill  would provide an undefined and indeterminate  
          extension, but in no case later than one year after death, for  
          dependents of deceased firefighters and peace officers who died  
          any of the following:

                 Cancer; 
                 Tuberculosis; 
                 Methicillin-resistant Staphylococcus aureus (MRSA) skin  
               infections; or 
                 Bloodborne infectious disease.


                                      COMMENTS

          
          1.  A Brief Discussion on Presumptions and Death Benefits:

            Presumptions for peace officers and firefighters have been a  
            part of workers' compensation law since 1917.  While their  
            scope has grown, the fundamental idea behind each and every  
            presumption remains the same: these are injuries that are  
            intuitively likely to be job related, and therefore  
            occupational injuries compensable in the workers' compensation  
            system, but are difficult for the employee to prove.  A good  
            example of this is the "heart trouble" presumption, which was  
            created in 1939: while many individuals suffer from heart  
            ailments for a variety of different reasons, the jobs we asked  
            firefighters and peace officers to fulfill are very stressful  
            and take a toll on their heart.  Therefore, for these  
            individuals, the Legislative granted a presumption that a  
            firefighter or peace officer's "heart trouble" is  
            occupational.

            Even with these presumptions in place, however, limits on the  
            ability of any individual to collect workers' compensation  
            death benefits, which can generally be defined as one year  
            from the date of death if the injury was within 240 weeks of  
            the initial injury, or about 4  years, were in place for all  
            workers until 1980.  Even when exceptions to the workers'  
            compensation death benefit timelines were approved by the  
            Legislative in 1999 and 2003, they were quite limited: it was  
            for asbestos workers who died from asbestosis, which is a lung  
          Hearing Date:  June 26, 2013                             AB 1373  
          Consultant: Gideon L. Baum                               Page 4

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            ailment that can only come from long-term exposure to  
            asbestos, is universally recognized as an occupational cancer,  
            and can take 30 years to manifest itself.

            Two other changes have been made to death benefit timelines  
            since then.  In 1999, it was for healthcare worker,  
            firefighter, peace officer, or correctional officer from  
            HIV-related disease, but only when the injury was recognize to  
            be occupational prior to the injured worker's death.  Then, in  
            2003, firefighters were added to the asbestosis exception due  
            to the significant and long-term occupational exposure to  
            asbestos due to its prominence as a building material.  Since  
            then, the timelines have remained unchanged.

          2.  A Brief Discussion on TB, MRSA & Bloodborne Pathogens  :
            
            As noted above, AB 1373 covers dependents of firefighters or  
            peace offices who died of cancer, tuberculosis, MRSA skin  
            infections, or bloodborne skin infections.  However, with the  
            exception of cancer, it would be an unlikely scenario where  
            the date of injury and death would fall outside of the 240  
            week period (60 months).  For example, the treatment regimen  
            suggested by the Center for Disease Control (CDC) for  
            antibiotic-resistant tuberculosis is 6 months to 2 years.  The  
            success rate of these treatments is quite high, and the  
            mortality rate of tuberculosis has fallen consistently since  
            1990 according to CDC data.

            Similarly, the incubation period for MRSA skin infections is 8  
            minutes to 10 hours, with clinical signs manifesting in 4 to  
            10 days.  Bloodborne pathogens, on the other hand, vary  
            significantly.  However, the rates of infection on the  
            relevant bloodborne pathogens that are not covered by existing  
            law (Hepatitis B & C) have declined significantly since 2000,  
            suggesting fatalities by bloodborne pathogens would also be  
            somewhat rare, though possibly outside of the 240 week period.

            In short, the inclusion of tuberculosis, MRSA, and bloodborne  
            pathogens in AB 1373 is unlikely to lead to significant  
            changes in workers' compensation utilization.

          3.  A Brief Discussion on Firefighters, Peace Officers, Cancer and  
          Hearing Date:  June 26, 2013                            AB 1373  
          Consultant: Gideon L. Baum                               Page 5

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            Future Research:  

            Several epidemiological studies have suggested that  
            firefighters have higher incidences of cancer due to their  
            exposure to contaminants.  This is particularly true of  
            bladder cancer, pancreatic cancer, and lung cancer.  However,  
            the sample sizes of the studies known to Committee Staff were  
            relatively small.

            In 2014, the National Institute on Occupational Safety and  
            Health (NIOSH) will be releasing a study of cancer incidence  
            in firefighters, looking at more than 30,000 firefighters,  
            making it one of the largest studies in this area.  A similar  
            study started by the Australian government in 2011 will look  
            at 162,000 former and current firefighters, should be released  
            by the end of this year.  Together, both of those studies will  
            shed a tremendous amount of light of firefighters, incidences  
            of cancer (particularly types of cancer), and mortality.

            On the topic of the cost, the Commission on Health and Safety  
            and Workers' Compensation (CHSWC) recently heard a  
            presentation that sought to quantify the costs of extending  
            the timelines for collection of workers' compensation death  
            benefits for firefighters and peace officers.  While specific  
            dollar amounts were unavailable, the presenter estimated a  
            7.7% to 14.8% increase in death benefits if the timeline was  
            extended to 480 weeks (10 years), assuming that the increase  
            in time does not lead to a marked increase in claims.




          3.  Proposed Amendments:

            Currently, AB 1373 is silent on how long the statute of  
            limitations is extended for filing for workers' compensation  
            death benefits.  As was noted above, the CHSWC presentation  
            gave guidance on expected costs and impacts, which give the  
            Legislature reasonable guidance on the impact of AB 1373 on  
            public entities.  By selecting one of the studied intervals,  
            the Committee would be able to frame the bill through the lens  
            of emerging research and also provide greater certainty for  
          Hearing Date:  June 26, 2013                             AB 1373  
          Consultant: Gideon L. Baum                               Page 6

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            the policy discussion.

             Therefore, the Committee may wish to strike the "blank" on  
            page 2, line 24 and insert "480 from the date of injury".  
           
          4.  Proponent Arguments  :
            
            Proponents argue that existing law is not meeting the needs of  
            California's firefighters and peace officers.  Proponents note  
            that if a firefighter or peace officer dies of an occupational  
            disease more than five years after being diagnosed with the  
            disease, his or her family members are unable to claim a death  
            benefit.  With occupational injuries such as cancer, the  
            timeframe between when the injury was discovered and when the  
            worker succumbs to the injury may be longer than 5 years.  In  
            these cases, proponents argue that the families of  
            firefighters and peace officers should not be denied their  
            right to workers' compensation death benefits due to their  
            families.

          5.  Opponent Arguments  :

            Opponents argue that AB 1373 will dramatically increase costs  
            on local governments and counties at a time when budgets are  
            limited and workers' compensation costs are rising.  Opponents  
            argue that AB 1373 does not act like existing presumptions or  
            exceptions to the statute of limitations on workers'  
            compensation death benefits, as there are no limits on when  
            such claims could be filed.  Opponents also note that this  
            could have significant impacts, as it will impact all  
            firefighters and peace officers currently employed, but also  
            all currently living retirees that are peace officers or  
            firefighters.  Due to this, the City of Torrance alone places  
            the cost of complying with AB 2451 at more than $25 million  
            annually.

          6.  Prior Legislation  :

            AB 2451 (Perez) would have allowed dependents of a firefighter  
            or peace officer who dies of certain occupational ailments to  
            file for workers' compensation death 480 weeks from the date  
            of injury.  AB 2451 was vetoed by Governor Brown.  In his veto  
          Hearing Date:  June 26, 2013                             AB 1373  
          Consultant: Gideon L. Baum                               Page 7

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            message, Governor Brown cited the fiscal impacts and the lack  
            of data, and also noted the following:

            "I understand that the National Institute for Occupational  
            Safety and Health is in the midst of one of the largest  
            studies of firefighters and risks of death from cancer and  
            other job related disease ever conducted.  It is my sincere  
            hope that this study, as well as data collected through our  
            comprehensive reform of the workers' compensation system, will  
            provide a basis to make a more informed policy and research  
            based decision on this question in the future."
          
                                       SUPPORT
          
          Association for Los Angeles Deputy Sheriffs (Co-sponsor)
          California Professional Firefighters (Co-sponsor)
          Los Angeles County Probation Officers Union (Co-sponsor)
          Los Angeles Police Protective League (Co-sponsor)
          Peace Officers Research Association of California (PORAC)  
          (Co-sponsor)
          Riverside Sheriffs' Association (Co-sponsor)
          American Federation of State, County and Municipal Employees,  
          Local 685
          Association of Orange County Deputy Sheriffs'
          California Fraternal Order of Police
          California Labor Federation, AFL-CIO
          Long Beach Police Officers Association
          Los Angeles County Professional Peace Officers Association
          Sacramento County Deputy Sheriffs' Association
          Santa Ana Police Officers Association
          

                                     OPPOSITION
          
          Acclamation Insurance Management Services (unless amended)
          Allied Managed Care (unless amended)
          California Association of Joint Powers Authorities (CAJPA)
          California Coalition on Workers' Compensation
          California Joint Powers Authorities
          California State Association of Counties
          City of Cypress
          City of Long Beach
          Hearing Date:  June 26, 2013                             AB 1373  
          Consultant: Gideon L. Baum                               Page 8

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          City of South San Francisco
          City of Torrance
          City of Visalia
          County of San Bernardino
          CSAC EIA California Joint Powers Authorities
          League of California Cities
          Los Angeles County Board of Supervisors
          Rural County Representatives of California
          Santa Cruz County Fire Agencies Insurance Group
          The City of Santa Barbara 
          The City of Torrance






























          Hearing Date:  June 26, 2013                             AB 1373  
          Consultant: Gideon L. Baum                               Page 9

          Senate Committee on Labor and Industrial Relations