BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1155
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          Date of Hearing:   April 13, 2011

                           ASSEMBLY COMMITTEE ON INSURANCE
                                 Jose Solorio, Chair
                 AB 1155 (Alejo) - As Introduced:  February 18, 2011
           
          SUBJECT  :   Workers' compensation: apportionment: death benefits

           SUMMARY  :   Prohibits discrimination on the basis of specified 
          protected classes for purposes of apportioning permanent 
          disability.  Specifically,  this bill  :

          1)Prohibits discrimination on the basis of race, religious 
            creed, color, national origin, age, gender, marital status, 
            sex or genetic characteristics in the process of apportioning 
            medical causation for purposes of determining an employer's 
            liability for the permanent disability of an employee injured 
            on the job.

          2)Provides that a workers' compensation claim shall not be 
            denied because the workers' injury or death was related to one 
            of the protected classes noted above.

          3)Defines "genetic characteristics" by citation to the life and 
            health insurance anti-genetic discrimination law that has been 
            in effect and used by insurers for a number of years.

           EXISTING LAW  :

          1)Provides for a comprehensive system of workers' compensation 
            benefits for workers who are injured on the job, including 
            payments to compensate an injured worker for the permanent 
            disability caused by an on-the-job injury.

          2)Establishes a formula that is used to determine the extent of 
            permanent disability, which is expressed as a percentage, and 
            compensates the injured worker based on the percentage to 
            which he or she is permanently disabled.

          3)Allows a permanent disability to be "apportioned" to the 
            various causes of the disability so that an employer is only 
            liable for the portion of the disability attributable to 
            employment by that employer.

          4)Requires a physician, when making a report on permanent 








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            disability, to make an apportionment determination by 
            providing an approximation of the percentage of the disability 
            that is caused by the injury at work, and an approximation of 
            the percentage of the disability that is caused by other 
            factors, whether industrial or nonindustrial, and whether 
            occurring before or after the workplace injury. 

           FISCAL EFFECT  :   While this bill is tagged as a nonfiscal bill, 
          the employer opponents raise concerns that the apportionment 
          provisions, in particular, could have the effect of increasing 
          costs by hampering the ability of an employer, including the 
          state, to prevail in apportionment cases.

           

          COMMENTS :   

           1)Purpose:   According to the author, some physicians are making 
            discriminatory generalizations, rather than examining actual 
            medical conditions or facts, when they are carrying out the 
            mandate that they assign percentages to the various causes of 
            a permanent disability.  Specifically, the author seeks to 
            prevent physicians from using "risk factors" as opposed to 
            actual medical conditions, when making these apportionment 
            determinations.  

           2)Discrimination in apportionment:   Proponents point to several 
            examples of inappropriate discrimination in application of the 
            apportionment laws.  In an  unpublished  appellate decision, 
             Vaira  v.  WCAB  , the Court of Appeal returned a case to the 
            Workers' Compensation Appeals Board (WCAB) because the record 
            was insufficient to determine whether the physician had based 
            his apportionment decision on medical facts that showed the 
            older female claimant suffered from osteoporosis, or on the 
            basis that the risk factor alone was sufficient to assign a 
            percentage of the causation to osteoporosis.  Among the cases 
            reported in the media is a case of an African-American man who 
            had his permanent disability rating cut in half because of the 
            fact that African-American males have a higher incidence of 
            high blood pressure, and thus there was a genetic 
            predisposition to hypertension, aside from his workplace's 
            contribution to hypertension.  These scenarios, among numerous 
            other potential fact patterns, are examples of unfair 
            reductions in permanent disability ratings that the bill is 
            designed to remedy.








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           3)Should Section 1 of the bill be deleted  ?  Section 1 of the 
            bill proposes to add a prohibition against denying a claim 
            based on the usual protected classes.  This is the same 
            language that was in SB 145 (DeSaulnier) from last Session.  
            However, that issue was addressed by AB 1093 (Yamada), 
            Statutes 2010, Chapter 272, albeit with slightly different 
            language.  In the process of reintroducing a new version of 
            the vetoed SB 145, the portion that that bill that has already 
            been adopted was apparently inadvertently included.  As the 
            issue raised by this portion of the bill has already been 
            addressed, it may be appropriate to delete this portion of the 
            bill.

           4)Opposition:   The opponents do not disagree that discrimination 
            based on risk factors associated with the bill's protected 
            categories is wrong.  They respond, however, by arguing that 
            the law already provides protections, and the bill only serves 
            to open a Pandora's Box of problems.  Specifically, opponents 
            argue that the  Vaira  case proves that the law is not in need 
            of change.  The court essentially determined that it is 
            improper to use risk factors, and sent the case back to the 
            WCAB to make sure that medical facts supported the 
            apportionment.

          With respect to unintended consequences, the opponents believe 
            that the effect of the bill would be to prohibit apportionment 
            even when there is an actual preexisting condition, if that 
            condition is in some way connected to one of the protected 
            categories.  At a minimum, they are concerned that the bill 
            would generate unnecessary litigation.

           5)Prior legislation.   In 2008, SB 1115 (Migden), and in 2010, SB 
            145 (DeSaulnier), addressed the apportionment discrimination 
            issue in virtually the same language as AB 1155.  Each was 
            vetoed by the Governor.  The Veto Message to SB 1115 follows:

            I am returning Senate Bill 1115 without my signature.

            This bill is intended to provide that race, religious creed, 
            color, national origin, age, gender, marital status, sex, or 
            genetic predisposition shall not be considered a cause or 
            other factor of disability when determining apportionment of 
            disability for the purposes of workers' compensation.  While I 
            support the intent of this measure, I do not believe it is 








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            necessary.  Current law, as well as court rulings, adequately 
            protects injured workers from inappropriate application of 
            apportionment statutes.  In addition, I am concerned that the 
            manner in which this bill is worded could inadvertently create 
            new ambiguities in the law and result in increased litigation.

            For these reasons I am unable to sign this bill.

           REGISTERED SUPPORT / OPPOSITION  :

           Support  

          American Civil Liberties Union
          CA Conference Board of the Amalgamated Transit Union
          CA Conference of Machinists
          CA Official Court Reporters Association
          California Communities Untied Institute (CalComUI.)
          California Labor Federation
          California Nurses Association (CNA)
          California State Conference of the NAACP (National Association 
          for the Advancement of Colored People)
          California Teamsters Public Affairs Council
          Consumer Attorneys of California
          Engineers and Scientists of California
          International Longshore and Warehouse Union
          Professional and Technical Engineers, Local 21
          Public Counsel
          UNITE HERE!
          United Food and Commercial Workers - Western States Conference
          Utility Workers Union of America, Local 132

           Opposition
           
          Acclamation Insurance Management Services
          Allied Managed Care
          ALPHA Fund
          American Insurance Association (AIA)
          Association of California Insurance Companies
          California Association of Joint Powers Authorities
          California Chamber of Commerce 
          California Coalition on Workers' Compensation (CCWC)
          California Farm Bureau Federation
          California Hospital Association 
          California Independent Grocers Association
          California Manufacturers & Technology Association (CMTA)








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          California Restaurant Association
          California Retailers Association
          Liberty Mutual Insurance Group
          Marriott
          Property Casualty Insurers Association of America
          Spa & Pool Industry Education Council (SPEC)
          United Parcel Service (UPS)
          Western Growers
          Western Occupational and Environmental Medical Association 
          (WOEMA)  
          Workers' Compensation Action Network

           Analysis Prepared by :    Mark Rakich / INS. / (916) 319-2086