BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | AB 1542|
|Office of Senate Floor Analyses | |
|(916) 651-1520 Fax: (916) | |
|327-4478 | |
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THIRD READING
Bill No: AB 1542
Author: Mathis (R) and Cooley (D)
AmendedIntroduced:4/23/15
Vote: 27 - Urgency
SENATE LABOR & IND. REL. COMMITTEE: 4-0, 8/24/15
AYES: Mendoza, Jackson, Leno, Mitchell
NO VOTE RECORDED: Stone
SENATE APPROPRIATIONS COMMITTEE: Senate Rule 28.8
ASSEMBLY FLOOR: 79-0, 7/16/15 (Consent) - See last page for
vote
SUBJECT: Workers'compensation: neuropsychologists
SOURCE: California Society of Industrial Medicine and
Rehabilitation
DIGEST: This bill permits the Division of Worker's Compensation
to appoint qualified clinical neuropsychologists as Qualified
Medical Examiners (QMEs).
ANALYSIS:
Existing law:
1)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
AB 1542
Page 2
the Department of Industrial Relations to self-insure or by
securing insurance against liability from an insurance company
duly authorized by the state.
2)Requires that the administrative director (AD) appoints
qualified medical evaluators (QMEs) in each of the respective
specialties as required for the evaluation of medical-legal
issues. In order to be appointed as a QME, the applicant must
pass a written examination and meet additional requirements
specific to each specialty.
a) For medical doctors or doctors of osteopathy, the
applicant must:
i) Be board certified in a specialty by a board
recognized by the AD and either the Medical Board of
California or the Osteopathic Medical Board of
California; or
ii) Have successfully completed a residency training
program accredited by the Accreditation Council for
Graduate Medical Education (ACGME) or the osteopathic
equivalent.
b) For psychologists, the applicant must:
i) Be board certified in clinical psychology by a board
recognized by the AD; or
ii) Hold a doctoral degree in psychology, or a doctoral
degree deemed equivalent for licensure by the Board of
Psychology from a university or professional school
recognized by the AD and has not less than five years'
postdoctoral experience in the diagnosis and treatment of
emotional and mental disorders; or
iii) Has not less than five years' postdoctoral
experience in the diagnosis and treatment of emotional
and mental disorders, and has served as an agreed medical
evaluator on eight or more occasions prior to January 1,
1990. (Labor Code §139.2)
This bill:
1)Permits a medical doctor to be appointed as a QME if his or
her residency training program was certified by a predecessor
to the ACGME.
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2)Permits the appointment of a clinical neuropsychologist as a
QME if:
a) The clinical neuropsychologist is certified by the
American Board of Clinical Neuropsychology, the American
Board of Professional Neuropsychology, or another
organization recognized by the AD, or was appointed as a
qualified medical evaluator in neuropsychology before
January 1, 2015; or
b) The clinical neuropsychologist is licensed to practice
psychology in this state who has a doctoral degree in
psychology from an accredited university or college
training program, has completed an internship or its
equivalent in a clinically relevant area of professional
psychology, and has at least two years of experience and
specialized training, at least one year of which is at the
post-doctoral level in the study and practice of clinical
neuropsychology and related neurosciences under the
supervision of a clinical neuropsychologist.
3)Provides that the bill is an urgency measure, to take effect
immediately.
Comments
1)QMEs and Medical-Legal Disputes: As was noted above,
Qualified Medical Examiners (QMEs) are medical examiners who
have taken an exam and met certain specific requirements that
are authorized to conduct an evaluation of medical-legal
issues. Medical-legal does NOT refer to if an injured worker
will or will not receive medical treatment. Rather,
medical-legal relates to the legal consequences of medical
conditions, frequently the extent to which an injured
employee's injuries or conditions are disabling, or whether
the injuries or conditions have become permanent and
stationary.
When there is a medical-legal dispute, a party can request
appointment of a QME. The requesting party specifies what
sort of expertise is needed to resolve the dispute, and the
DWC appoints a panel, from which a single QME is selected. If
both parties can agree to a single medical examiner, than the
agreed upon doctor, known as an Agreed Medical Evaluator
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(AME), is used instead of the QME panel to resolve the
Medical-legal issues.
Until recently, Clinical Neuropsychologists were included as
being eligible for selection as QMEs. Generally, Clinical
Neuropsychologists were selected for their expertise in cases
involving head trauma. For reasons discussed below, that is no
longer the case. However, Clinical Neuropsychologists may
still be selected as AMEs.
2)AB 1542 and Clinical Neuropsychologists as QMEs: According to
the American Neuropsychiatric Association (ANPA), clinical
neuropsychology is distinct from traditional psychology due to
the focus on understanding brain function. The ANPA states:
"A clinical neuropsychologist usually holds an
advanced degree in clinical psychology (Ph.D.,
Psy.D.), and has completed a clinical internship
and specialized post-doctoral training in clinical
neuropsychology. What distinguishes a clinical
neuropsychologist from other clinical
psychologists is knowledge of the brain, including
an understanding of areas such as neuroanatomy and
neurological disease?. They use neuropsychological
tests to assess cognitive deficits, and they are
involved in the management, treatment and
rehabilitation of cognitively impaired patients."
As noted above, the DWC may only certify a psychologist if the
psychologist is board certified by the Board of Psychology or
a board recognize by the DWC. Currently, Clinical
Neuropsychology is not a recognized specialty by the Board of
Psychology. Despite this, the DWC recognized Clinical
Neuropsychologists as QMEs until recent regulations removed
Clinical Neurologists from the list of potential QMEs. While
this decision brought the QME regulations in line with
statute, it was met with disappointment from some
stakeholders.
AB 1542 returns the QME process to the prior status quo,
allowing clinical neuropsychologists to be appointed as QMEs.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:YesLocal: No
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SUPPORT: (Verified8/24/15)
California Society of Industrial Medicine and Rehabilitation
(source)
Brain Injury Coalition of California
California Conference of Machinists
California Neurology Society
California Psychological Association
California Society of Physical Medicine and Rehabilitation
Californian Applicants' Attorney Association
2 individuals
OPPOSITION: (Verified8/24/15)
California Department of Industrial Relations
ARGUMENTS IN SUPPORT: Proponents note that, until recently,
clinical neuropsychologists were eligible for appointment as
QMEs. Proponents further note that clinical neuropsychologists
are trained in understanding neuro-diseases and neuro-anatomy,
differentiating neuropsychologists from traditional
psychologists. Proponents argue that neuropsychologists are
needed to evaluate a number of serious head and brain injuries
including penetrating brain injuries, anoxia/Hypoxia, Diffuse
Axonal Injury, and Coup-contrecoup injuries. Proponents also
argue that denying injured workers access to neuropsychologists
as QMEs will require traditional psychologists serving as QMEs
to contact clinical neuropsychologists in order to adequately
perform their duties as a QME, creating unnecessary delay and
cost for injured workers and employers.
ARGUMENTS IN OPPOSITION: The Department of Industrial
Relations (DIR) respectfully opposes AB 1542. Specifically, DIR
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notes that it is the Administrative Director's policy to
recognize only specialty boards that are recognized by one of
the state's professional licensing boards, such as the
California Board of Psychology, as licensing boards have the
requisite professional background and expertise to evaluate and
identify subspecialties as appropriate. DIR notes that the
Administrative Director has proposed regulations on QMEs
enacting this policy so as to be consistent across all
disciplines. DIR also notes concern because the California
Board of Psychology does not recognize neuropsychology as a
subspecialty in psychology. As a result, DIR argues that AB
1542 would contravene the Division's proposal and would also
undermine DWC's current policy of applying uniform criteria for
QME specialty certification that meet professional standards
accepted by the wider lay and professional communities.
ASSEMBLY FLOOR: 79-0, 7/16/15
AYES: Achadjian, Alejo, Travis Allen, Baker, Bigelow, Bloom,
Bonilla, Bonta, Brough, Brown, Burke, Calderon, Campos, Chang,
Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle,
Daly, Dodd, Eggman, Frazier, Beth Gaines, Gallagher, Cristina
Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez, Gray,
Grove, Hadley, Harper, Roger Hernández, Holden, Irwin, Jones,
Jones-Sawyer, Kim, Lackey, Levine, Linder, Lopez, Low,
Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin,
Nazarian, Obernolte, O'Donnell, Olsen, Patterson, Perea,
Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas, Santiago,
Steinorth, Mark Stone, Thurmond, Ting, Wagner, Waldron, Weber,
Wilk, Williams, Wood, Atkins
NO VOTE RECORDED: Gordon
Prepared by:Gideon L. Baum / L. & I.R. / (916) 651-1556
8/31/15 22:14:42
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