BILL ANALYSIS                                                                                                                                                                                                    Ó






                 Senate Committee on Labor and Industrial Relations
                              Senator Ben Hueso, Chair

          Date of Hearing: April 9, 2014               2013-2014 Regular  
          Session                              
          Consultant: Gideon L. Baum                   Fiscal:No
                                                       Urgency: No
          
                                  Bill No: AB 1035
                                    Author: Perez
                        As Introduced/Amended: March 27, 2014
          

                                       SUBJECT
          
               Workers' compensation: firefighters and peace officers.


                                      KEY ISSUE

          Should the Legislature extend the timelines that limit a  
          dependent from filing for workers' compensation death benefits  
          if the deceased worker died of Cancer, Tuberculosis,  
          Methicillin-Resistant Staphylococcus aureus (MRSA) skin  
          infections, or a bloodborne infectious disease?


                                      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  creates a series of disputable presumptions of an  
          occupational injury for peace and safety officers for the  
          purposes of the workers' compensation system.  These  
          presumptions include:

                 Heart disease;
                 Hernias;
                 Pneumonia;









                 Cancer;
                 Meningitis;
                 Tuberculosis;
                 Methicillin-resistant Staphylococcus aureus (MRSA) skin  
               infections; and
                 Bloodborne infectious disease.

          The compensation awarded for these injuries must include full  
          hospital, surgical, medical treatment, disability indemnity, and  
          death benefits, as provided by workers compensation law.  These  
          presumptions tend to run for 5 to 10 years commencing on their  
          last day of employment, depending on the injury and the peace  
          officer classification involved.  (Labor Code §§3212 to 3213.2)

           Existing law  provides that the presumptions listed above are  
          disputable and may be controverted by evidence.  However, unless  
          controverted, the Workers' Compensation Appeals Board must find  
          is accordance with the presumption.  (Labor Code §§3212 to  
          3213.2)

           Existing law  provides for the payment of a workers' compensation  
          indemnity death benefit.  The amount of the benefit is  
          determined by the date of injury, the number dependents, and if  
          those dependents are partially dependent or wholly dependent on  
          the deceased worker.  
          (Labor Code §§ 4700 to 4709)

           Existing law  provides that no person is a dependent of any  
          deceased employee unless in good faith a member of the family or  
          household of the employee, or unless the person bears to the  
          employee the relation of husband or wife, child, posthumous  
          child, adopted child or stepchild, grandchild, father or mother,  
          father-in-law or mother-in-law, grandfather or grandmother,  
          brother or sister, uncle or aunt, brother-in-law or  
          sister-in-law, nephew or niece.  (Labor Code §3503)
           
          Existing law  requires,  with certain exceptions  , that the  
          collection of workers' compensation death benefits must be  
          commenced one year from:

             1)   The date of death where death occurs within one year  
               from date of injury; or
          Hearing Date:  April 9, 2014                             AB 1035  
          Consultant: Gideon L. Baum                               Page 2

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             2)   The date of last furnishing of any benefits where death  
               occurs more than one year from the date of injury; or
             3)   The date of death, where death occurs more than one year  
               after the date of injury and compensation benefits have  
               been furnished.

          No such proceedings may be commenced more than one year after  
          the date of death, nor more than 240 weeks from the date of  
          injury. 

          (Labor Code §5405)
           
          The exceptions to the above timelines are as follows:  

             a)   In the case of the death of an asbestos worker or  
               firefighter from asbestosis, the period within which  
               proceedings may be commenced for the collection of workers'  
               compensation death benefits is one year from the date of  
               death;

             b)   In the case of the death of a healthcare worker,  
               firefighter, peace officer, or correctional officer from  
               HIV-related disease, the period within which proceedings  
               may be commenced for the collection of workers'  
               compensation death benefits is one year from the date of  
               death, provided they meet certain requirements.
           
           (Labor Code §§ 5406.5 and 5406.6)
           
          Existing law  defines the "date of injury",  in cases of  
          occupational diseases  or cumulative injuries is that date upon  
           which the employee first suffered disability therefrom and  
          either knew, or in the exercise of reasonable diligence should  
          have known  , that such disability was caused by his present or  
          prior employment.  

          (Labor Code §5412)
           

          This bill  would provide an extension for dependents of deceased  
          firefighters and peace officers to file for workers'  
          compensation death benefits who died any of the following:
          Hearing Date:  April 9, 2014                             AB 1035  
          Consultant: Gideon L. Baum                               Page 3

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                 Cancer; 
                 Tuberculosis; 
                 Methicillin-resistant Staphylococcus aureus (MRSA) skin  
               infections; or 
                 Bloodborne infectious disease.

           This extension is for up to 420 weeks from the date of injury,  
          or  slightly more than 8 years  , but in no case more than one year  
          from the date of death.

           This bill  requires that the above-discussed extension would  
          sunset on January 1, 2019.

           This bill  would also make findings and declarations on the  
          sacrifices made by firefighters and peace officers and the need  
          for the grieving families of firefighters and peace officers to  
          have sufficient time to file for workers' compensation death  
          benefits.

           This bill  further declares the need for the Administrative  
          Director of the Division of Workers' Compensation (DWC) to study  
          mortality rates prior to extending or allowing the extension to  
          sunset.


                                      COMMENTS
          
          1.  A Brief Discussion on Presumptions and Death Benefits:

            Presumptions for peace officers and firefighters have been a  
            part of workers' compensation law since 1917.  While their  
            scope has grown, the fundamental idea behind each and every  
            presumption remains the same: these are injuries that are  
            intuitively likely to be job related, and therefore  
            occupational injuries compensable in the workers' compensation  
            system, but are difficult for the employee to prove.  A good  
            example of this is the "heart trouble" presumption, which was  
            created in 1939: while many individuals suffer from heart  
            ailments for a variety of different reasons, the jobs we asked  
            firefighters and peace officers to fulfill are very stressful  
            and take a toll on their heart.  Therefore, for these  
          Hearing Date:  April 9, 2014                             AB 1035  
          Consultant: Gideon L. Baum                               Page 4

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            individuals, the Legislative granted a presumption that a  
            firefighter or peace officer's "heart trouble" is  
            occupational.  
           
            While the number of presumptions has grown in recent years,  
            the time limits on a dependent to collect workers'  
            compensation death benefits has largely remained the same  
            since 1980: 240 weeks of the initial injury, or about 4   
            years, and no more than one year from the date of injury.  The  
            only two exceptions to this timeline in current law are for  
            HIV-related diseases and asbestosis, as was discussed above.

            AB 1035 would nearly double the timelines for dependents of  
            firefighters and peace officers to file for workers'  
            compensation death benefits if the firefighter or peace  
            officer died of cancer, tuberculosis, MRSA, or a bloodborne  
            pathogen.

          2.  A Brief Discussion on TB, MRSA & Bloodborne Pathogens  :
            
            As noted above, AB 1035 covers dependents of firefighters or  
            peace offices who died of cancer, tuberculosis, MRSA skin  
            infections, or bloodborne skin infections.  However, with the  
            exception of cancer, it would be an unlikely scenario where  
            the date of injury and death would fall outside of the 240  
            week period (60 months).  For example, the treatment regimen  
            suggested by the Center for Disease Control (CDC) for  
            antibiotic-resistant tuberculosis is 6 months to 2 years.  The  
            success rate of these treatments is quite high, and the  
            mortality rate of tuberculosis has fallen consistently since  
            1990 according to CDC data.

            Similarly, the incubation period for MRSA skin infections is 8  
            minutes to 10 hours, with clinical signs manifesting in 4 to  
            10 days.  Bloodborne pathogens, on the other hand, vary  
            significantly.  However, the rates of infection on the  
            relevant bloodborne pathogens that are not covered by existing  
            law (Hepatitis B & C) have declined significantly since 2000,  
            suggesting fatalities by bloodborne pathogens would also be  
            somewhat rare, though possibly outside of the 240 week period.

            In short, the inclusion of tuberculosis, MRSA, and bloodborne  
          Hearing Date:  April 9, 2014                             AB 1035  
          Consultant: Gideon L. Baum                               Page 5

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            pathogens in AB 1035 is unlikely to lead to significant  
            changes in workers' compensation utilization.

          3.  A Brief Discussion on Firefighters, Peace Officers, Cancer and  
            Cost:  

            Prior to 2013, several epidemiological studies have suggested  
            that firefighters have higher incidences of cancer due to  
            their exposure to contaminants.  This is particularly true of  
            bladder cancer, pancreatic cancer, and lung cancer.  However,  
            the sample sizes of the studies known to Committee Staff were  
            relatively small.

            In late 2013, the National Institute on Occupational Safety  
            and Health (NIOSH) released a study of cancer incidence in  
            firefighters, looking at more than 30,000 firefighters, making  
            it one of the largest studies in this area.  The sample  
            included firefighters from San Francisco, providing direct  
            applicability from the study to California's workers.  The  
            NIOSH study found elevated cancer incidence (6-12% increase)  
            and mortality (10-18% increase) when compared to the general  
            population.  This included  digestive  (10-25% increase in  
            incidence; 18-34% increase in mortality)  and respiratory   
            (8-24% increase in incidence; 4-17% increase in mortality)  
            cancers. 

            On the topic of the cost, the Commission on Health and Safety  
            and Workers' Compensation (CHSWC) recently heard a  
            presentation that sought to quantify the costs of extending  
            the timelines for collection of workers' compensation death  
            benefits for firefighters and peace officers.  While the  
            report is currently in draft form, the current rough estimate  
            on the cost of extending the timeline for filing for workers'  
            compensation death benefits is that it will impact  
            approximately 20 firefighters and peace officers  and cost  
            between  $4.25 and $5 million per year  .  While the estimate was  
            based on a timeline extension to 480 weeks (10 years), rather  
            than 420 weeks, the estimate remains a likely range.



          4.  Proponent Arguments  :
          Hearing Date:  April 9, 2014                             AB 1035  
          Consultant: Gideon L. Baum                               Page 6

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            Proponents argue that existing law is not meeting the needs of  
            California's firefighters and peace officers.  Proponents note  
            that if a firefighter or peace officer dies of an occupational  
            disease more than five years after being diagnosed with the  
            disease, his or her family members are unable to claim a death  
            benefit.  With occupational injuries such as cancer, the  
            timeframe between when the injury was discovered and when the  
            worker succumbs to the injury may be longer than 5 years.  In  
            these cases, proponents argue that the families of  
            firefighters and peace officers should not be denied their  
            right to workers' compensation death benefits.

          5.  Opponent Arguments  :

            Opponents argue that AB 1035 will increase costs on local  
            governments and counties at a time when budgets are limited  
            and the full impact of the 2012 Workers' Compensation reform  
            is unknown.  Opponents also argue that AB 1035 is being  
            considered at the same time as other bills which add to the  
            number of peace officers who qualify for existing  
            presumptions, and that these bills could increase the fiscal  
            impacts of AB 1035.  Opponents also note that the recent NIOSH  
            study only noted increases in some cancers, while the existing  
            workers' compensation presumption covers all cancers.   
           
          6. Prior Legislation  :

            AB 2451 (Perez) of 2012 would have allowed dependents of a  
            firefighter or peace officer who dies of certain occupational  
            ailments to file for workers' compensation death 480 weeks  
            from the date of injury.  AB 2451 was vetoed by Governor  
            Brown.  In his veto message, Governor Brown cited the fiscal  
            impacts and the lack of data, and also noted the following:

            "I understand that the National Institute for Occupational  
            Safety and Health is in the midst of one of the largest  
            studies of firefighters and risks of death from cancer and  
            other job related disease ever conducted.  It is my sincere  
            hope that this study, as well as data collected through our  
            comprehensive reform of the workers' compensation system, will  
            provide a basis to make a more informed policy and research  
          Hearing Date:  April 9, 2014                             AB 1035  
          Consultant: Gideon L. Baum                               Page 7

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            based decision on this question in the future."

            It is currently unknown if the recent NIOSH study addresses  
            the Governor's concerns.


                                          


                                       SUPPORT
          

          Peace Officers Research Association of California (Co-Sponsor)
          The Association for Los Angeles Deputy Sheriffs (Co-Sponsor)
          The California Professional Firefighters (Co-Sponsor)
          The Los Angeles Police Protective League (Co-Sponsor)
          The Los Angeles Probation Officers' Union, AFSME, Local 685  
          (Co-Sponsor)
          The Riverside Sheriffs' Association (Co-Sponsor)
          California Applicants' Attorneys Association
          Californian Labor Federation, AFL-CIO
          Los Angeles County Professional Peace Officers Association  
          

                                     OPPOSITION

          California Association of Joint Powers Authorities 
          California Coalition of on Workers' Compensation
          California State Association of Counties
          CSAC Excess Insurance Agency
          League of California Cities
          Rural County Representatives of California









          Hearing Date:  April 9, 2014                             AB 1035  
          Consultant: Gideon L. Baum                               Page 8

          Senate Committee on Labor and Industrial Relations