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By Julius Young, Esq., Richard M. Jacobsmeyer, Esq., Barry D. Bloom
Welcome to the forthcoming 2020 edition of Herlick, California Workers’ Compensation Handbook.
The transition from 2018 to 2019 marked the transition from the Brown Administration to a new Governor, Gavin Newsom.
Since the publication of the 2019 edition of Herlick Handbook, there have been three new appointments to the W.C.A.B. Outgoing Governor Brown appointed Katherine Williams Dodd, Juan Pedro Gaffney, and Craig Snellings to slots as Commissioners. Recently retired W.C.A.B. Commissioner Frank Brass passed away in 2019. In July 2019 Governor Newsom reappointed Marguerite Sweeney to another term as W.C.A.B Commissioner.
In March 2019 the California State Auditor released a report critical of certain personnel actions by former Director of Industrial Relations Christine Baker, and an April 2019 report from the State Personnel Board revoked for up to a year the authority of the Department of Industrial Relations to hold career executive assignment exams and to process civil service appointments.
Here is a recap of some of the other noteworthy developments in California workers’ compensation since the publication of the 2019 edition:
Legislation signed by Governor Newsom in 2019 included the following:
In 2019 Governor Newsom vetoed a bill, AB 346, that would have expanded Labor Code § 4850 benefits to police officers employed by school districts and community colleges.
During 2019 the Division of Workers’ Compensation approved a series of evidence-based updates to the Medical Treatment Utilization Schedule.
Progress on several other significant regulatory reform issues had not come to fruition by the fall of 2019, however.
Interpreter regulations had not been adopted after an April 2018 DWC comment forum.
An August 2019 online comment forum on a copy service fee schedule closed, but rulemaking has not begun by the time this edition went to press.
As in 2018, there has been much controversy in the workers’ comp stakeholder community over possible reforms to the Medical-Legal Fee Schedule that governs how QMEs can bill for reporting. An online comment forum closed in August 2019 after a large outpouring of opposition by QMEs to a proposed new payment structure.
Utilization review regulations were the subject of an online comment forum which closed in January 2019, but no subsequent formal rulemaking was undertaken by September 2019.
In 2019 the Division of Workers’ Compensation arranged for treating physicians to have online access to the MTUS Guidelines.
Proposed changes to the W.C.A.B. Rules of Practice and Procedure were under consideration at the time this edition of Herlick Handbook went to press.
III. CASE DEVELOPMENTS
As always, Herlick, California Workers’ Compensation Handbook notes a number of significant recent cases. Readers may want to pay special attention to the following cases from the California Supreme Court, the California Court of Appeal, and the WCAB en banc, all of which have been added to this addition:
IV. THE SYSTEM GENERALLY
California workers’ compensation rates continued to decline for most employers, as advisory “pure premium” and “average charged rates” continued to decline for many employers. According to a June 2019 WCIRB presentation, the average charged rate for the first quarter of 2019 was $2.04 per $100 of payroll (compared with $2.97 in 2014 and $6.02 in 2003). In August 2019 the WCIRB proposed an additional advisory rate cut to go into effect for 2020.
A WCIRB study on the prescription drug formulary that was adopted in 2018 can be found here:
Workers and their advocates continued to complain about treatment delays, problems with the QME system, the high level of insurer allocated and unallocated loss adjustment expenses, and the ratio of system expenses to benefits paid.
California workers’ compensation can be quite complex, and there are a number of issues and potential developments on the horizon worth keeping in mind:
© Copyright 2019 LexisNexis. All rights reserved. This article is excerpted from the upcoming 2020 Edition of Herlick, California Workers’ Compensation Handbook.