BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1687
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          ASSEMBLY THIRD READING
          AB 1687 (Fong)
          As Amended  March 12, 2012
          Majority vote 

           INSURANCE           9-3         APPROPRIATIONS      12-5        
           
           ----------------------------------------------------------------- 
          |Ayes:|Solorio, Bradford,        |Ayes:|Fuentes, Blumenfield,     |
          |     |Charles Calderon, Carter, |     |Bradford, Charles         |
          |     |Feuer, Hayashi, Skinner,  |     |Calderon, Campos, Davis,  |
          |     |Torres, Wieckowski        |     |Gatto, Hall, Hill, Lara,  |
          |     |                          |     |Mitchell, Solorio         |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Hagman, Beth Gaines,      |Nays:|Harkey, Donnelly,         |
          |     |Olsen                     |     |Nielsen, Norby, Wagner    |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Requires an employer or insurer to provide an 
          explanation of options for objecting to decisions to delay, deny 
          or modify medical treatment recommended by a treating physician, 
          and provides for compensation for attorneys in connection with 
          enforcing future medical treatment orders.  Specifically,  this 
          bill  :  

          1)Requires, in connection with a utilization review (UR) 
            decision to delay, deny or modify medical treatment 
            recommended by a treating physician, that an employer or 
            insurer include a clear and concise explanation of the 
            available options for objecting to the delay, denial or 
            modification.

          2)Requires the explanation to be in no less than 12-point bold 
            type on the first page of the communication to the injured 
            employee.

          3)Authorizes the payment of reasonable attorney's fees where a 
            dispute arises concerning medical treatment where there has 
            been an award of future medical treatment and the applicant 
            has employed an attorney to enforce his or her rights.

           EXISTING LAW  :









                                                                  AB 1687
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          1)Provides for a comprehensive system of workers' compensation 
            benefits for workers who are injured on the job, including 
            medical benefits.

          2)Establishes a formal process, known as UR, to resolve disputes 
            concerning the appropriateness of medical treatment being 
            recommended for an injured worker.

          3)Provides generally that attorneys representing injured workers 
            are paid as a percentage of the permanent disability award, 
            but does not expressly provide for compensation in 
            medical-only or in future medical cases.

           FISCAL EFFECT  :  According to the Assembly Appropriations 
          Committee, minor absorbable costs to the Department of 
          Industrial Relations.  Potentially minor increase of workers' 
          compensation insurance premiums due to the added costs 
          associated with the relatively few challenges to the relatively 
          few denials.

           COMMENTS  :   

           Purpose  .  According to the author, this bill is designed to 
          provide injured workers more information about how to navigate 
          the workers' compensation system in the event treatment 
          recommended by their treating physician is delayed, denied, or 
          modified, and to establish an appropriate incentive for 
          attorneys to take on "future medical" cases when the injured 
          worker requires the assistance of counsel.

           Future medical awards  .  It is common in a workers' compensation 
          case to enter into settlement agreements that resolve disability 
          and retraining and other issues, but leave future medical 
          benefits open.  This occurs when the parties are unable or 
          unwilling to make reasonable guesses about future medical needs. 
           That uncertainty, however, is not and should not be a barrier 
          to settlement of all other issues.  This is particularly true 
          when there is a recognition that future medical needs may last 
          for years or for a lifetime.

          It is unfortunately true that disputes can arise long after all 
          other matters have been resolved, often years after an attorney 
          has handled the case.  In these circumstances, it is frequently 
          difficult or impossible for an injured worker to find an 








                                                                  AB 1687
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          attorney to assist in enforcing the award.  If the employer or 
          insurer behavior is egregious enough, there is the potential 
          that attorney's fees can be taken from penalties imposed, but in 
          the usual case, there is no provision for attorney's fees.  This 
          bill is designed to address this issue.

           Opposition  .  Employers and insurers are opposed to the bill, 
          arguing that the additional notification requirements are unduly 
          complicating and costly additions to a UR system that is 
          performing a valuable function of preventing inappropriate 
          treatment that is not evidence-based, and which forces treating 
          physicians to practice evidence-based medicine because the 
          failure to provide proper documentation for treatment requests 
          will result in delays due simply to inadequate medical 
          information.  They point out that there are already enforcement 
          provisions for unreasonable delays, denials or modifications, 
          but that good faith use of the UR system should not be made more 
          costly and burdensome.  They argue that this bill creates more 
          frictional costs of the very sort we are trying to eliminate.

          With respect to the attorney's fees provision, they argue that 
          it will add costs to the system, and that the Division of 
          Workers' Compensation already has an Information and Assistance 
          Unit located in 24 places throughout California to help injured 
          workers in these sorts of cases.


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


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