In a master stroke of double-edged legislative slight of hand, Governor Brown vetoed a bill that would've given injured workers a fighting chance when faced with wrongful denial of treatment.
In his veto message, the Governor said "The recently enacted landmark comprehensive workers' compensation reform legislation makes this measure unnecessary. These reforms -- backed by both Democrats and Republicans -- reduce costs to businesses and protect workers. Further, they will help to avert an imminent crisis of skyrocketing rates that would have hurt both injured workers and businesses."
Yeah, right! There's a line about this kind of reasoning in The King and I when the beleagured king says he doesn't know whether or not to make an alliance with a stronger country. The weaker countries, he says, can't really help him. By contrast the larger and stronger countries may protect him out of everything he has. That's the situation injured workers will face when SB 863 becomes effective on 1 Jan 2013. They'll be "protected" out of some benefits they currently have in return for some benefits many will never get.
The recently enacted reform legislation to which the Governor refers is SB 863 which creates a secret panel of Independent Medical Review (IMR) doctors who will replace the current Utilization Review system (UR). Currently, utilization review doctors can be challenged in court for incorrect decisions. Under the new system the IMR doctors can only be challenged for bias, fraud, or conflict of interest. Trouble is that SB 863 also contains a provision which protects and conceals the names of the IMR doctors.
SB 863 increases permanent disability (PD) in one section of the legislation while another part of the bill disqualifies conditions that currently qualify for PD such as dyssomnia from chronic pain and sexual dysfunction from spinal injuries.
On the other hand, Paul Fong's legislation, AB 1687, would have required denials of care to be made in plain language so that obfuscations and wrongful denials of treatment dished out to injured workers could be stopped dead in their perfidious tracks. Now that that bill has been vetoed, injured workers have lost their last chance at fair play.
We have witnessed a sleek lesson in political maneuvering. First, the Governor personally worked for passage of SB 863 with its provision for Alternative Dispute Resolution (ADR) and keeping secret the names of Independent Medical Review (IMR) doctors. One would think the unions would have opposed the bill because of the ADR provision alone. One might even have expected principled opposition from the California Medical Association (CMA) because of the secrecy provisions that would be bestowed on an entire cadre of doctor-judges including doctors unlicensed to practice in California. In fact, the International Longshore and Warehouse Union, Southern California District Council, California Teamsters Public Affairs Council, SEIU 121, and the United Firefighters of Los Angeles did oppose SB 863. But the California Labor Federation which helped create the bill with the assistance of big business including Grimmway Farms got support from other unions including the American Federation of State, County and Municipal Employees (AFSCME) and from the California Medical Association (CMA).
One of the same unions that supported AB 1687, the California Labor Federation, was simultaneously involved in writing SB 863 with provisions that would eventually doom AB 1687, e.g., the secrecy provisions protecting the non-California licensed doctors. It's logical that if the Governor supported SB 863 he would veto AB 1687 since enforcement of AB 1687 would put a legal crimp into the secrecy provisions of SB 863. The California Labor Federation's support for AB 1687 came before SB 863 was completely written. In short, CLF was engaged in the composition of SB 863 even while CLF was ostensibly supporting AB 1687. AB 1687 passed the legislature before SB 863 was finalized. Fong's bill turned out to be an inconvenience to Gov. Brown and to the California Labor Federation and was doomed for failure once SB 863 passed. When SB 863 got signed by the Governor, the fate of AB 1687 was sealed.
The Open Government website reports that Assemblyman Fong voted for SB 863 which turns out to have been equivalent to voting against his own bill. The irony is that Paul Fong was obliged to stand by while SB 863 got signed into law and his own bill got vetoed.
Score: Governor Brown goes 2 for 2, Fong is 1 for 2, while the injured worker community goes scoreless, again.
Injured workers do not have to worry about the big increase in total permanent disaitity in SB863 because now their injuries will not be recognized by IMR's or so these reports will state for insurers. But I have a question. If IMR's don't have to reveal themselves, then how do we know they even exist to even write a medical report with language that doesn't have to be exact to deny medical care? Does this mean the insurer's crystal ball will be the only way to mete out medical care or any other benefit?
ReplyDeleteIn legalities of workman;s compensation, we n o longer have not workman's compensation as required by the state constitution or the U.S. federal mandate!
RIP WORKNANS' Compensation 1989-2012
Good questions, Dina. The California Applicants Attorneys Association (CAAA) should be interested. Ask their executive, Steve Hopcraft. Some pundits think that a proper challenge will have to wait until an injured worker is seriously harmed or killed by an unchallenged incorrect medical decision made under the aegis of this spiteful legislation.
ReplyDeleteRobert L. Weinmann, MD, Editor
AND EVEN then, any time injured workers are seriously injured or killed because of an OTJI their cases won't matter, they never did before!
ReplyDeleteAgain, workman's compensation is an employer holocaust on all workers. I don't like being dramatic or unrealistic ( in a CHS&WC hearing I think the employer side stated "surreal" but nothing surreal about it when it is being experienced by an injured worker) but the facts presented to me over the years have proven that workers or worse when they are injured, their lives are totally destroyed along with their families. I know too many of them and in some cases I KNEW them since they are now gone from our earth plane because of a lack of medical care!
As far as the CAAA,THEY are just as much a part of the problems for union members and thus all workers. Saw that one too with my own witnessing!.
Union dues and initiation fees are all that is important. Money is a ferociously hungry madame and taskmaster...mistress) with judges, lawyers, employers and unions and with the total disregard and complicity from the state of CA..
The CA system provides many billions of dollars for the WC feeding machine, all for the system that "eats its own", working citizens
I have just about seen it all, except for medical , justice and restitution!
As far as Steve Hopcraft and the CAAA, this explains much of the lack of their real credibility or humanity!