Comp News - Member Newsletter

Newsletter January 2008

caaaAdmin — Tue, 01 Jan 2008 18:55:00 GMT

VOLUME IV, ISSUE I

“I NEVER WANT TO HURT ANY ONE OF THE WORKERS OR THE PEOPLE THAT GET THE BENEFITS.”
Gov. Schwarzenegger, Sacramento Bee, Nov. 19, 2003

VETO OF POTENTIAL BOOST IN PD BENEFITS

Gov. Schwarzenegger has used his veto pen for the second consecutive year to block potential increases in permanent disability (PD) benefits.
The most recent veto was of Senate Bill 936, sponsored by Senate President pro Tem Son Perata. SB 936 would have doubled PD benefits in California
by January 1, 2010. Gov. Schwarzenegger can be contacted at 916-445-2841.

104 WEEK TD CAP MODIFIED

Injured workers who are recovering from surgery have finally received some relief in the post-SB 899 era. The previously strict 104-week limitation on temporary disability (TD) benefits has been modified.

Gov. Schwarzenegger signed AB 338 on Oct. 13, extending the TD window to five years. The bill authored by Rep. Joe Coto still only allows for 104 weeks of TD, but injured workers can now receive those amounts at non-consecutive times over the course of five years.

Also signed into law on Oct. 13, was AB 1073, authored by Rep. Pedro Nava, lifts the 24-visit cap on chiropractic, physical and occupational therapy following surgery.

COURT HOLDING:
APPORTIONMENT = DISCRIMINATION

Last month, the Third District Court of Appeal validated a legal challenge, joined by the AARP, ACLU and other civil rights
groups, to Gov. Schwarzenegger’s workers’ comp cuts. The court ordered the WCAB to restore benefits taken from a Sacramento woman based on her age.

Injured worker’s advocates and civil rights groups argued that the law discriminates against women and elderly workers by reducing
the compensation they would otherwise receive for a disability caused by a work injury simply because of their age, gender or other "risk factors."

Lois Vaira, 76, a receptionist for the California Tourism Department, was able to perform her job prior to her work injury but
her disability compensation was reduced by 40% due to "the aging process" and underlying osteoporosis. The court found that the prohibition against discrimination contained in Govt. Code §11135 applies to the WCAB.

HORROR STORY HITS CHP OFFICER

Bill Parkin, a 40-year old resident of Galt, CA, and 10-year veteran of the California Highway Patrol (CHP) thought the State of
California would back him up if he was injured on the job.

On a 115 degree summer day in July 2006, he made numerous roadside assists for stranded motorists, multiple traffic stops, responded
to traffic collisions and cleared debris from the highway. He was in and out of the car all shift. The next day he woke up
and could barely walk. Then, the battle began and he had to fight for medical care. His knee surgery was delayed for 8 months. During
the delay, his knee worsened. He ended up with multiple surgeries involving both knees and now wonders whether he will be able to return to his CHP Officer job.

Bill Parkin put his health and safety at risk to protect the people of California. Now, he wonders why the protection that workers’ compensation insurance supposedly guarantees is sorely lacking.

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Newsletter June 2007

caaaAdmin — Fri, 01 Jun 2007 17:40:00 GMT

VOLUME III, ISSUE II

MAKE HIM KEEP HIS PROMISE!
“I NEVER WANT TO HURT ANY ONE OF THE WORKERS OR THE PEOPLE THAT GET THE BENEFITS.”
Gov. Schwarzenegger, Sacramento Bee, Nov. 19, 2003

HELP ON THE WAY?
Senate President pro Tem Don Perata has introduced legislation, Senate Bill 936, that would double permanent disability (PD) benefits in California by January 1, 2010.

Assembly Speaker Fabian Nunez has introduced legislation, Assembly Bill 1212, that would require the Administrative Director to increase PD to conform with wage loss data and studies by the California Commission on Health and Safety in Workers’ Compensation (CHSWC). Both SB 936 and AB 1212 are supported by organized labor including the California Labor Federation, AFL-CIO, Teamsters Public Affairs Council, UFCW, CA Professional Firefighters, SEIU, AFSCME, LIUNA and SBCTC. Discussions between staff members from the Assembly and Senate leadership and the Administration’s staff have taken place.

It is critical to write, phone, or email your legislator and Gov. Schwarzenegger to urge them to support SB 936 and AB 1212 so that fair and reasonable PD benefits are restored. Find your legislator’s contact info at: www.leginfo.ca.gov/yourleg.html. Gov. Schwarzenegger can be contacted at 916-445-2841.

ADMINISTRATION’S OWN STUDY ACKNOWLEDGES DRASTIC PD CUTS

The Department Industrial Relations’ Division of Workers’ Compensation latest wage loss study recently
released reconfirms yet again numerous previous studies that document the urgent need to restore
fair and reasonable PD benefits. Three of its major findings are:

• In 12,800 claims rated under the 2005 PDRS, ratings were reduced on average by 43.4%; almost identical to reductions found earlier by CHSWC.

• Workers’ comp benefits replaced 52.5% of wages lost in the first three years after injury, even lower than the amount in the original RAND study.

• The average amount of a disabled worker’s wage loss replaced in those first three years is just $6.600 per year.

CHSWC studied 30,000 PD cases and found that the Administration’s PD schedule reduces benefits by more than 50%, and was not based on empirical evidence, as required by SB 899.

Also affirming the illegality of the Administration’s PD schedule was the recent court decision by San Francisco Workers’ Compensation Judge Jacqueline Duncan in Boughner vs. Comp USA and Zurich North America (Case No. SFO 491230). Judge Duncan held, “The Administrative Director failed to base the adjusted rating schedule on empirical data and findings…The AD acted arbitrarily and in violation of the requirements of the statute in unilaterally terminating all efforts to obtain sufficient empirical data.”

APPALLING: CALIFORNIA LAGS BEHIND RURAL DEEP SOUTH IN PD COMPENSATION

Benefits for California’s injured workers rank among the lowest in the nation compared to injured workers in other states.

• Loss of an eye: California ranks lowest in the nation!
• Hearing loss in one ear: California ranks lowest in the nation!
• Loss of a toe: California ranks lowest in the nation!
• Loss of a foot: California ranks 2nd lowest in the nation!
• Loss of 1st finger: California ranks 2nd lowest in the nation!
• Loss of a leg at hip: California ranks 6th lowest in the nation!
• Loss of a thumb: California ranks 7th lowest in the nation!

(Source: “Analysis of Workers’ Compensation Laws,” US Chamber of Commerce)
Despite its high cost of living, California’s weekly maximum PD benefits at $270 is 4th lowest in nation compared to national average of $595. (Source: workerscompensation.com)

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Newsletter January 2007

caaaAdmin — Mon, 01 Jan 2007 16:25:00 GMT

Vol III, Issue I

CAAA WILL CONTINUE EFFORTS TO CHANGE GOVERNOR’S PD CUTS

CAAA will continue to challenge the Schwarzenegger Administration’s deep cuts in injured workers’ permanent disability (PD) compensation. President Linda Atcherley says, “We will continue our fight to overturn the governor’s drastic reductions in the already meager compensation permanently injured workers receive.”

Four studies have found the Schwarzenegger Administration’s ratings reduce compensation to permanently disabled workers by more than half. A UC Davis professor conducted one; another was by the State’s own Commission on Health, Safety and Workers’ Compensation (CHSWC); yet another was by an insurance expert; and the fourth was from the insurance carriers’ own ratings bureau. The studies have consistently shown the Schwarzenegger Administration’s schedule cuts PD compensation by an average of 50% to 70%. “The Schwarzenegger Administration’s Permanent Disability Ratings Schedule is inconsistent with SB 899, and is not based on empirical data. Its continued use relegates thousands of workers to subsist on constitutionally inadequate benefits,” Atcherley said. “The Schwarzenegger Administration failed to link the new permanent disability ratings to wage loss by using empirical data and findings.”

Do you have a horror story to tell? Many injured workers are losing their homes, cars and life’s savings due to inadequate compensation.

The hardship suffered by Californians injured at work will be important in persuading lawmakers to change the current law and disability schedule. Please share your story by visiting denialofcare.org (fill out the “Share your Story” form), or visit viaw.org, and fill out the “Bodies of Evidence” form. You can also tell your story be calling 916-457-5546.

TRAGEDY: A “HORROR STORY”

Scott Hayes lived in Sacramento until his death at 45 in December 2006. His Job and What Happened: Scott worked for six years as a workers’ comp claims examiner. Scott worked very hard on his job, and in 1999 developed a herniated disk in his back and neck problems as a result of sitting all day doing his job. Scott filed a workers’ comp claim, and was fired that very afternoon. That was the beginning of Scott’s horror story, which lasted until his death. Scott was 100% disabled, settled his claim, and was awarded future medical care. Getting promised medical care became a full-time effort. Scott was repeatedly denied care and filed for more than 40 separate penalties for denial of care and compensation. Scott lived in tremendous pain - both physical and mental - from his injury. He couldn’t sit for long without having to lie down. He took pain medications or just suffered through the pain.

What this meant to his life: Scott became an advocate for injured workers. “If I, with my knowledge of workers’ compensation rules and regulations, have had such a difficult time in getting treatment and benefits, how can the average person with no experience get what they need?” Scott became a founding board member of VotersInjuredatWork. org, helping injured workers get the care and compensation they need.

His insurance carrier claimed Scott was now “working,” even though his service was as a volunteer with no compensation. This is a tactic insurers have used against other viaw.org board members.

How Workers’ Comp was supposed to help: Scott needed medical care for his continuing pain. He benefited from procedures like acupuncture that were routinely denied. Scott had to go to court to force the insurer to pay for a shot to ease his pain. Scott waited one year for a court date and then had to wait three months for the shot. Scott developed brain cancer which took his life.

TD BLURBS

TD CAP: On April 19, 2006, one of Senate Bill 899’s most merciless benefit cuts took effect: the two-year cap on temporary disability indemnity (TD). Any worker injured after SB 899 became law on April 19, 2004, who received 104 weeks of TD, regardless of their condition, may have their benefits terminated.

TD can be terminated 104 weeks after the first payment of TD, even if the worker returned to work. Regardless of how many weeks of TD the worker actually received, the TD clock runs from the first TD payment and keeps running for 104 weeks.

SEASONAL WORKERS: On August 31, 2006, the California Fifth District Court of Appeal held in Signature Fruit Co. v. WCAB F048255, that seasonal workers are not entitled to TD in the off-season. The court held that under Labor Code § 4453, an employee does not have any off-season earnings and does not compete in the open labor market during a portion of the year, and as such, the employee not entitled to TD payments during that season.

If you have been cut-off TD for either reason, you should file for State Disability Insurance (SDI) benefits through the State Employment Development Department (EDD).

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Newsletter June 2006

caaaAdmin — Thu, 01 Jun 2006 17:45:00 GMT

VOLUME II, ISSUE II

THE MAN WHO COULD SAVE WORKERS’ COMP

When State Treasurer Phil Angelides addressed a packed CAAA summer convention in Las Vegas on June 24, 2005, his words gave hope to all those who represent injured workers. His victory over State Controller Steve Westly in the democratic primary election on June 6, 2006, has given California voters a legitimate alternative to anti-worker Gov. Schwarzenegger in November.

Here are excerpts from Angelides’ speech to the CAAA membership:

I appreciate your passion and your commitment to help those who have been injured in the course of their work. You and I know the truth of what made California and America the richest society in the history of humankind. It was the blood, the sweat, and the toil of the working men and women of this great state and this great nation.

I know this is a tough season for you, but most importantly the people you represent. I want to tell you that help is on the way. And come November
2006, we’re going to drive Arnold Schwarzenegger out of the state house, and we’re going to put California on the march again and make our state a beacon of progressive hope for this whole nation and this world.

Schwarzenegger has attacked the basic rights of injured workers, of the very people who built the strength of our society and sacrificed to make our
economy strong. But he has never uttered one word about the 100 – 200- and 300 percent increases in the premiums being charged by insurance companies. It is time for a new Governor who is on the side of working men and women in the state of California.

Instead of trying to take away care and fair compensation from injured workers, I will be a Governor who stands up for the millions of working men and women who will make us a power house in the 21st century. And I pledge to you, in the first month in office, I will appoint an administrative director for the workers’ compensation system who understands fairness and the dignity of workers. I promise to do it as fast as I get into office. I will stand with you.

“DENIAL OF CARE” HEARING SHINES LIGHT ON INSURERS

The Senate Labor and Industrial Relations Committee hearing held on May 3, 2006, focused on the crippling effect of medical treatment denials currently plaguing injured workers and their doctors.

Acting Administrative Director of the Division of Workers' Compensation Carrie Nevans faulted insurers stating, “Many insurers have gone too far,”
referring to utilization review. Nevans was especially critical with regards to treatment denials issued for requested treatment by a physician in the employer’s medical provider network and said that new penalties were being formulated to combat improper treatment denials.

Committee Chairman Richard Alarcón stated, “Two years is inexcusable. We ought to come up with another system to get them (injured workers) treated faster. We are losing good workers forever."

PD CUTS: THE DATA IS IN

In February, the results of a state-sponsored study conducted by the Commission on Health and Safety and Workers' Compensation (CHSWC) were issued. After reviewing approximately 7,000 cases, CHSWC, comprised of employer and labor representatives, announced that their study revealed that the average permanent disability (PD) benefit level had dropped by 55 percent. Previously, the Workers’ Compensation Insurers Rating Bureau (WCIRB), comprised of representatives from insurance companies, estimated PD would be cut by 76 percent.

Gov. Schwarzenegger has previously said that his workers’ comp reform could be achieved without cutting benefits to “truly injured workers.” CHSWC provides clear evidence the Governor did not keep his word. He had been unwilling to revise the PD schedule claiming more data was needed. The data now exists.

On July 1, 2006, the Division of Workers’ Comp is required to review the disability-slashing regulations put in place as a result of SB 899 that took effect on January 1, 2005. Injured workers can only hope that Schwarzenegger will remember his promise not to cut benefits to “truly injured workers” and to work together with democratic lawmakers to fix the PD schedule.

CALIFORNIA LABOR FED DEMANDS INCREASED PD

The California Labor Federation’s 2006 Legislative agenda includes three key workers’ comp bills that the Federation is supporting, all of which will be of great benefit to injured workers. Senate Bill 1730 will address the devastating permanent disability cuts that the recent Commission on Health and Safety and Workers' Compensation (CHSWC) study has shown were slashed by 55 percent.

Assembly Bill 2068 would allow injured workers to continue to predesignate his or her own doctor. Currently, injured workers’ right to predesignate will be eliminated as of April 30, 2007. A November 2005 study conducted by the Public Policy Institute of California concluded that employer costs are no higher when workers choose a doctor.

Senate Bill 1781 will address the delays and denials of treatment injured workers are facing. It would declare the intent of the Legislature to enact legislation that would improve process for determining appropriate and necessary medical treatment for injured workers.

TWO YEAR CAP ON TEMPORARY DISABILITY

Injured Workers unable to return to work are starting to suffer from the TD cap that took effect 4/19/06. Injured workers who are receiving TD and who are unable to work should apply for State Disability (SDI) before the two-year cap expires.

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