BILL ANALYSIS �
AB 1454
Page 1
Date of Hearing: March 28, 2012
ASSEMBLY COMMITTEE ON INSURANCE
Jose Solorio, Chair
AB 1454 (Solorio) - As Introduced: January 9, 2012
SUMMARY : Authorizes certain audiologists to be qualified
medical evaluators (QMEs) in the workers' compensation system.
Specifically, this bill :
1)Provides that an audiologist who holds a doctoral degree in
audiology, and who has five years post-doctoral experience in
the practice of audiology, may apply to the Administrative
Director (AD) of the Division of Workers' Compensation (DWC)
to be a QME, if he or she passes the examination required of
all QME applicants.
2)Requires an audiologist QME to use a diagnosis made by a
physician when preparing a QME report.
3)Adds audiologist QMEs to the section of the workers'
compensation law that defines which health care professions
are considered "physicians" for workers' compensation
purposes.
4)Prohibits an audiologist authorized to be a "physician" under
the workers' compensation law from advertising or holding his
or herself out as a physician.
EXISTING LAW
1)Provides that a person who meets specified criteria in the
Business and Professions Code, including holding a masters
degree in audiology, may be licensed as, and perform the
functions of, an audiologist, as defined.
2)Authorizes the AD to appoint QMEs, who meet specified criteria
and pass an examination, to perform medical-legal evaluations
to resolve medical-legal issues in the workers' compensation
system.
3)Provides that physicians and surgeons, psychologists,
acupuncturists, optometrists, dentists, podiatrists, and
chiropractors are "physicians" as that term is used in the
workers' compensation law, and therefore eligible to be
AB 1454
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appointed as QMEs.
4)Specifies that these health care providers can only provide
services that are within their defined scope of practice.
5)Provides that a QME be able to conduct an evaluation to
determine compensability of a disputed medical issue,
including course of treatment and causation, and evaluate
whether or not the injury causes a permanent disability.
FISCAL EFFECT : Minor costs to the Department of Industrial
Relations.
COMMENTS :
1)Purpose. According to the author, audiologists are qualified
to perform the QME functions in cases that involve hearing
loss. They argue that other allied health care professionals
are already allowed, within their specialized areas, to
perform QME functions, and that there is no reason to preclude
audiologists from performing this function in their area of
expertise.
2)Use of the term "physician". In general, only medical doctors
- "physicians and surgeons" with M.D. or D.O. degrees who are
licensed by the medical board or the osteopathic medical board
- are authorized to use the term "physician." Many
professions may use the term "doctor," but the "physician"
designation has been reserved to medical doctors to avoid
confusion. The workers' compensation law, for unclear
historical reasons, uses the term "physician" to describe the
range of health care providers who provide treatment to
injured workers. As a result, care is taken in the workers'
compensation law to ensure that this broader policy is not
undermined by non-physician practitioners listed as lawful
workers' compensation providers.
3)Support. Supporters (audiology professional associations)
generally make a fairness argument, noting that other
providers who are no better trained in their respective
specialties are already allowed to be QMEs. They additionally
argue that the bill benefits injured workers by ensuring their
cases can be evaluated by a professional who is specially
trained in hearing and hearing loss cases. In addition,
supporters point to increased hearing-related issues
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associated with an aging workforce, and suggest that
increasing the number of hearing specialists able to
participate in the evaluation process will be beneficial.
4)Prior legislation. SB 577 (Wiggins) from 2007 proposed, in
the form it went to the Governor, the same provisions as in
this bill. SB 577 was vetoed by Governor Schwarzenegger. The
veto message provides:
"This bill would allow audiologists to issue qualified medical
evaluator (QME) reports relative to workers' compensation
claims.
Although SB 557 would allow audiologists to issue a QME
report, it would still require the final diagnosis to be made
by a physician as audiologists are not able to render
disability determinations in the workers' comp system. This
could result in unnecessary delays for injured workers and
increased costs to the system by delaying prompt resolution of
claims. In addition, the proponents of this measure have not
demonstrated an unmet need for evaluating hearing loss in the
workers' comp system.
For these reasons, I am unable to sign this bill."
Support
California Academy of Audiology
California Speech-Language Hearing Association
Opposition
None received.
Analysis Prepared by : Mark Rakich / INS. / (916) 319-2086