|
NEWS:
UTILIZATION MOVES TO FRONT BURNER:
Division of Workers' Compensation Administrative Director Dick Gannon says
the top priority for his cash-strapped agency is completing a medical
treatment study to find out why medical costs keep climbing despite fixed
fees.
CIGA DODGES CLAIMS:
This report examines the reasoning behind the California Insurance
Guarantee Association's decision to refuse to pay claims by employees of
temporary agencies or reimburse the state for unemployment insurance benefits
that were paid while injured workers awaited resolution of their workers'
comp claims.
DOI CANCELS FRAUD MEETING:
After the Advisor complained about a possible violation of public meetings
law, the Department of Insurance cancelled a meeting by an advisory board
that plays a key role in doling out $16 million in fraud-fighting grants
to county prosecutors.
STUDY CONCLUDES COMP PATIENTS REQUIRE MORE WORK:
This story gives the details in the second of three studies by a consultant
for the Industrial Medical Council whose final work product can make a big
difference in how much medical providers are paid for their services to
workers' comp patients.
NEWS: June 26th 2002
State Compliance Audits Yield Record Penalties
The Division of Workers' Compensation Audit Unit assessed the highest number
and greatest dollar amount of penalties since 1994.
WCAB Rules CIGA Liable for Penalties Caused by Insolvent Insurers
The decision requires the California Guarantee Association to pay 10 percent
penalties for delays in payments before insurance companies were liquidated.
Industrial Medical Council Debates Fibromyalgia
Members of the council disagree on whether to issue educational guidelines
on a syndrome when doctors aren't sure it even exists.
Applicants Attorneys Prepare New Strategies for Psyche Claims
After the California Supreme Court refuses to review the McCullough
decision, members of the California Applicants Attorneys Association get
advice on how to keep psychiatric-injury claims alive.
Acupuncturists Seek Status Upgrade
A bill before the California Legislature would allow acupuncturists to write
disability reports and another would increase educational standards for
acupuncturists.
FLASH REPORT: NEWS
WCAB Rules CIGA Must Pay Section 5814 Penalties: The California Insurance
Guarantee Association must pay 10-percent penalties for delays in paying
claims, even when the delays are no fault of its own and occurred before
liquidation, the Workers' Compensation Appeals Board has decided. The
six-judge panel issued a collective, or "en banc," decision on June
11.
The court affirmed a workers' compensation judge's ruling that held CIGA
liable for penalties mandated by Section 5814 of the Labor Code. CIGA had
argued that as a public agency, it should be exempt from awards for
punitive damages, just as are the Unemployed Insurers' Fund and
Self-Insurers' Security Fund. The WCAB, however, said previous case law has
clearly established that the Section 5814 penalties are not damages, but
compensation to the injured worker. Therefore, CIGA is responsible under
its obligation to pay all outstanding claims of liquidated insurers, the
commissioners decided.
For the full story, read the June 26 edition of the California Workers'
Compensation Advisor.
News:
Rand Study Shows Both Workers And Employers Do Poorly
Preliminary data from the Rand think tank shows that California employers
pay the most of five states studied yet the state's comp system ranks in the
middle when measuring replacement wages.
DIR Kicks Off Voc-Rehab Rulemaking on Web
The Department of Industrial Relations releases a rough draft of rules to
implement a new law that allows injured workers to settle their vocational
rehabilitation claims for up to $10,000
California Labor Agencies Take Narrow View on Hoffman Decision
The Supreme Court's ruling in favor of a California employer who fired an
undocumented worker for union organizers won't have much effect on
enforcement of state labor laws, a lawyer for the state labor commissioner
says
Gossip not a Cause of Workplace Injury
The Second District Court of Appeals overturns a WCAB decision that allowed
a woman to collect temporary disability benefits for major depression set
off because of workplace gossip about her affair with a co-worker.
Two Chiropractic QMEs Target of Enforcement
One of the doctors admitted that he had a patient massage him, while the
other is accused of fronting a prostitution ring.
BULLETIN: FLASH REPORT
WORKERS' COMP ADVISOR
Thursday, June 6, 2002
-------------------------------------------------
Brought to you via EARTHMAILT E-Delivery. http://www.earthmail.com
A broadcast-type report of breaking news about workers'
compensation provided whenever news of significance develops.
---------------------------------------------------
FLASH REPORT: DWC Starts Debate over Voc-Rehab Settlement Rules
The Division of Workers' Compensation yesterday released proposed
regulations on vocational-rehabilitation settlements, the first step toward
implementing a provision in this year's benefits bill that allows injured
workers to give up their job-retraining benefits in exchange for cash.
The division posted the proposed rules and accompanying forms on its
website, www.dir.ca.gov/dwc, under
"forums." Interested parties can make
comments by posting messages directly into the website. Administrative
Director Dick Gannon has said previously that his agency plans to make more
extensive use of web-based message boards to solicit comments before
adopting regulations.
The division is likely to get an earful on the first set of rules out of the
box. Already, industry professionals are complaining that the proposed
settlement rules would give the division's Vocational Rehabilitation Unit
too little information before deciding whether to approve settlements.
For the full story, read the June 12 edition of the California Workers' Comp
Advisor.
--------------------------------------------------
And that, as they say is -30-
--------------------------------------------------
FLASH REPORTS cover time sensitive stories and, we hope, piques
Your interest for our newsletter which is published in print
format 22 times per year. YOU MAY FEEL FREE TO FORWARD this report,
provided you forward it in its entirety, as per the copyright notices
below. See information at the end to learn how to subscribe to both
the electronic and full newsletter versions. Also the legal stuff.
NEWS MEDIA IS REQUESTED TO CREDIT THE SOURCE.
Workers' Comp Advisor FLASH REPORTS are happily written and filed
from the field by Jim Sams (jsams@wcadvisor.com)
and are delivered
to you by means of EARTHMAILT E-Delivery Service
(http://www.earthmail.com). Voice:
530-470-7500, Fax: 530-470-7600.
EARTHMAIL provides technical support. (help@earthmail.com)
----------------------------------------------
The Workers' Comp Advisor is our semimonthly print newsletter about
workers' compensation. Subscriptions are $287 a year in the US; send
e-mail along with M/C or VISA information and phone number to
offer@wcadvisor.com
----------------------------------------------
FOR A FREE SUBSCRIPTION to the Electronic Summary of our newsletter
and FLASH REPORTS send mail to: listmgr@wcadvisor.com
with the
message: Subscribe CAWCA Wes Bannister(if your name is Wes
Bannister, otherwise substitute your own name). To UNSUBSCRIBE
send a message to listmgr@wcadvisor.com
with the message: Unsubscribe
CAWCA. To CHANGE your address, unsubscribe your old then subscribe
your new e-mail address.
---------------------------------------------
LEGAL NOTICE AND COPYRIGHT
The editors have made every effort to ensure the accuracy of
information published in each issue. Opinions on financial and
legal matters are those of the editors and others; professional
counsel should be consulted before any action or decision based
upon this material is taken. The material herein is copyright 2002
Providence Publications, LLC. All Rights Reserved. This document
may be copied and distributed subject to the following conditions:
(1) All text must be copied without modification and all pages must
be included; (2) All copies must contain Providence Publications'
copyright notice; (3) This document may not be distributed for profit.
-----[ End of Transmission ]------
News:
Ergonomics Muscles Into Politics Again:
The Bush Administration released its plan for voluntary ergonomic guidelines,
unleashing a new partisan battle in Washington.
Court Ruling Could Spark More Disability Lawsuits:
A recent appelate court case could put California employers on the hook for
damages if they don't buy special equipment or make other "reasonable
accommodations" to keep disabled workers on the job.
Legislature Won't Make Major Changes to Benefits Bill:
Legislative staffers turned down requests by the State Compensation Insurance
Fund to make major policy changes in AB 749.
Committee Rejects Republican Reforms:
The Assembly Insurance Committee shot down cost-saving reforms proposed by
Assemblyman Keith Richman, R-Northridge.
Latest Presumption Bill Extends to Non-workers:
The tragic infection of a 15-year old girl during birth with Hepatitis C
prompted lawmakers to move forward with a bill that would extend workers'
comp benefits to the family members of certain public safety employees.
NEWS:
Researcher Says More WCAB Judges Won't Help
Nicholaus Pace of the Rand Corp. reports that the Workers' Compensation
Appeals Board needs clerks more badly than judges, despite legislation
that creates eight new judgeships.
Latino-Dominated Voc-Rehab Alliance Pushes 749 Reform
A relatively obscure group of bilingual vocational rehabilitation counselors
is creating a fissure within Democratic Party leadership by pushing to
restrict voc-rehab settlement rights.
Advisor Gets a New Publisher
Publisher J Dale Debber announces he has stepped down and appointed retired
admiral and workers' comp judge Doug Moore to replace him.
Taxi Drivers Push for Workers' Comp Benefits
A bill by Senate President John Burton, D-San Francisco, would force cab
companies to provide coverage for every driver, regardless of lease
arrangements.
Survey Shows HR Directors Skeptical About Fraud
In a survey of Sacramento-area employers, 26 percent of human-resource
directors say that between a quarter to one half of all workers' comp claims
involve fraud.
FLASH REPORT: INSURANCE
COMMITTEE APPROVES COMP COVERAGE FOR NON-WORKERS
SACRAMENTO -- The Assembly Insurance Committee today passed a bill that
would for the first time make some non-workers eligible for workers' comp
benefits, but tossed out three cost-saving measures introduced by a
Republican lawmaker.
The committee unanimously approved a bill which would allow dependents of
certain public-safety officers to collect workers' comp benefits if they
contract blood-borne infectious diseases from their guardians. Assemblyman
Bill Leonard, R-Cucamonga, introduced AB 2131 on behalf of a correctional
officer presumably infected with Hepatitis C during a 1982 prison riot who
had unwittingly passed the disease along her daughter during childbirth.
The Insurance Committee voted down three cost-saving bills introduced by
Assemblyman Keith Richman, R-Northridge on party-line votes. Richman's AB
1808 would have required training and certification for treating physicians,
AB 1809 would have mandated an outpatient fee schedule and AB 2611 would
have tightened standards for practicing as a medical provider or Qualified
Medical Evaluator.
For the full story on legislative actions, read the May 8 edition of the
California Workers' Compensation Advisor.
WCAB Aims to Focus Fuzzy
Insurance Arrangements
The Workers' Compensation Appeals Board is considering sanctioning a
third-party administrator that failed to disclose that its employer client
was covered by workers' compensation insurance until six years after an
employee filed a claim.
High-Tech Hardware Dominates Debate over Hospital Fee Schedule
A $1.5 billion-a-year industry that started with technology designed to
extend the useful life of racehorses is at the center of debate over the
state's update of its Inpatient Hospital Fee Schedule.
CWCI Advises Employers, Insurers to be Aware of Privacy
State and federal regulations coupled with a more litigious environment give
claims administrators good reason to release only the minimum amount of
medical records necessary, experts for the California Workers' Compensation
Institute say.
Public Employers Unhappy with New Presumption Bills
Three Democrats and a Republican have introduced bills that would create a
presumption of work-related causes of injuries for public-safety employees
and health-care workers.
News:
CONTRACTOR SLIPS THROUGH LOOPHOLE:
A recent court decision exposed the state Uninsured Employers Fund to millions
of dollars in new claims, but the small painting contractor whose negligence
led to the precedent-setting lawsuit got nothing more than a disciplinary
letter from the Contractors State License Board.
IMC HIRES NEW CHIEF:
Not much change in direction at the Industrial Medical Council after vote to
replace outgoing Executive Medical Director Allan MacKenzie with Associate
Medical Director Susan McKenzie.
QME LOSES LICENSE OVER FORGERY:
The Industrial Medical Council revokes the license of a Fresno Qualified
Medical Evaluator who forged documents to send his competitors on long
vacations.
DATA PEDDLER DUELS WITH RATINGS BUREAU:
The publisher of The Advisor joins insurance brokers to block a move by
the Workers' Compensation Insurance Rating Bureau that they say will
lead to privatization of information that is now public.
DAVIS LABOR REORGANIZATION PLAN STUMBLES:
Members of a state commission say the governor's proposal to combine several
departments under a new agency to be headed by a first-ever state labor
secretary is low on substance and short on details.
|
