BILL ANALYSIS �
SB 375
Page 1
Date of Hearing: August 7, 2013
ASSEMBLY COMMITTEE ON INSURANCE
Henry T. Perea, Chair
SB 375 (Committee on Labor and Industrial Relations) - As
Amended: August 5, 2013
SENATE VOTE : 36-0
SUBJECT : Workers' compensation: technical clean-up
SUMMARY : Contains a number of corrections to erroneous
cross-references and other technical clean-up provisions to the
2012 workers' compensation reform Specifically, this bill :
1)Corrects an erroneous reference to "administrative hearing"
interpreters by replacing the phrase with "medical
examination" interpreters.
2)Corrects two inaccurate Labor Code citations that relate to
regulations to be adopted by the Administrative Director (AD)
of the Division of Workers' Compensation (DWC) relating to
qualified medical evaluators (QMEs).
3)Corrects an erroneous cross-reference with respect to the
prohibition against independent medical reviewers also being
QMEs.
4)Adds an accidentally neglected cross reference in two places
concerning the duties of a QME or the AD with respect to
calculating permanent disability benefits.
5)Clarifies that a bar against commencing proceedings involving
permanent disability benefits before the Workers' Compensation
Appeals Board (WCAB) absent an evaluation by the treating
physician and either a QME or an agreed medical evaluator
(AME) only applies to cases where there is a dispute relating
to those benefits.
6)Corrects an erroneous reference to the "plan" (a "health plan"
as defined in the Knox-Keene health care service plan law) in
the workers' compensation IMR law, and replaces that term with
"employer."
7)Corrects an erroneous Labor Code citation in the provision
SB 375
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that establishes WCAB authority to handle liens outside of the
regular workers' compensation adjudicatory process.
8)Corrects an erroneous cross-reference to the Civil Code's
definition of personal medical information on the provision
governing limitations on the medical information that a lien
claimant for medical bills can obtain concerning the injured
worker.
EXISTING LAW :
1)Authorizes the DWC to establish a program to certify
interpreters for administrative hearings and medical
examinations.
2)Authorizes a QME to evaluate an injured worker to make
recommendations concerning "medical-legal" issues that affect
the benefits that may be owed to the injured worker in the
workers' compensation system, including permanent disability
benefits.
3)Establishes an independent medical review (IMR) system to
resolve medical disputes in the workers' compensation system,
patterned after the IMR process used for health insurance
disputes, and prohibits a physician who is a QME from also
serving as an independent medical reviewer.
4)Prohibits the filing of a declaration of readiness to proceed
to hearing on permanent disability matters unless both the
treating physician and either a QME or AME has evaluated the
injured worker.
5)Authorizes medical providers to file a lien in the event of a
dispute over medical services provided to an injured worker,
and authorizes the WCAB to resolve any disputes concerning
liens in separate proceedings from the proceedings on the
underlying workers' compensation claim.
FISCAL EFFECT : Unknown. The bill is not tagged "fiscal."
COMMENTS :
1)Purpose . The purpose of SB 375 is to enact a number of
technical clean-up provisions to SB 863 (De Leon), Statutes
2012, Chapter 363, which enacted a major workers' compensation
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reform package last year. The provisions of SB 375 are
intended to be only those clearly technical drafting mistakes
that commonly occur in a 160 page bill.
2)Related Legislation . SB 258 (Lieu) is also before the
Assembly Insurance Committee, and contains other potential
clean-up provisions to SB 863. However, the provisions in SB
258 did not meet the "clearly technical drafting mistakes"
standard for inclusion in this Labor and Industrial Relations
Committee bill.
REGISTERED SUPPORT / OPPOSITION :
Support
None received.
Opposition
None received.
Analysis Prepared by : Mark Rakich / INS. / (916) 319-2086