AB 305, as amended, Gonzalez. Workers’ compensation: permanent disability apportionment.
Existing workers’ compensation law generally requires employers to secure payment of workers’ compensation, including medical treatment, for injuries incurred by their employees that arise out of, or in the course of, employment. An employer is liable only for the percentage of the permanent disability directly caused by the injury arising out of, and occurring in the course of, employment.
Existing law requires apportionment of permanent disability to be based on causation, and a physician who prepares a report addressing the issue of permanent disability due to a claimed industrial injury is required to address the issue of causation of the permanent disability. The physician is required to make an apportionment determination by finding what approximate percentage of the permanent disability was caused by the direct result of injury arising out of and occurring in the course of employment, and what approximate percentage of the permanent disability was caused by other factors both before and subsequent to the industrial injury, including prior industrial injuries.
This bill would prohibit apportionment of permanent disability, in the case of a physical injury occurring on or after January 1, 2016, from being based on pregnancy,begin delete menopause, or osteoporosis causally related toend deletebegin insert orend insert menopause if the condition is contemporaneous with the claimed physicalbegin insert psychiatricend insert injury. The bill would also prohibit apportionment of permanent disability, in the case of a psychiatric injury occurring on or after January 1, 2016,
from being based on psychiatric disability or impairment caused by sexual harassment,begin delete pregnancy, menopause, or osteoporosis causally related toend deletebegin insert
pregnancy orend insert menopause if the condition is contemporaneous with the claimedbegin insert psychiatricend insert injury. The bill would also provide, notwithstanding any other law, for injuries occurring on or after January 1, 2016, that the impairment ratings for breast cancer and the aftereffects of the disease, known as sequelae, shall in no event be less than comparable ratings for prostate cancer and its sequelae.
Vote: majority. Appropriation: no. Fiscal committee: no. State-mandated local program: no.
The people of the State of California do enact as follows:
Section 4660.2 is added to the Labor Code, to
2read:
Notwithstanding any other law, for injuries occurring
4on or after January 1, 2016, the impairment ratings for breast cancer
5and its sequelae shall in no event be less than comparable ratings
6for prostate cancer and its sequelae.
Section 4663 of the Labor Code is amended to read:
(a) Apportionment of permanent disability shall be based
9on causation.
10(b) Any physician who prepares a report addressing the issue
11of permanent disability due to a claimed industrial injury shall in
12that report address the issue of causation of the permanent
13disability.
P3 1(c) (1) In order for a physician’s report to be considered
2complete on the issue of permanent disability, the report must
3include an apportionment determination.
4(2) (A) A
physician shall make an apportionment determination
5by finding what approximate percentage of the permanent disability
6was caused by the direct result of injury arising out of and
7occurring in the course of employment and what approximate
8percentage of the permanent disability was caused by other factors
9both before and subsequent to the industrial injury, including prior
10industrial injuries.
11(B) Apportionment in the case of a physical injury occurring
12on or after January 1, 2016, shall not be based onbegin delete anyend deletebegin insert either end insert of
13the following conditions if those conditions are contemporaneous
14
with the claimed physical injury:
15(i) Pregnancy.
16(ii) Menopause.
17(iii) Osteoporosis causally related to menopause.
end delete
18(C) Apportionment in the case of a psychiatric injury occurring
19on or after January 1, 2016, shall not be based on psychiatric
20disability or impairment caused by sexual harassment that is
21contemporaneous with the claimed psychiatric injury, or caused
22by any of the conditions listed in subparagraph (B) that are
23contemporaneous with the claimed psychiatric injury.
24(3) If the physician is unable to include an apportionment
25determination in his or her report, the physician shall state the
26specific reasons why the physician could not make a determination
27of the effect of a prior condition on the permanent disability arising
28from the injury. The physician shall then consult with other
29physicians or refer the employee to another physician from whom
30the employee is authorized to seek treatment or evaluation in
31accordance with this division in order to make the final
32determination.
33(d) An employee who claims an industrial injury shall, upon
34request, disclose all previous permanent disabilities or physical
35impairments.
36(e) Subdivisions (a), (b), and (c) shall not apply to injuries or
37illnesses
covered under Sections 3212, 3212.1, 3212.2, 3212.3,
P4 13212.4, 3212.5, 3212.6, 3212.7, 3212.8, 3212.85, 3212.9, 3212.10,
23212.11, 3212.12, 3213, and 3213.2.
O
94