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Welcome to the Resources Section. Here you will find a plethora of original materials as referenced in the print edition.
OSIP has scheduled a public hearing to take comments on the proposed self-insured regulations update package.
Read the Appellate decision here
They're nearly a year late, but the State Compensation Insurance Fund has finally produced an annual report on its performance in 2006. A year marked by scandal also produced a sharp drop in earned premiums. See more details inside.
Proposed regulations out for comment that will strengthen SIGs
Another Class Action filed against State Fund in the Group scandals.
In this issue we publish the third quarter national workers' comp results of carriers that also write business in California. This comprehensive list shows the premiums written and year-to-date loss percentages for all carriers with any significant amounts of workers' comp business.
Insurance Commissioner Steve Poizner's order on the average pure premium rate for 2008. Find out his rationale for keeping rates steady.
Here is the Letter from Janet Frank, President of State Fund telling brokers that she wants them to keep their clients with State Fund and promising to provide "the best possible service."
Here is the letter which solicits employers directly to leave State Fund and get better pricing through Tangram.
Here is the complaint in which the AG accuses PacificStaff of false representations.
The second quarter national workers' comp results of carriers that also write business in California. This comprehensive list shows the premiums written and year-to-date loss percentages for all carriers with any significant amounts of workers' comp business.
According to this new report by California’s Workers’ Compensation Insurance Rating Bureau, the cost savings resulting from reforms to the state’s workers’ comp system have been 25 percent greater than anticipated. Read the full report here, and find out where the savings are adding up and where they’ve been less than stellar.
In this amicus brief filed on behalf of a 72-year-old injured worker, the American Association of Retired Persons and a number of other civil rights groups argue that factoring age, race and gender when apportioning is illegal.
The Insurance Department helds its workers' compensation pure premium rate hearing yesterday in San Francisco.
Zenith National Insurance Group has announced its 2007 third quarter results, early as always. Find out how the company is fairing while competition hits a fevered pitch.
Insurance Regulatory Information System (IRIS) ratios from the National Association of Insurance Commissioners have arrived. Which insurance companies have been cruising on easy street this year, and which carriers are cruisin' for a bruisin'?
A professional association representing nearly 500 attorneys within the State Compensation Insurance Fund alleges the carrier failed to meet a contractual agreement to limit the work it offers to outside counsel. Here is the complaint.
Workers' Comp Carriers' First-Quarter Results for 2007 are on in the resources section of our web site. Find first-quarter results for national workers' compensation carriers writing business in California.
Agitated politicians on Capitol Hill want to repeal the insurance industry’s antitrust exemptions. Read the related bills currently in motion:
The National Insurance Act of 2007 would allow carriers to choose between federal regulation and state regulation. But what are the draw backs? Read the legislation for yourself here:
Applicant attorneys are pushing hard for AB 437, a bill that would substantially alter the timeline for filing wage discrimination suits under California's Fair Employment and Housing Act. Check it out here:
Daylight is burning fast in Sacramento, but a half-dozen workers’ compensation bills are still vying for attention. Read up on what’s left.
Obesity causes enough medical problems on its own, but when work-related injuries occur, the issues are magnified. In a study recently published by Duke University, researchers outline just how serious an impact our growing waist lines are having on California's workers' compensation system - the numbers are more surprising than you might think.
As a vehicle for change for permanent disability benefits, AB 1212 directs the DWC's administrative director to revise the permanent disability rating schedule to increase benefits. But does the bill, authored by Assembly Speaker Fabian Nunez, offer enough direction? Read the bill for yourself right here...
A fresh look at the impact of on-the-job auto accidents on the workers' compensation industry offers some surprising insight and serves as a reminder that no carrier is immune to this risk. So just how much are accidents costing? Sources say it's far less now than it will be in the future, find out why inside...
Last year's Senate Bill 815, a bill that sought to nearly triple permanent disability benefits and was vetoed by Gov. Arnold Schwarzenegger, has been resubmitted by Senate President Pro Tem Don Perata this year as SB 936. Take a good look at these numbers as compared to those in Labor Code 4658 and determine for yourself if SB 936 is the way to go.
Whiplash and crushed metal doesn't begin to scratch the surface when it comes to explaining the ramifications of work-place motor vehicle accidents. A report by the National Council on Compensation Insurance, Inc. delves into the issues of subrogation, injury severity and attorney involvement with raw data that's hard to ignore.
The new utilization review regulations that took effect Jun 7, 2007, authorizing a new audit function by the Division of Workers'
Compensation.
Read the language that will likely go into one of two bills that aims to a better system of governance over State Fund
Click here to see how the WCE unfolded the continuing scandal at State Fund. A timeline of the reality of the unfolding scandal con tains some historical references to the factual making of California's own little Watergate.
A listing of all the top workers' comp carriers in the Golden State and their results for the quarter ending March 31, 2006
The language from AB 881, requiring roofing contractors in California with C-39 licenses to purchase workers’ compensation, even though they have no employees.
The Senate legislative analysis of AB 881 and the Assembly analysis with amendments.
Appeal of WCIRB's Decision Regarding the Proper Workers' Comp Classification for Roofers
Workers' Compensation Insurance Rating Bureau of California Decision Regarding the Proper Workers' Comp Classification for Roofers
Filed by the United Union of Roofers et al. for Unfair Competition and Request for Injunctive Relief
Sen. Don Perata (D-Oakland) introduces amendments to SB 815 phasing in an increase to the permanent disability benefit over three years. Benefits to permanently disabled workers will double by 2009.
The California workers' comp market keeps getting better. Find out where the carriers stack up in our 2005 year-end results in the current print edition of Workers' Comp Executive
Division of Worker's Compensation cautions community about coercing medical evaluators
Palm Medical’s Answer to State Fund’s Motion for a JNOV
State Fund’s Motion for a Judgment Not Withstanding the Verdict (JNOV)
Transcript of Dr. Regina Shay’s testimony Part 1
Transcript of Dr. Regina Shay’s testimony Part 2
An audit of the Department of Insurance's Conservation and Liquidation Office raises concerns about the how the CLO handles financial reporting, tracks receivables and manages and verifies data.
A copy of the settlement reached by Mainstay Business Solutions, a tribally owned company of the Blue Lake Rancheria, and California insurance regulators over the tribe's right to self-insure its workers compensation coverage.
A draft copy of the Treatment Utilization Guidelines circulated among members of the Division of Workers' Compensation Advisory Group
State Fund's Memorandum of Points and Authorities on its PEO policy
Settlement Agreement between Pennsylvania Insurance Commissioner Diane Koken and Reliance Insurance
The Dept. of Insurance Proposed Fiduciary regulations have brokers frothing at the mouth.
DIR Memo sent to the WCAB, the Occupational Safety and Health Appeals Board, and California Unemployment Insurance Appeals Board regarding their status under the governor's proposal.
Alarcon sends a letter to the Governor asking him to order the Administrative Director to redo the Permanent Disability Schedule.
The numbers are in and, as expected, most California workers' comp carriers are not decreasing pure premium rates to the levels approved by Insurance Commissioner John Garamendi. But, industry experts say, the July 1 decreases filed by the companies from some of the larger carrier groups such as AIG, State Fund and others, show that carriers are willing to make some bold decreases, despite a still-volatile market.
Providence Publications LLC, the parent company of Workers' Comp Executive has filed papers in San Francisco Superior Court seeking access to the depositions of Norris Clark, Deputy Insurance Commissioner for Financial Surveillance and Dorothy Zelenko, consulting actuary for AMI Risk Consultants, Inc. A hearing on the matter is scheduled for June 18, 2004.
The Executive has obtained a copy of the letter sent by Commissioner John Garamendi to Governor Arnold Schwarzenegger responding to the letter sent by State Fund to the Governor.
A letter sent to Governor Arnold Schwarzenegger from State Fund reveals documents showing that the Department of Insurance ordered actuaries to use methods that would force State Fund into insolvency and to withhold the information from State Fund.
Commissioner Garamendi sends a letter to Governor Schwarzenegger warning about the dire consequences of exempting State Fund from RBC-statutes.
The Commission on Health and Safety and Workers' Compensation has released a matrix comparing the governor's bill - sponsored by Assemblyman Abel Maldonado, R-Santa Maria and Sen. Charles Poochigian, R-Fresno - with both the Labor and Garamendi proposals. A copy is available on our resource page.
AB 572 (Lee) This bill would amend various sections of the Labor Code and would provide standards and establish time limits for the Labor Commissioner's investigation and decision relating to complaints of unlawful employment practices.
AB 87 (Bogh) This bill would add Labor Code §4352.5 and would establish the Workers' Compensation for Disaster Service Workers Fund that would provide funds for the purpose of furnishing workers' compensation to disaster service workers and their dependents.
This file is a copy of Insurance Commissioner Harry Low's order increasing the California's average pure premium rate by 10.5 percent for 2003 policies.
AB 136 (Kehoe) This bill would add Labor Code § 4850.2 and would provide that police officers, sheriffs, or fire-fighters are entitled to a leave of absence without loss of salary while disabled by injury or illness arising out of and in the course of employment, for the period of disability, not exceeding 2 years.
AB 1324 (Steinberg) This bill would add Labor Code § 3212.86 and would provide that if a person who is a specified state or local firefighting, law enforcement, or patrol member sustains an injury that meets the definition of a bloodborne infectious disease, and a dependent of that person, contracts the bloodborne infectious disease from that person, the dependent may elect to receive compensation under the workers' compensation law, for the duration of the disease, for all medically necessary health care costs associated with the disease. The election would constitute the sole and exclusive remedy of the dependent against the employer and the dependent may not bring a civil action against the employer for damages.
SB 714 (Battin) This bill would add Labor Code §5705.1 and is very similar to AB 1481 but does not contain the provision prohibiting the payment of permanent disability and death benefits unless the industrial injury has contributed at least 10% to the cause of death or disability when compared to all causes of injury in total.
AB 1580 (Cogdill and Dutton) This bill would amend various Labor and Penal Code sections to exclude from the definition of employee for purpose of workers' compensation certain persons confined in county or city jail, regardless of whether the services performed are on a voluntary or involuntary basis.
AB 1582 (Koretz) This bill would add Part 12 to Division 5 of the Labor Code relating to employment and would make it an unlawful employment practice to subject an employee to an abusive work environment and would specify that an employer is vicariously liable for a violation committed by its employee, but would prescribe certain affirmative defenses. The bill would specify that it is enforceable solely by a private right of action, would authorize injunctive relief and would limit an employer's liability for emotional distress to $25,000 where the unlawful employment practice does not result in a negative employment decision.
AB 274 (Koretz) This bill would add Labor Code § 1182.9 and would create a rebuttable presumption that an adverse employment action taken within 90 days after an employee exercises his or her employment rights is retaliatory, unless there is clear and convincing evidence that the employee made up the claim to prevent the employer from taking adverse employment action. This presumption would not apply to the criminal penalty for retaliation.
AB 1643 (Ridley-Thomas) This bill would amend Labor Code §§ 2750.5, 3357, 4157 and 5705. Under existing law there is a rebuttable presumption that a worker is an employee, and not an independent contractor for various purposes in employment law relating to workers' compensation. This bill would establish a new category of workers, contract service providers, if specified criteria are satisfied.
AB 968 (Correa) This bill would add Labor Code § 3600.7 and would provide that any adverse reaction, injury, disability or death incurred by an employee, as a result of a vaccination or medication that is administered to prevent the transmission of, infection by, or exposure to, a biochemical substance, or bloodborne infectious disease shall be deemed to have arisen out of and in the course of employment for purposes of workers' compensation benefits.
AB 1579 (Cogdill and Richman) This bill would amend Labor Code § 139.3 and would extend the provisions of Labor Code relating to referral of patients to an entity in which the physician or his or her immediate family has a financial interest to a physician referring a patient for outpatient surgery goods or services.
AB 1483 (Richman and Daucher) This bill would add various subsections to Labor Code §139.7 and would require every physician who treats and evaluates injured workers, on or after January 1, 2006 to be certified by the Industrial Medical Council as a Qualified Workers' Compensation Physician (QWCP). It would exempt physicians who are qualified medical evaluators from the QWCP certification requirement and would authorize the IMC to waive this requirement under certain conditions. The bill would require the Administrative Director by Jan. 1, 2005 to establish a mandatory annual training program for persons in the Disability Evaluation Unit within the Division of Workers' Compensation who determine permanent disability ratings for injured workers. The bill would require the Administrative Director by Jan. 1, 2005 to establish a mandatory annual insurance claim administrator training program for any person who is the primary handler of workers' compensation claims for an injured worker.
SB 354 (Speier) This bill would amend various sections of the Labor Code and would add section 4600.2. The bill would preclude an insurer from insuring an employer for more than 15 one-hour visits to a chiropractor by an employee in connection with any claim made under the policy, unless the employee has obtained the approval of a physician for additional visits. The bill would provide that an employer is not required to provide, and is not liable for, more than 15 of these visits without physician approval.
Download the 21.5 percent rate filing the National Council on Compensation Insurance's made for 2003 Florida workers' comp rates
Here it is: the California Legislature's 2002 benefit increase and "reform" vehicle.
This is the Workers' Compensation Insurance Rating Bureau's cost estimate for AB 749.
Here is the state Division of Workers' Compensation's new regulations for implantable hardware in spinal fusion surgeries, which takes effect April 13, 2001.
SB 867 (Burton) This will would amend Labor Code §§ 139.2 and 3209.3 and would authorize the Industrial Medical Council to appoint an acupuncturist as a qualified medical evaluator and would delete the provision of the existing law that states the inclusion of acupuncturists in the definition of 'physician' shall not be construed to authorize acupuncturists to determine disability under specified provision of the workers' compensation law or the law providing for nonindustrial disability.
SB 757 (Poochigian) This bill would add Labor Code § 5307.27 and would require the Administrative Director by July 1, 2004, to adopt an official utilization schedule, which shall be based on prescribed findings and recommendations that specifies utilization guidelines and protocols for purposes of workers' compensation law.
AB 1262 (Matthews) This bill would add Article 5 to the Insurance Code and would require the Insurance Commissioner to adopt regulations setting forth the minimum standards of training, experience and skill that workers' compensation adjusters must possess. The bill would require every workers' compensation insurer to certify to the commissioner that the personnel employed by the insurer to adjust workers' compensation claims, or employed for that purpose by a medical billing entity, meet minimum standards.
AB 1215 (Vargas) This bill would add Insurance Code §11861 and would require State Compensation Insurance Fund in consultation with the Employment Development Department to develop a program that allows insurers offering workers' compensation insurance to have access to quarterly wage and withholding reports filed with the department for the purpose of confirming payroll reported to the insurer for premium calculations. The bill would require that the program place specified restrictions on employer access to and use of this information, and would further require that State Fund impose a user fee on admitted workers' compensation insurers in an amount sufficient to pay the costs of the program.
SB 228 (Alarcon) This bill would amend various Labor Code sections and would require the funding methodology for the administration of the workers compensation program be altered so that employer assessments account for a greater proportion of the funding than appropriations from the General Fund and a sufficient portion of these funds shall be dedicated to implement the fraudulent claims reporting and medical fee schedule reporting provisions contained in the bill. The bill would require the Administrative Director to develop procedures to receive and review reports of medical billing fraud and report these violations of law. This bill also would delete some existing fee schedule requirements and would, instead, prohibit charges under the official medical fee schedule from exceeding 120 percent of the fee prescribed fro the same item in the applicable Medicare payment system, or, with regard to pharmacy services and drugs, 100 percent of the fee prescribed by the applicable Medi-Cal payment system. This bill also would reduce the period of time for payment to a physician for medical treatment of injured workers to 45 days. The bill would provide that if liability is not rejected by the employer within 60 days after the date a claim for workers' compensation benefits is filed by the employee, the injury shall be presumed compensable.
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