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Reform May Be Saved From the Applicant’s Attorneys

Employers, payers, and Insurance representatives have dropped their opposition —for now-- to a bill that would have exempted the victims of terrorist acts and workplace violence from utilization review (UR) and independent medical review (IMR) process. Medical decisions would have been placed back in the hands of workers’ comp judges, as opposed to doctors for this class of injured. The Assembly Insurance Committee voted to accept an amendment to the bill and incorporate the language prepared by Committee staff.

In its original form, AB 44, authored by applicant’s attorney and Assemblyman Eloise Gomez Reyes (D-San Bernardino), would have allowed employees injured by terrorist attacks and workplace violence to skip UR and go to the WCAB. It would have been a first step in the decimation of a key workers’ comp reform that is working and is bringing down costs.

Behind the façade of the legislature, calmer heads made the case to keep reform (or less politely not to screw it up) and solve the problem of decisions and speed for this class of injured worker. The staff analysis below sums it up.

The New Plan

A proposed amendment replaces the lawyers and judges dispute resolution with an ombudsman approach. “Specifically, an amendment mandates an employer to implement the nurse case manager/ombudsman approach upon an appropriate declaration by the Governor would appear to better serve the needs of the victims of a terrorist attack than a return to the failed litigation approach,” the analysis reads.

AB 44 was introduced after a media uproar over San Bernadino County’s inadequate handling of treatment requests from workers injured as a result of the Islamist terrorist attack in San Bernardino in December 2015.

The Committee heard emotional testimony from the victims who say they had their claims delayed and denied after suffering the equivalent of “battlefield injuries,” including post-traumatic stress disorder.

Assemblyman Tom Daly, (D-Anaheim), sympathized with the victims but says significant changes to the workers’ comp system need to be carefully considered regardless of circumstance. “To take that exception and extend it county-wide to every public and private workplace is a big step,” Daly said.

Employers and insurers removed their opposition to the amended bill, but comments by some members and supporters of AB 44 indicate it’s not over. They say the ombudsman change “guts” the original intention of the bill and hope to get some of the original language reinstated. “I came to say I was not going to support the amendments, but I recognize that’s not the way it’s going to go,” Assemblyman Reyes said, adding that she wants to continue working with the stakeholders to make it a “meaningful bill.” In other words, the applicant’s attorneys still want to modify a working reform.

The amended bill passed the Committee and heads to Appropriations next.


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