California lawmakers work hard to make sure that the state laws are reformed to best protect and serve the residents of California. The labor code and workers’ compensation are not exceptions to these efforts. Workers’ compensation is a complicated area of the law and one of the oldest social institutions in California. This does not mean, however, that these statutes do not need updating and improving. The California Assembly recently passed A.B. 1107 in an effort to improve the workers’ compensation process.
California Assembly Bill 1107 amends labor code 4610.01. The purpose of the amendment is to reduce the delays sometimes facing injured employees in receiving medical treatment for their work-related industrial injuries. The bill as originally filed was partially in reaction to a case called King v. CompPartners Inc. In that case, an employee was harmed when his medication was withdrawn after a wrongful utilization review. The injured employee then tried to sue the utilization review provider in civil court, not under workers’ compensation, because of the injuries and the wrongful withdrawal of his medication. The California Supreme Court held, however, that the injured employee’s exclusive remedies were under workers’ compensation and the employee could not sue the utilization review provider outside of that framework. The bill was originally filed with the aim of reducing administrative time as well as access to treatment for injured employees by exempting treating physicians from utilization review under specific circumstances. The bill was later amended to provide that stakeholders may challenge utilization review conclusions. Critics of the amendment are concerned that the amendment will just result in more litigation and legal gymnastics, which could reduce an injured employee’s access to care. This is because the injured employee’s treatment will likely be delayed while waiting for the legal dust to settle. Conversely, proponents of the amendment state that allowing stakeholders to challenge the result of a utilization review provides another much needed layer of oversight. These advocates of the process point out that having additional oversight can help reduce the incidence of fraud in the workers’ compensation field, which could help save millions of dollars every year for Californians.
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