BILL ANALYSIS                                                                                                                                                                                                    �



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          ASSEMBLY THIRD READING
          AB 1155 (Alejo, Roger Hern�ndez and Lara) 
          As Amended  May 9, 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 
            compensates the injured worker based on the percentage to which 







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            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) 319-2086  FN: 
          0000559  
           










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