BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 2604
                                                                  Page  1

          Date of Hearing:   April 23, 2014

                           ASSEMBLY COMMITTEE ON INSURANCE
                                Henry T. Perea, Chair
                 AB 2604 (Brown) - As Introduced:  February 21, 2014
                            And As Proposed To Be Amended
           
          SUBJECT  :   Workers' compensation: penalties

           SUMMARY  :   Increases the potential penalties that can be imposed  
          on an insurer or employer if an unreasonable delay or denial of  
          medical treatment results in a catastrophic injury or death to  
          the injured worker.  Specifically,  this bill  :  

          1)Provides that an unreasonable delay or denial of medical  
            treatment required to be provided to an injured worker through  
            the workers' compensation system that causes or results in a  
            catastrophic injury, the Workers' Compensation Appeals Board  
            (WCAB) may impose an award of up to $100,000.

          2)Adopts a definition of "catastrophic injury" by reference to  
            an existing Labor Code Section that define the exceptions to  
            limitations on psychiatric injuries that are compensable  
            consequences of a primary injury.  That provision provides  
            that the limitation on psychiatric "add-ons" does not apply in  
            cases where the injured worker's primary injury was a  
            "catastrophic injury, including, but not limited to, loss of  
            limb, paralysis, severe burn, or severe head injury."

          3)Provides that an unreasonable delay or denial of medical  
            treatment required to be provided to an injured worker through  
            the workers' compensation system that causes or results in a  
            death, the Workers' Compensation Appeals Board (WCAB) may  
            impose an award of up to $250,000

          4)Requires the WCAB, in imposing these awards, to use its  
            discretion to accomplish a fair balance and substantial  
            justice under the circumstances of the case.

           EXISTING LAW  :

          1)Establishes a comprehensive system of workers' compensation  
            benefits, including medical treatment, indemnity benefits for  
            temporary and permanent disability, and death benefits, for  
            workers whose injuries arise out of or in the course of  








                                                                  AB 2604
                                                                  Page  2

            employment.

          2)Establishes a system to ensure that benefits to which an  
            injured workers is entitled are provided in a timely manner,  
            including detailed time frames that must be complied with in  
            cases where disputes arise over whether the injured worker is  
            entitled to the benefits being sought.

          3)Provides that where payment of compensation has been  
            unreasonably delayed or refused, the amount of the payment  
            that was unreasonably delayed or refused shall be increased up  
            to 25%, or up to $10,000, whichever is less.

          4)Provides that the WCAB shall use its discretion to accomplish  
            a fair balance and substantial justice between the parties.

           FISCAL EFFECT  :   Undetermined

           COMMENTS  :   

           1)Purpose  .  For a work-related injury, the workers' compensation  
            system is the injured worker's "exclusive remedy" to obtain  
            treatment and other compensation.  The complexity of the  
            system, the author argues, frequently makes it difficult for  
            injured workers to obtain the benefits to which they are  
            entitled.  While there are penalties for unreasonable delays  
            or denials of benefits, the author believes that these  
            penalties are not sufficient to cause insurers and other  
            payors to act properly, and least not in all cases.  The  
            author points to a recent case where there was significant  
            misbehavior that led to the death of the injured worker, and  
            argues that where misbehavior has deadly or catastrophic  
            consequences, the potential penalties should be higher than  
            other cases.

           2)Background  .  Labor Code Section 5814, and related provisions,  
            have long defined the penalties that can be imposed for the  
            unreasonable delay or denial in paying benefits.  Prior to the  
            2004 workers' compensation reforms, "5814 penalties" presented  
            a highly controversial issue, as employers made reform of the  
            penalty process one of their highest priorities.  Before the  
            2004 reform, a 5814 penalty applied to the entire specie of  
            benefits.  As an example, if an employer failed to timely pay  
            a physician a $500 fee for treatment that was actually  
            provided to the injured worker, and it was determined the  








                                                                  AB 2604
                                                                  Page  3

            delay was unreasonable, the penalty - paid to the injured  
            worker, not the physician -- was imposed not only on the $500,  
            but also on all future medical payments.  Another example  
            involved the requirement that benefit payments be made by  
            readily negotiable instruments.  Some participants were able  
            to manipulate their cases by closing bank accounts so that  
            normal benefits checks were determined to be not readily  
            negotiable, and penalties applied to all future temporary or  
            permanent disability payments, even if made timely and direct  
            deposited into an account.  The employer community sought  
            reforms to this system, arguing that results were random,  
            irrational, and incentivized gaming the system to generate  
            future increased payments.  Current law on late payment  
            penalties was adopted as part of the 2004 reforms, and was  
            intended to ensure that significant penalties could be  
            imposed, but without the unintended consequences of prior law.  
             

           3)Romano case  .  One of the primary motivations behind the bill  
            is a case, Romano v. Kroeger, in which a grocery store  
            employee at a Ralph's store in southern California suffered an  
            injury.  In that case, the claims adjuster, for reasons  
            difficult to explain, was quite hostile to authorizing  
            treatment for Mr. Romano's injuries.  In fact, according to  
            the WCAB decision in the case, the adjuster ignored rulings by  
            Workers' Compensation Judges (WCJs) even after Mr. Romano  
            challenged denials and prevailed.  His health status  
            deteriorated significantly, and he required surgery.  A  
            surgery-based infection ultimately caused his death. 

          Proponents point to this case as an example where the penalties  
            available under existing law were inadequate to incentivize  
            proper behavior in approving treatment.  The case involved  
            behavior that was beyond the normal range of "unreasonable  
            delay" and the consequences were undeniably catastrophic.  The  
            opposition acknowledges that the Romano case was a tragedy  
            that should never happen, but point out that current law  
            penalties are imposed on a "per act" basis.  In fact, over  
            $260,000 in penalties were imposed in the Romano case, and not  
            only was the adjuster fired, but the adjuster's supervisor was  
            also fired. The opposition argues that changing the penalty  
            laws will not change this sort of unusual abhorrent behavior,  
            but will create litigation and other challenges in cases that  
            do not present such clearly bad behavior.









                                                                  AB 2604
                                                                  Page  4

           4)Catastrophic injury  .  The bill, as proposed to be amended,  
            applies only to death and catastrophic injury.  The opposition  
            fears that the bill's formulation of "catastrophic injury"  
            will result in litigation, and tactical efforts to fit many  
            injuries into this category.  Opponents note two aspects of  
            the proposed statute.  First, the language addresses  
            "unreasonable" delays or denials, and under current law, it  
            does not take outrageous behavior to qualify as an  
            unreasonable delay.  Second, the definition of "catastrophic"  
            will generate excess litigation, as claimants attempt to prove  
            that any serious injury was catastrophic, and that some delay  
            was the cause.  This, they argue, turns the no-fault concept  
            of workers' compensation on its head.

          The proposal does include, by simply referencing an existing  
            definition, an open-ended definition of "catastrophic" injury.  
             The referenced statute provides what "catastrophic," without  
            limitation, includes, but does provide more precise limiting  
            language.  The author may wish to consider a definition of  
            "catastrophic" that is more precise, and that better describes  
            the cases to which the special penalty provisions would apply.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          Voters Injured At Work (sponsor)
          Association for Los Angeles Deputy Sheriffs
          California Applicants' Attorneys Association (CAAA)
          California Association of Professional Employees
          Fraternal Order of Police
          Long Beach Police Officers Association
          Los Angeles Police Protective League 
          Los Angeles Probation Officers Union, AFSCME Local 685
          Los Angeles Professional Peace Officers Association
          Peace Officers Research Association of California
          Riverside Sheriffs' Association
          Sacramento County Deputy Sheriffs Association

           Opposition 
           
          Acclamation Insurance Management Services (AIMS)
          Allied Managed Care Incorporated
          ALPHA Fund 
          American Insurance Association








                                                                  AB 2604
                                                                  Page  5

          Association of California Insurance Companies
          California Association of Joint Powers Authorities (CAJPA)
          California Chamber of Commerce
          California Coalition on Workers' Compensation
          California Farm Bureau Federation
          California Manufacturers and Technology Association
          California Professional Association of Specialty Contractors
          California Restaurant Association
          California Special Districts Association
          California State Association of Counties
          Construction Employers' Association 
          County of Los Angeles 
          CSAC Excess Insurance Authority 
          CSG Associates, Inc.
          Independent Insurance Agents and Brokers of California 
          Liberty Mutual Insurance
          National Association of Mutual Insurance Companies
          National Federation of Independent Business
          Pacific Compensation Insurance Network 
          Republic Indemnity 
          Safeway
          State Compensation Insurance Fund
          The Zenith
           
          Analysis Prepared by  :    Mark Rakich / INS. / (916) 319-2086