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Voters Injured at Work Policy Position

Posted on 22 March 2012 by admin

Voters Injured at Work is a non-profit political organization of injured workers and their families established in 2005 for the purpose of protecting and enforcing California’s constitutional guarantee of a fair and adequate system of compensating workers and their dependents for injury or disability from a work injury.

Voters Injured at Work provides a strong voice in Sacramento to help enact legislation that will rebalance the California workers’ compensation system that has been “fixed” at the expense of injured workers.

The Schwarzenegger era workers’ compensation “reforms” of 2004, while seemingly well intentioned to improve the system, produced a number of unintended consequences that materially harmed injured workers and their families. In spite of well-documented examples of these devastating outcomes, the former Governor refused to consider any changes to address the inequities. The time has come to repair the damage and to restore justice and dignity to California’s injured workers. The following subjects require the immediate attention of the Legislature and Governor Brown:

• Restore Permanent Disability Benefits: The statutory language of Senate Bill 899 in 2004, and the Schwarzenegger administration’s interpretation of that language, slashed some permanent disability awards by as much as fifty percent (50%) or more. In spite of a clear legislative mandate, Governor Schwarzenegger failed to adjust benefits in 2009 and injured workers continue to suffer. Fair and equitable payments to injured workers for serious, permanent injuries must be restored immediately, without them being forced to accept “offsets” or “savings” that cause decreases in these and other benefits. The cases of Almaraz-Guzman and Ogilvie must not be overturned.

• Prompt Access to Quality Medical Treatment: Injured workers need to be able to receive care from doctors of their own choosing and not forced into doc-in-the-box clinics controlled by insurance companies. Before the Schwarzenegger reforms, injured workers had free choice of physician 30 days after their injury. The basic right to choose your own doctor is good medicine and good policy. On balance, employers and insurance companies have abused the medical provider network (MPN) law and it should be repealed. In addition, payments to all doctors – both first injury treaters and specialists – should be fair and adequate to ensure that they will remain willing and able to treat injured workers and accept work injury cases.

• Eliminate Administrative Delays in Treatment: Urgently needed treatment for serious injuries is routinely delayed, modified or denied through the abuse of the utilization review (UR) process by employers and insurance companies. Recent studies have questioned the cost-effectiveness of UR. Some UR adds needless costs and impedes rapid recovery and return to work for workers needing treatment. Doctors’ treatment recommendations that follow existing state-promulgated guidelines should be immediately approved and not subjected to administrative reviews and delays. In addition, VIAW supports the reintroduction of Assembly Bill 584 (Fong) that would provide that all physicians performing UR for insurance companies must be licensed to practice in California.

• Disability Payments and Other Benefits Should Not Be Reduced or Denied Based on Discrimination: Age, gender, race, national origin and immigration status are all currently being used to reduce or deny permanent disability and other benefits to injured workers. This is morally wrong and cannot continue. Under existing law, this impermissible discrimination is called “apportionment,” and is used to reduce benefits that should otherwise lawfully be paid to injured workers. Discrimination, whatever its form or fancy name, must be eliminated inworkers’ compensation. For this reason, VIAW supports the reintroduction and swift enactment of Assembly Bill 1155 (Alejo).

• The 2004 Reforms Should Not Change the Rules for Cases Settled Previously: Injured workers who settled their cases before the reforms of 2004 that included awards for future medical care should not be subject to UR or forced to obtain treatment from subsequently- created medical provider networks. If they have established a rapport with a treating physician, it should continue. Injured workers with old settled awards should not have to change physicians solely because their current treating physician is not a member of their employer’s MPN.

• Physically Able Permanently Injured Workers Need to be Retrained As Soon As Possible: Employees, employers and the State of California all benefit when someone who is seriously injured at work is able to return to a meaningful, productive job in the workforce. Currently, there is no effective training program for workers who cannot return to their pre-injury jobs. This leads to many injured workers being unable to work even though they want to work. Current law must be reformed to provide that once injured workers have been medically cleared to return to work, their employers must bring them back to their jobs, accommodate them, or provide appropriate retraining funding. Experience demonstrates that the sooner retraining starts, the more likely the injured worker will return to the workforce as opposed to becoming needlessly unemployed and eventually dropping out of the workforce.

• Workers’ Privacy Must be Protected: In response to the filing of a workers’ compensation claim, some insurance carriers and third party administrators use private investigators to provide surveillance of injured workers. These investigators conduct sub rosa recordings and use other investigative tools that would not be available to government entities. As private companies, they are not required to obtain prior court approval for any part of this surveillance. Current law provides little oversight of this cost driver to the workers’ compensation system. Carriers and TPAs should be limited in their ability to use material collected during these investigations and the workers should have access to materials even if no fraud is ever alleged. It also may be necessary to require prior approval to use certain investigative tools.

For further information contact:

Jesse Ceniceros

President

Voters Injured At Work

714 W. Olympic Blvd.

Suite 450

Los Angeles, CA 90015

1-800-401-VIAW

VOTERS INJURED AT WORKWHITEPAPER

1 Comments For This Post

  1. Nachman Brautbar, M.D. Says:

    As these words are written, quality physicians-specialists are leaving the workers’ compensation system in California as treaters. If this attitude of cutting physicians’ fees continues and MPNs, in my opinion, continue to limit access of injured workers to real specialists, you will essentially see decline of the economy. Why? The word gets around faster than you think. Workers will not risk their health or undertake heavy physical work knowing that no quality doctors are there to treat them.

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