BILL ANALYSIS
Senate Committee on Labor and Industrial Relations
Richard Alarcon, Chair
Date of Hearing: January 14, 2004 2003-2004 Regular
Session
Consultant: Patrick W. Henning, Sr. Fiscal:No
Urgency:No
Bill No: SB 414
Author: McClintock
Version: As Introduced February 20, 2003
Subject:
Workers' compensation: objective medical findings
Purpose:
To revise the definition of a workers' compensation injury
to mean one which is certified by a physician using medical
evidence based on objective medical findings.
Analysis:
Existing law defines injury, for the purposes of workers'
compensation, to mean any injury or disease arising out of
the employment. When an injured worker seeks the care of a
medical provider for treatment of an occupational injury,
the medical provider must make an initial determination
regarding whether an injury exists, but not whether the
injury was work related. The latter determination, if in
dispute, is made by an administrative law judge of the
Division of Workers Compensation in the Department of
Industrial Relations.
Existing law generally provides that a medical provider's
evaluation be supported, to the extent possible, by medical
findings based on standardized examinations and testing
techniques generally accepted by the medical community.
Additionally, the method of measuring a disability is
required to be in accordance with the report of the Joint
Committee of the California Medical Association and
Industrial Accident Commission.
Among other things, medical providers are not limited to
consideration of objective findings alone in medical
determinations for the purposes of workers' compensation.
It is current practice for medical providers to use
subjective as well as objective evidence in making medical
determinations for workers' compensation purposes.
This Bill , redefines "injury" as it pertains to workers'
compensation to require certification by a physician using
"medical evidence based on objective medical findings."
Comments:
1. The sponsor of this measure, the California Chamber of
Commerce, argues that California businesses are being
harmed by out-of-control workers' compensation insurance
premium increases and the system must be reformed in
order to lower the costs of providing benefits for
injured workers.
The California Association for Health Services at Home
asserts that back injuries to home care workers are
common, and that this bill will help ensure that monetary
awards are based on injuries in the workplace.
2. Opponents state contend that a bill of this nature
will be more costly to employers in the long run because
injured workers will wait to report their occupational
injury until the pain has manifested itself into
something which can be quantified by objective medical
findings. Resultantly, permanent disability awards and
medical costs would increase.
The California Society of Industrial Medicine and Surgery
argues that the diagnosis of an injury involves a
combination of objective and subjective findings by the
physician. In fact, in many injuries there may be no
objective findings due to the current state of medicine.
They conclude that prohibiting the consideration of
Hearing Date: January 14, 2004 SB
414
Consultant: Patrick W. Henning, Sr.
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Senate Committee on Labor and Industrial Relations
subjective findings would have the effect of not
recognizing many valid occupational injuries, and would
lead to employers increased vulnerability to legal
action.
The California Applicants' Attorneys Association (CAAA)
asserts that this bill confuses "disability" with
"impairment," because disability refers to limitations on
the quality of life and the ability to compete in the
labor market and impairment refers to functional
limitations. CAAA argues that it is for this reason that
the American Medical Association has held that objective
medical findings are not appropriate for determining
disability.
3.Current Practice and Potential Impact . There are many
injuries or illnesses, which if
required to be diagnosed by objective findings alone,
might remain undiagnosed,
untreated and uncompensated. Examples of these are
strain injuries, brain
concussions, chemical exposures, psychiatric injuries
and all such injuries, which are
determined mostly by patient pain. A large majority
of back injuries, which comprise
one third of all workers' compensation injuries,
initially present themselves as pain to
the patient, but would be undetectable on an MRI.
Amending the definition of injury in this manner would
not only impact initial diagnoses, and initial
compensability determinations, but also would also impact
the permanent disability rating system, which takes into
account subjective complaints.
4. Commission on Health and Safety and Workers'
Compensation (CHSWC) /RAND
Study .
The RAND Corporation, under contract with CHSWC is
Hearing Date: January 14, 2004 SB
414
Consultant: Patrick W. Henning, Sr.
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Senate Committee on Labor and Industrial Relations
currently conducting an in-depth study of workers'
compensation permanent disability. The CHSWC/RAND study
proposes to include a review of increased reliance on
objective medical findings in disability ratings,
including the extent to which such an approach can
improve consistency and appropriate benefit disbursement.
Support:
California Chamber of Commerce (Sponsor)
Agricultural Council of California -Support in Concept
American Electronics Association
ARV Assisted Living
Association of California Water Agencies
Automotive Aftermarket Services, Inc.
Best Western South Coast Inn
Blue Banner Company, Inc.
BMW of North America
Brawley Chamber of Commerce
CA Agricultural Aircraft Association -Support in Concept
CA Assoc. of Nurseries & Garden Centers -Support in Concept
CA Beer and Beverage Distributors -Support in Concept
CA Citrus Mutual -Support in Concept
Ca Cotton Ginners Association -Support in Concept
CA Farm Bureau Federation -Support in Concept
CA Fig Institute -Support in Concept
CA Grocers Association -Support in Concept
CA Lodging Industry Association -Support in Concept
CA Plant Health Association -Support in Concept
CA Restaurant Association -Support in Concept
CA State Association of Counties -Support in Concept
Ca Women for Agriculture -Support in Concept
California Apartment Association
California Association for Health Services at Home
California Association of Independent Business, Inc.
California Association of Joint Powers Authorities
California Cut Flower Commission
California Landscape Contractors Association
Hearing Date: January 14, 2004 SB
414
Consultant: Patrick W. Henning, Sr.
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Senate Committee on Labor and Industrial Relations
California Manufacturers and Technology Association
California Retailers Association
California Sheet Metal and Air Conditioning Contractors
National Association
California Space Authority
Camarillo Chamber of Commerce
Camelot Furniture Corporation (Orange)
Carpenteria Chamber of Commerce
Cathy Martinez (Lompoc)
CB Richard Ellis Brokerage Services of Ventura
Chico Chamber of Commerce
Chocolates a la Carte
DAC International
Dr. Charles Durand
Eagle Road Service and Tire, Inc. (Riverside)
Eastern Municipal Water District
Engineering and Utility Contractors Association
Execuplan Full Service Executive Suite Offices
Family First out of Woodland Hills (with 17 individuals
from that company also adding
their name)
Gandrud Financial Services Corporation (Carpenteria)
Golden State Builders Exchanges
Goleta Chamber of Commerce
Goodwill Industries of Orange County
Hobbs Trucking Company
Industrial Mental Supply Co. (Sun Valley)
Insurance Agents and Brokers Legislative Council
Irvine Chamber of Commerce
Kristen Amyx, President/CEO, Goleta Valley Chamber of
Commerce
League of California Cities -Support in Concept
Liberty Mutual Group
Maximum Nursery (Carpenteria)
Milk Producers Council -Support in Concept
National Bank of California
Nat'l Federation of Independent Business -Support in
Concept
New United Motor Manufacturing, Inc.
Hearing Date: January 14, 2004 SB
414
Consultant: Patrick W. Henning, Sr.
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Senate Committee on Labor and Industrial Relations
Murrieta Chamber of Commerce
Murrill Forrester, Board Member, Goleta Valley Chamber of
Commerce
Natalie Peterson (Volt Services Group)
National Federation of Independent Business
Orange County Business Council
Perfect Promotional Products (Oxnard)
Piano City (Colton)
R and W Enterprises
Reetz, Fox and Barlett LLP
Roofing Contractors Association of California
Russell A. Goodman, Board Member, Goleta Valley Chamber of
Commerce
Sacramento Metropolitan Chamber of Commerce
SAI Spectrum Assembly, Inc.
Santa Barbara County Farm Bureau
Santa Barbara County Taxpayers Association
Santa Barbara Human Resources Association
Santa Barbara Industrial Association
Sares-Regis Group (Oxnard)
Schnadig Corporation
Select Personnel Services
Senderex Cargo Inc. out of LA
Small Business of America, Inc.
Steven Fedde, Board Member, Goleta Valley Chamber of
Commerce
Sun Valley Floral Farms
Sunrise Growers
TBS Teamwork Business Services, Inc. of Santa Maria
The Lafayette Company
Tulare Chamber of Commerce
United Agribusiness League
Ventura Chamber of Commerce
Volt Services Group (Abbi Dodds, Sacramento Manufacturing
and Logistics Division)
Volt Services Group (Angie Isais, Recruiting Coordinator)
Volt Services Group (Carla Moorehead)
Volt Services Group (Carmen Meeks)
Volt Services Group (Chad Garrison, Sacramento
Manufacturing and Logistics Division)
Hearing Date: January 14, 2004 SB
414
Consultant: Patrick W. Henning, Sr.
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Senate Committee on Labor and Industrial Relations
Volt Services Group (Costa Mesa)
Volt Services Group (Dolores Torres, Sacramento
Manufacturing and Logistics Division)
Volt Services Group (Donna Persson, Brea)
Volt Services Group (Hope Miller)
Volt Services Group (Jeff Barnett, Torrance)
Volt Services Group (Jeff Langenwalter, Brea)
Volt Services Group (Jessica Ortiz, Roseville)
Volt Services Group (Judy Fox, Anaheim branch)
Volt Services Group (Karen Brooks, Santa Barbara)
Volt Services Group (Kathi Rutherford)
Volt Services Group (Kathryn Rigney, Mission Viejo)
Volt Services Group (Kirk A. Martin, Santa Barbara)
Volt Services Group (Laura Lemmons, Santa Barbara)
Volt Services Group (Linda Shriffman, Los Angeles Branch
Manager)
Volt Services Group (Martin Boggs, Sacramento
Administrative and Accounting Div)
Volt Services Group (Mayra Carranza, Sacramento
Manufacturing and Logistics Div)
Volt Services Group (Michele Pagliar, Santa Claritai)
Volt Services Group (Rochelle Burge, Cerritos)
Volt Services Group (Salena Sweet-Robinson, Torrance)
Volt Services Group (Santa Barbara)
Volt Services Group (Sharon Barton, Regional Manager Santa
Barbara)
Volt Services Group (Sherrie Stanton, Anaheim)
Volt Services Group (Sherry Craig, Torrance)
Volt Services Group (Stormy Morris, Sacramento
Manufacturing and Logistics Division)
Volt Services Group (Tania Lewis, Pasadena)
Volt Services Group (Teri Mustol)
Volt Services Group (Tracie Haidle, Sacramento
Manufacturing and Logistics Division)
Volt Workforce Design (Chasin Scott, Menlo Park)
Volt Workforces Design (Alexis Macias, Roseville)
Volt Workforces Design (April Castro, Roseville)
Volt Workforces Design (Carmen Meeks, Roseville)
Volt Workforces Design (Marlee Leavitt, El Cajon)
Volt Workforces Design (Nicole Feltsen, Roseville)
Hearing Date: January 14, 2004 SB
414
Consultant: Patrick W. Henning, Sr.
Page 7
Senate Committee on Labor and Industrial Relations
Western Growers Association -Support in Concept
White Sands of La Jolla, The
William J. Clark, D.D.S., M.D.
Wollborg/Michelson Personnel Services, Inc. (San Francisco)
Opposition:
California Applicants' Attorneys Association
California Conference Board of the Amalgamated Transit
Union
California Conference of Machinists
California Independent Public Employees Legislative Council
California Labor Federation, AFL-CIO
California Medical Association oppose unless amended
California Psychiatric Association
California Society of Industrial Medicine and Surgery
California Teamsters Public Affairs Council
Consumer Attorneys of California
Engineers and Scientist of California, IFPTE Local 20,
AFL-CIO
Hotel Employees & Restaurant Employees International Union
Jockeys' Guild
Professional and Technical Engineers, IFPTE Local 21,
AFL-CIO
United Food & Commercial Workers Region 8 States Council
* * *
Hearing Date: January 14, 2004 SB
414
Consultant: Patrick W. Henning, Sr.
Page 8
Senate Committee on Labor and Industrial Relations