BILL ANALYSIS                                                                                                                                                                                                    �






                 Senate Committee on Labor and Industrial Relations
                                 Ted W. Lieu, Chair

          Date of Hearing: July 6, 2011                2011-2012 Regular 
          Session                              
          Consultant: Gideon L. Baum                   Fiscal:No
                                                       Urgency: No
          
                                  Bill No: AB 1155
                                    Author: Alejo
                                Version: May 9, 2011
          

                                       SUBJECT
          
                               Workers' compensation.


                                      KEY ISSUE

          Should the Legislature prohibit discrimination in the 
          apportionment of industrial disabilities?
          

                                       PURPOSE
          
          To bar the consideration of race, national origin, gender, sex, 
          genetic predisposition, and certain other factors in the 
          determination of an apportionment of the causes of an industrial 
          disability.



                                      ANALYSIS
          
           Existing law  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 the 
          Department of Industrial Relations to self-insure or by securing 
          insurance against liability from an insurance company duly 
          authorized by the state.  
           
           Existing law  requires that a physician examine an injured 
          employee and, and when determining permanent percentages of 









          permanent disability, the physician must take into account the 
          nature of the physical injury or disfigurement, the occupation 
          of the injured employee, and his or her age at the time of the 
          injury, with consideration being given to an employee's 
          diminished future earning capacity.  (Labor Code �4660)

           Existing law  requires that a physician make an "apportionment 
          determination" with respect to the permanent disability.  In 
          order to do this, the physician must find (a) what approximate 
          percentage of the permanent disability is caused by the direct 
          result of the injury arising out of and in the course of 
          employment, and (b) what approximate percentage of the permanent 
          disability is caused by other factors both before and subsequent 
          to the industrial injury.  The employer is only liable for the 
          percentage of permanent disability caused by injury arising out 
          of and in the course of employment.  (Labor Code �� 4663 and 
          4664)

           Existing law  provides that no person in the State of California 
          shall, on the basis of race, national origin, ethnic group 
          identification, religion, age, sex, sexual orientation, color, 
          or disability, be unlawfully denied full and equal access to the 
          benefits of, or be unlawfully subjected to discrimination under, 
          any program or activity that is conducted, operated, or 
          administered by the state or by any state agency, is funded 
          directly by the state, or receives any financial assistance from 
          the state.  (Government Code �11135)

           This bill  would prohibit race, religious creed, color, national 
          origin, age, gender, marital status, sex, sexual orientation, or 
          genetic characteristics from being considered  a cause or other 
          factor of disability  with regard to any apportionment 
          determination.

           This bill  would also make findings on federal and state laws on 
          discrimination, previous reductions and denials in workers' 
          compensation benefits that would normally be prohibited in a 
          work environment as discriminatory, and declare the intent of 
          the Legislature to enact legislation to apply existing workplace 
          discrimination protections to workers' compensation benefits.


          Hearing Date:  July 6, 2011                              AB 1155  
          Consultant: Gideon L. Baum                               Page 2

          Senate Committee on Labor and Industrial Relations 
          








                                      COMMENTS

          
          1.  Need for the Bill?  

            AB 1155 seeks to address is the issue of apportionment on the 
            basis of "risk factors" - such as age, race, sex, and genetic 
            predisposition - rather than basing the apportionment on 
            actual documented and evaluated evidence of pre-existing 
            medical condition.  This practice has been documented in the 
            media and by the supporters of this bill.   

            For example, Dean Calbreath, in a February 17, 2008 article in 
            the San Diego Union Tribune, cited a number of similar 
            instances of improper apportionment procedures.  He 
            highlighted one case where a medical examiner cut a man's 
            workers' compensation payments in half because, as an 
            African-American, he had a "genetic" predisposition to high 
            blood pressure or hypertension.  

            Other examples Calbreath included:

             a)   In January of 2008, medical examiners at Kaiser 
               Permanente in San Diego cut down a food service worker's 
               claims for carpal tunnel syndrome because she had several 
               pre-existing conditions, including "being female." In the 
               past several years, medical examiners in other locales have 
               cited "female gender" as a reason for cutting carpal tunnel 
               claims, since women statistically report more problems than 
               men. 

             b)   In March of 2007, a medical examiner in Torrance 
               disallowed a portion of a cleaning woman's claims that her 
               work-related back injury had resulted in depression. The 
               examiner's reasons for slimming down the claim included 
               that she was a woman from Central America. "She's from El 
               Salvador and she is, as the pronoun indicates, a woman," 
               the examiner said in a deposition. "She has a personality 
               disorder, which sadly might apply to all too many women. 
               And I must say, when it comes to Central America, it might 
               apply to more men than I would care to mention." 

          Hearing Date:  July 6, 2011                              AB 1155  
          Consultant: Gideon L. Baum                               Page 3

          Senate Committee on Labor and Industrial Relations 
          








            The supporters of this bill have also provided the Committee 
            letters where counsel for an employer requested that the 
            doctor selected through the Panel Qualified Medical Examiner 
            (PQME) process address if the fact that the employee was 
            African American may have contributed to his diabetes and 
            hypertension. 

          2.  Legislative and Legal Background:

            In 2004, the Legislature passed SB 899 (Poochigian), which 
            completely overhauled the workers' compensation system.  As 
            part of the overhaul, SB 899 brought in the concept of 
            apportionment, which was discussed above.  Prior to SB 899, 
            "�a]pportionment �was] justified only if the Board �found] 
            that part of the disability would have resulted from the 
            normal progress of the underlying nonindustrial disease."  
            (Pullman Kellogg v. WCAB (1980), as cited in Vaira v. WCAB 
            (2007), 9 WCAB Rptr. 10,371)(Vaira).  

            The Legislature changes to apportionment were recognized by 
            the State Supreme Court in Brodie v. Workers' Comp. Appeals 
            Bd. (2007) 40 Cal.4th 1313.  In that case, the Court found 
            that "�f]ormer section 4750 required consideration of the new 
            injury `by itself and not in conjunction with or in relation 
            to the previous disability or impairment' and further called 
            for compensation for the later injury to be determined `as 
            though no prior disability or impairment had existed.' But 
            under Senate Bill No. 899 (2003-2004 Reg. Sess.), the new 
            approach to apportionment is to look at the current disability 
            and parcel out its causative sources - nonindustrial, prior 
            industrial, current industrial - and decide the amount 
            directly caused by the current industrial source. This 
            approach requires thorough consideration of past injuries, not 
            disregard of them." (Id. at p. 1328., as cited in Vaira)  
            (Emphasis added)

            In the same year, the California Court of Appeals issued an 
            unwritten decision on the appropriateness of apportioning on 
            the basis of risk factors, such as such as age, race, sex, and 
            genetic predisposition.  In Vaira, the petitioner accused the 
            doctor of apportioning a 73 year old injured worker's 
            permanent disability award on the basis of the injured 
          Hearing Date:  July 6, 2011                              AB 1155  
          Consultant: Gideon L. Baum                               Page 4

          Senate Committee on Labor and Industrial Relations 
          








            worker's age and osteoporosis.  While the Court side-stepped 
            the issue of if the doctor actually did this, it did weigh in 
            on if such an apportionment was legal.

            Early on in the decision, the Court found that "�t]he short 
            answer to this contention is that? we conclude the WCAB may 
            not use risk factors of injury in apportioning disability."  
            (Emphasis in original)  The court continued "The  WCAB may not 
            reduce petitioner's benefits simply because she is older than 
            another similarly situated worker  ?. To the extent osteoporosis 
            or some other physical or mental condition that might 
            contribute to a work-related disability arises or becomes more 
            acute with age, we see no problem with apportioning disability 
            to that condition." (Underline added)

            In short, the Vaira court found apportionment must occur when 
            real contributing medical conditions are found, but not on the 
            basis of risk factors not rooted in a demonstrable condition.

          3.  Disparate Impact and the Vaira Decision:  

            The court also explored other issues surrounding apportionment 
            and federal and state anti-discrimination.  Specifically, the 
            issue of disparate impact, which is a concept found in both 
            federal and state anti-discrimination law where a policy may 
            be illegal if it has a disproportionate impact on a protected 
            class.  

            One of the Amici in the case, the Impact Fund, argued that 
            apportionment on the basis of osteoporosis created a disparate 
            impact, as it disproportionately impacts women.  As such, 
            Impact Fund argued that apportioning on the basis of factors 
            such as osteoporosis, "even where those factors contribute to 
            disability rather than injury, violates �Government Code] 
            section 11135."

            Here the court found that: 

            "assuming such disparate impact exists, we disagree? that this 
            establishes a violation of �Government Code] section 11135. 
             Reducing permanent disability benefits based on a preexisting 
            condition that is a contributing factor of disability is not 
          Hearing Date:  July 6, 2011                             AB 1155  
          Consultant: Gideon L. Baum                               Page 5

          Senate Committee on Labor and Industrial Relations 
          








            discrimination.  When the WCAB determines a preexisting 
            condition contributes to a given disability, and apportions 
            accordingly,  this is merely a recognition that a portion of 
            the disability exists independent of the industrial injury.  "  
            (Emphasis and Underline added)

            As such, the Vaira decision appears to foreclose the use of a 
            disparate impact argument when challenging an apportionment of 
            disability benefits due to medical conditions that 
            disproportionately impact a protected class.  Rather, the 
            apportionment of an individual injured worker's medical 
            condition, irrespective of their membership in a protected 
            class, is lawful if it might contribute to a work related 
            disability.

          4.  The Status of Vaira under AB 1155: 

            As currently written, AB 1155 does not make an explicit 
            reference to Vaira and appears to overturn several aspects of 
            the decision.  While AB 1155 codifies Vaira's prohibition of 
            the use of membership in a protected class as a factor of 
            disability, the addition of "cause" complicated Vaira and 
            apportionment generally.  As was discussed above, 
            apportionment on the basis of a preexisting condition that can 
            be documented as contributing to an industrial's disability is 
            not discrimination under Vaira.  Would an individual's age or 
            gender be considered a "cause" of osteoporosis or a similar 
            condition which contributes to the occupational injury?  If 
            that was so, the requirement in Labor Code � 4663(c) for the 
            physician's report to factors outside of the industrial injury 
            would require the physician to make such a conclusion, which 
            may prove to be a difficult proposition.

            Also of note are the legislative findings and declarations 
            which would apply discrimination law to the workers' 
            compensation system.  This seems to suggest the availability 
            of a disparate impact argument when discussing apportionment.  
            As such, any preexisting condition for which apportionment 
            would create a disproportionate impact on any protected class 
            could be prohibited from being considered.

          5. Proponent Arguments  :
          Hearing Date:  July 6, 2011                              AB 1155  
          Consultant: Gideon L. Baum                               Page 6

          Senate Committee on Labor and Industrial Relations 
          








            
            Proponents argue that before SB 899 (Poochigian) of 2004, 
            employers could not penalize an injured worker for a 
            pre-existing condition if it did not impair the worker's 
            ability to do his or her job.  Since SB 899, however, 
            proponents reports that apportionment has occurred on the 
            basis of risk factors, such as race, gender, or age, 
            regardless of symptoms or if the risk factors had any affected 
            the ability of an individual to do his or her job.  Proponents 
            believe that AB 1155 will bring the workers' compensation 
            apportionment process in line with federal and state 
            anti-discrimination law, and ensure that the apportionment 
            process can continue without penalizing workers on the basis 
            of discriminatory risk factors. 

          6.  Opponent Arguments  :

            Opponents of this measure have taken a 'oppose unless amended' 
            position.  Opponents argue that apportionment is a 
            "long-standing concept intended to protect employers from 
            being forced to pay for disability that is not directly caused 
            by an industrial injury.  There is currently nothing in the 
            Labor Code that allows for discrimination based on protected 
            classes when adjusting the worker's compensation disability 
            rating."  Opponents also argue that case law demonstrates that 
            courts do not uphold apportionment based on discrimination.  

            For this reason, opponents are requesting amendments to the 
            bill to strike the intent language and delete the words "cause 
            or other".

          7.  Prior Legislation :

            SB 145 (DeSaulnier) of 2010 was identical to this bill.  It 
            was vetoed by Governor Schwarzenegger.

            SB 1115 (Migden) of 2008 would have barred the consideration 
            of race, national origin, gender, sex, genetic predisposition, 
            and certain other factors in the determination of an 
            apportionment of the causes of an industrial disability.  It 
            was vetoed by Governor Schwarzenegger.

          Hearing Date:  July 6, 2011                              AB 1155  
          Consultant: Gideon L. Baum                               Page 7

          Senate Committee on Labor and Industrial Relations 
          








            SB 899 (Poochigian), Chapter 34, Statutes of 2004, was 
            discussed above.
          

                                       SUPPORT
          
          CA Conference Board of the Amalgamated Transit Union
          CA Conference of Machinists
          CA Official Court Reporters Association
          California Labor Federation, AFL-CIO
          California Nurses Association
          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
          UNITE HERE!
          United Food and Commercial Workers-Western States Conference
          Utility Workers Union of America, Local 132
          

                                     OPPOSITION
          
          Acclamation Insurance Management Services (Unless Amended)
          Allied Managed Care (Unless Amended)
          Association of California Insurance Companies (Unless Amended)
          California Association of Joint Powers Authorities (Unless 
          Amended)
          California Chamber of Commerce (Unless Amended)
          California Coalition of Workers' Compensation (Unless Amended)
          California Farm Bureau Federation (Unless Amended)
          California Grocers Association (Unless Amended)
          California Hospital Association (Unless Amended)
          California Independent Grocers Association (Unless Amended)
          California Manufacturers & Technology Association (Unless 
          Amended)
          California Restaurant Association (Unless Amended)
          California Retailers Association (Unless Amended)
          California Trucking Association (Unless Amended)
          County of Los Angeles
          Marriott (Unless Amended)
          Property Casualty Insurers Association of America (Unless 
          Hearing Date:  July 6, 2011                              AB 1155  
          Consultant: Gideon L. Baum                               Page 8

          Senate Committee on Labor and Industrial Relations 
          








          Amended)
          Safeway (Unless Amended)
          UPS, Inc. (Unless Amended)
          Western Growers (Unless Amended)
          Workers' Compensation Action Network (Unless Amended)




































          Hearing Date:  July 6, 2011                              AB 1155  
          Consultant: Gideon L. Baum                               Page 9

          Senate Committee on Labor and Industrial Relations