BILL ANALYSIS                                                                                                                                                                                                    �



                                                                      



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          |SENATE RULES COMMITTEE            |                  AB 1168|
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                                 THIRD READING


          Bill No:  AB 1168
          Author:   Pan (D)
          Amended:  8/18/11 in Senate
          Vote:     21

           
           SENATE LABOR & INDUST. RELATIONS COMMITTEE :  6-0, 6/29/11
          AYES:  Lieu, Wyland, DeSaulnier, Leno, Padilla, Yee
          NO VOTE RECORDED:  Runner
           
          SENATE APPROPRIATIONS COMMITTEE  :  6-0, 8/15/11
          AYES:  Kehoe, Alquist, Emmerson, Lieu, Price, Steinberg
          NO VOTE RECORDED:  Walters, Pavley, Runner

           ASSEMBLY FLOOR  :  70-0, 5/12/11(Consent) - See last page for 
            vote


           SUBJECT  :    Workers compensation:  vocational expert fee 
          schedule

           SOURCE  :     Author


           DIGEST  :    This bill requires, by January 1, 2013, the 
          Administrative Director of the Division of Workers 
          Compensation to adopt a fee schedule that establishes 
          reasonable hourly fees paid for services provided by 
          vocational experts.  This bill prohibits a vocational 
          expert from being paid, and prohibits the Workers' 
          Compensation Appeals Board from allowing, vocational expert 
          fees in excess of those that are reasonable, actual, and 
          necessary.
                                                           CONTINUED





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           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 the administrative director of the 
          Division of Workers' Compensation (DWC) to adopt and 
          periodically revise an Official Medical Fee Schedule to 
          establish reasonable maximum medical fees for medical 
          services, including physician services and medical-legal 
          expenses. 

          This bill:

          1. Requires, by January 1, 2013, the Administrative 
             Director of the DWC to adopt a fee schedule that 
             establishes reasonable hourly fees paid for services 
             provided by vocational experts.  

          2. Prohibits a vocational expert from being paid, and 
             prohibits the Workers' Compensation Appeals Board from 
             allowing, vocational expert fees in excess of those that 
             are reasonable, actual, and necessary.

           Comments  

           Vocational Experts and Existing Fee Schedules  .  Currently, 
          the Labor Code is silent as to the fees for vocational 
          experts.  Prior to 2004, the Labor Code contained 
          vocational rehabilitation services provided by vocational 
          counselors.  They were covered by a fee schedule and their 
          services were cost contained through statute.  In 2004, the 
          Legislature passed SB 899 (Poochigian), Chapter 34, 
          Statutes of 2004, which completely overhauled the workers' 
          compensation system.  As part of that reform, the 
          vocational rehabilitation structure was dramatically 
          altered, eventually sun-setting in 2009.








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          As was discussed above, many medical professions have their 
          fees capped through a fee schedule.  These include 
          physicians, Qualified Medical Examiners (QME), Agreed 
          Medical Examiners (AME), chiropractors, and physical 
          therapists.  

          The same is true of medical-legal evaluations, which are 
          evaluations done by either a primary treating physician, 
          QME, or AME which is to develop a narrative medical report 
          for the purposes of proving or disproving a contested 
          medical fact or workers' compensation benefit.  These 
          evaluations usually include face to face visit(s) with the 
          injured worker, review of records, and addressing medically 
          complex issues, such as causation and apportionment.  

           Ogilvie and the Use of Vocational Experts  .  In 2009, the 
          WCAB found in  Ogilvie v. City and County of San Francisco  
          that permanent disability ratings were rebuttable.  This 
          successful rebuttal of the permanent disability rating was 
          successful in part due to the expert testimony and reports 
          provided by two certified vocational rehabilitation 
          counselors.  The  Ogilvie  case is currently being appealed, 
          and therefore the final details on how and when a permanent 
          disability rating can be disputed remain unclear, but the 
          use of vocational experts by injured workers and employers 
          to refute permanent disability rating findings is almost 
          certain to continue for the foreseeable future.

          This bill does not touch upon the issues raised in  Ogilvie 
          or any of the related cases.  Rather, this bill seeks to 
          provide a fee schedule to set maximum fees if and when a 
          vocational expert is used by either an injured worker or an 
          employer.  This would bring fee practices for vocational 
          experts in line with other workers' compensation services, 
          as well as historical norms.

           Prior Legislation  

          AB 228 (Alarcon), Chapter 639, Statutes of 2003, 
          establishes the existing fee schedule structure for medical 
          services.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes   
          Local:  No







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          According to the Senate Appropriations Committee:

                          Fiscal Impact (in thousands)

             Major Provisions         2011-12    2012-13     2013-14    Fund  

            Adoption of vocational          Up to $75          Up 
            to $75                          Special*
            services fee schedule

            * Workers' Compensation Administrative Revolving Fund
           
           SUPPORT  :   (Verified  8/18/11)

          Acclamation Insurance Management Services
          Allied Management care
          Alpha Fund
          Association of California Insurance Companies
          California Applicants' Attorneys Association
          California Association of Joint Powers Authorities
          California Chamber of Commerce
          California Coalition on Workers Compensation
          California Grocers Association
          California Joint Powers Authorities
          California Manufacturers & Technology Association
          California Special Districts Association
          California State Association of Counties
          CSAC Excess Insurance Authority
          League of California Cities

           OPPOSITION  :    (Verified  8/18/11)

          American Board of Vocational Experts
          Career Associates Inc. 
          Cascade Disability Management 
          Hall Associated Rehabilitation Consultants 
          International Association of Rehabilitation 
          Professionals/California Chapter 
          Work-Wise, Inc. 

           ARGUMENTS IN SUPPORT  :    Supporters note that fee schedules 
          are the norm in workers' compensation.  They also point out 
          that allowing the administrative director to adopt the 







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          schedule after public hearings, as opposed to adopting a 
          statutory schedule, provides the flexibility to adjust 
          compensation levels over time.  Delegation of this duty to 
          the administrative director is also common in the workers' 
          compensation system.  Employer supporters also note that 
          "�t]he imposition of fee schedules in workers' compensation 
          is an issue of fairness to employers.  More importantly, 
          controlling administrative costs in the workers' 
          compensation system ensures that workers' compensation 
          dollars are preserved for injured worker benefits."

           ARGUMENTS IN OPPOSITION  :    Opponents have taken an "oppose 
          unless amended" position, arguing that that this bill 
          places unreasonable and excessive burdens in place for 
          vocational experts to be paid appropriately.  Opponents 
          believe that the bill as currently written will make it 
          very difficult for a vocational expert to be appropriately 
          paid for services rendered, thereby hurting injured workers 
          and preventing them from receiving the expert testimony 
          they need.  Opponents request that: 
           
           1. The requirement that they only be paid upon their 
             testimony being found admissible be removed;

          2. That billing in excess of the medical the schedule be 
             allowed in the event of extraordinary circumstances, as 
             is currently allowed with medical-legal reports; and

          3. Revising the fee schedule requirement so that charging 
             at the fee schedule is considered prima facie evidence 
             that the fees are reasonable.


           ASSEMBLY FLOOR  :  70-0, 5/12/11 (Consent) 
          AYES:  Achadjian, Allen, Ammiano, Atkins, Beall, Bill 
            Berryhill, Block, Blumenfield, Bonilla, Bradford, 
            Brownley, Buchanan, Butler, Charles Calderon, Campos, 
            Carter, Chesbro, Cook, Davis, Dickinson, Donnelly, Eng, 
            Feuer, Fletcher, Fong, Fuentes, Furutani, Beth Gaines, 
            Galgiani, Gatto, Gordon, Grove, Hagman, Halderman, Hall, 
            Harkey, Hayashi, Hill, Huber, Hueso, Huffman, Jeffries, 
            Jones, Knight, Lara, Logue, Ma, Mansoor, Mendoza, Miller, 
            Monning, Morrell, Nestande, Nielsen, Norby, Olsen, Pan, 
            Perea, V. Manuel P�rez, Silva, Skinner, Smyth, Solorio, 







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            Swanson, Valadao, Wagner, Wieckowski, Williams, Yamada, 
            John A. P�rez
          NO VOTE RECORDED:  Alejo, Cedillo, Conway, Garrick, Gorell, 
            Roger Hern�ndez, Bonnie Lowenthal, Mitchell, Portantino, 
            Torres


          PQ:mw  8/18/11   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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