BILL ANALYSIS                                                                                                                                                                                                    �



                                                                AB 1155
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        ASSEMBLY THIRD READING
        AB 1155 (Alejo, et al.)
        As Amended April 26, 2011
        Majority vote 

         INSURANCE           8-4                                          
         
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        |Ayes:|Solorio, Charles          |     |                          |
        |     |Calderon, Carter, Feuer,  |     |                          |
        |     |Hayashi, Skinner Torres,  |     |                          |
        |     |Wieckowski                |     |                          |
        |     |                          |     |                          |
        |-----+--------------------------+-----+--------------------------|
        |Nays:|Hagman, Grove, Miller,    |     |                          |
        |     |Olsen                     |     |                          |
        |     |                          |     |                          |
         ----------------------------------------------------------------- 
         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 worker's 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 








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          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 
          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 keyed as a non-fiscal bill, the 
        employer opponents raise concerns that the bill could have the 
        effect of increasing costs by hampering the ability of an employer, 
        including the state, to prevail in apportionment cases.
         
        COMMENTS  :  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.  

        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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        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.

        In 2008, SB 1115 (Migden), and in 2010, SB 145 (DeSaulnier), 
        addressed the apportionment discrimination issue in virtually the 
        same language as this bill.  Each was vetoed by the Governor.  The 
        veto message to SB 1115(Migden) 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 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.


         Analysis Prepared by  :    Mark Rakich / INS. / (916) 319-2086FN: 
        0000369










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