Bill Text: CA SB258 | 2013-2014 | Regular Session | Enrolled
Bill Title: Workers' compensation.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Vetoed) 2014-02-27 - Consideration of Governor's veto stricken from file. [SB258 Detail]
Download: California-2013-SB258-Enrolled.html
BILL NUMBER: SB 258 ENROLLED
BILL TEXT
PASSED THE SENATE SEPTEMBER 6, 2013
PASSED THE ASSEMBLY SEPTEMBER 3, 2013
AMENDED IN ASSEMBLY AUGUST 30, 2013
AMENDED IN SENATE MAY 2, 2013
AMENDED IN SENATE MARCH 19, 2013
INTRODUCED BY Senator Lieu
FEBRUARY 13, 2013
An act to amend Sections 112, 4600, 4903.07, 4903.8, and 5410 of
the Labor Code, relating to workers' compensation.
LEGISLATIVE COUNSEL'S DIGEST
SB 258, Lieu. Workers' compensation.
Existing law establishes the 7-member Workers' Compensation
Appeals Board, and provides that the members of the appeals board are
appointed by the Governor with the advice and consent of the Senate.
Existing law requires that 5 of the 7 members of the board be
experienced attorneys admitted to practice in the State of
California, and provides that the other 2 members need not be
attorneys.
This bill would require that all 7 members of the board be
experienced attorneys admitted to practice in the State of
California.
Existing law establishes a workers' compensation system,
administered by the Administrative Director of the Division of
Workers' Compensation, to compensate an employee for injuries
sustained in the course of his or her employment. Existing law
requires that medical, surgical, chiropractic, acupuncture, and
hospital treatment that is reasonably required to relieve the injured
worker from the effects of his or her injury be provided by the
employer. Existing law prohibits a chiropractor from being a treating
physician after the employee has received a certain number of
chiropractic visits.
This bill would correct an erroneous cross-reference with respect
to these provisions.
Existing law requires that a lien claimant is entitled to an order
or award for reimbursement of a lien filing fee or lien activation
fee, together with interest at the rate allowed on civil judgments,
if certain conditions are satisfied.
This bill would specify that these fees are to be paid by the
employer.
Existing law requires an order or award for payment of a lien for
medical or hospital treatment, as specified, to be made for payment
only to the person who was entitled to payment for the expenses for
medical or hospital treatment at the time the expenses were incurred,
and not to an assignee unless the person has ceased doing business
in the capacity held at the time the expenses were incurred and has
assigned all right, title, and interest in the remaining accounts
receivable to the assignee.
This bill would authorize an assignment of that payment if the
assignment was completed prior to January 1, 2013, or if it was
required by a contract that became enforceable and irrevocable prior
to January 1, 2013. The bill would state that this provision is
declarative of existing law.
Existing law authorizes an injured worker to institute proceedings
for the collection of compensation, including vocational
rehabilitation services, within 5 years after the date of the injury
upon the ground that the original injury has caused new and further
disability or that providing vocational rehabilitation services has
become feasible because the employee's medical condition has improved
or because of other factors not capable of determination at the time
the employer's liability for vocational rehabilitation services
otherwise terminated.
This bill would delete the provisions relating to vocational
rehabilitation, but retain the authority of an injured worker to
institute proceedings for the collection of compensation within 5
years after the date of the injury upon the ground that the original
injury has caused new and further disability.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 112 of the Labor Code is amended to read:
112. (a) The members of the appeals board shall be appointed by
the Governor with the advice and consent of the Senate. The term of
office of the members appointed prior to January 1, 1990, shall be
four years, and the term of office of members appointed on or after
January 1, 1990, shall be six years and they shall hold office until
the appointment and qualification of their successors.
(b) All of the members of the appeals board shall be experienced
attorneys at law admitted to practice in the State of California. All
members shall be selected with due consideration of their judicial
temperament and abilities. Each member shall receive the salary
provided for by Chapter 6 (commencing with Section 11550) of Part 1
of Division 3 of Title 2 of the Government Code.
SEC. 2. Section 4600 of the Labor Code is amended to read:
4600. (a) Medical, surgical, chiropractic, acupuncture, and
hospital treatment, including nursing, medicines, medical and
surgical supplies, crutches, and apparatuses, including orthotic and
prosthetic devices and services, that is reasonably required to cure
or relieve the injured worker from the effects of his or her injury
shall be provided by the employer. In the case of his or her neglect
or refusal reasonably to do so, the employer is liable for the
reasonable expense incurred by or on behalf of the employee in
providing treatment.
(b) As used in this division and notwithstanding any other
provision of law, medical treatment that is reasonably required to
cure or relieve the injured worker from the effects of his or her
injury means treatment that is based upon the guidelines adopted by
the administrative director pursuant to Section 5307.27.
(c) Unless the employer or the employer's insurer has established
or contracted with a medical provider network as provided for in
Section 4616, after 30 days from the date the injury is reported, the
employee may be treated by a physician of his or her own choice or
at a facility of his or her own choice within a reasonable geographic
area. A chiropractor shall not be a treating physician after the
employee has received the maximum number of chiropractic visits
allowed by subdivision (c) of Section 4604.5.
(d) (1) If an employee has notified his or her employer in writing
prior to the date of injury that he or she has a personal physician,
the employee shall have the right to be treated by that physician
from the date of injury if the employee has health care coverage for
nonoccupational injuries or illnesses on the date of injury in a
plan, policy, or fund as described in subdivisions (b), (c), and (d)
of Section 4616.7.
(2) For purposes of paragraph (1), a personal physician shall meet
all of the following conditions:
(A) Be the employee's regular physician and surgeon, licensed
pursuant to Chapter 5 (commencing with Section 2000) of Division 2 of
the Business and Professions Code.
(B) Be the employee's primary care physician and has previously
directed the medical treatment of the employee, and who retains the
employee's medical records, including his or her medical history.
"Personal physician" includes a medical group, if the medical group
is a single corporation or partnership composed of licensed doctors
of medicine or osteopathy, which operates an integrated
multispecialty medical group providing comprehensive medical services
predominantly for nonoccupational illnesses and injuries.
(C) The physician agrees to be predesignated.
(3) If the employee has health care coverage for nonoccupational
injuries or illnesses on the date of injury in a health care service
plan licensed pursuant to Chapter 2.2 (commencing with Section 1340)
of Division 2 of the Health and Safety Code, and the employer is
notified pursuant to paragraph (1), all medical treatment,
utilization review of medical treatment, access to medical treatment,
and other medical treatment issues shall be governed by Chapter 2.2
(commencing with Section 1340) of Division 2 of the Health and Safety
Code. Disputes regarding the provision of medical treatment shall be
resolved pursuant to Article 5.55 (commencing with Section 1374.30)
of Chapter 2.2 of Division 2 of the Health and Safety Code.
(4) If the employee has health care coverage for nonoccupational
injuries or illnesses on the date of injury in a group health
insurance policy as described in Section 4616.7, all medical
treatment, utilization review of medical treatment, access to medical
treatment, and other medical treatment issues shall be governed by
the applicable provisions of the Insurance Code.
(5) The insurer may require prior authorization of any
nonemergency treatment or diagnostic service and may conduct
reasonably necessary utilization review pursuant to Section 4610.
(6) An employee shall be entitled to all medically appropriate
referrals by the personal physician to other physicians or medical
providers within the nonoccupational health care plan. An employee
shall be entitled to treatment by physicians or other medical
providers outside of the nonoccupational health care plan pursuant to
standards established in Article 5 (commencing with Section 1367) of
Chapter 2.2 of Division 2 of the Health and Safety Code.
(e) (1) When at the request of the employer, the employer's
insurer, the administrative director, the appeals board, or a workers'
compensation administrative law judge, the employee submits to
examination by a physician, he or she shall be entitled to receive,
in addition to all other benefits herein provided, all reasonable
expenses of transportation, meals, and lodging incident to reporting
for the examination, together with one day of temporary disability
indemnity for each day of wages lost in submitting to the
examination.
(2) Regardless of the date of injury, "reasonable expenses of
transportation" includes mileage fees from the employee's home to the
place of the examination and back at the rate of twenty-one cents
($0.21) a mile or the mileage rate adopted by the Director of Human
Resources pursuant to Section 19820 of the Government Code, whichever
is higher, plus any bridge tolls. The mileage and tolls shall be
paid to the employee at the time he or she is given notification of
the time and place of the examination.
(f) When at the request of the employer, the employer's insurer,
the administrative director, the appeals board, or a workers'
compensation administrative law judge, an employee submits to
examination by a physician and the employee does not proficiently
speak or understand the English language, he or she shall be entitled
to the services of a qualified interpreter in accordance with
conditions and a fee schedule prescribed by the administrative
director. These services shall be provided by the employer. For
purposes of this section, "qualified interpreter" means a language
interpreter certified, or deemed certified, pursuant to Article 8
(commencing with Section 11435.05) of Chapter 4.5 of Part 1 of
Division 3 of Title 2 of, or Section 68566 of, the Government Code.
(g) If the injured employee cannot effectively communicate with
his or her treating physician because he or she cannot proficiently
speak or understand the English language, the injured employee is
entitled to the services of a qualified interpreter during medical
treatment appointments. To be a qualified interpreter for purposes of
medical treatment appointments, an interpreter is not required to
meet the requirements of subdivision (f), but shall meet any
requirements established by rule by the administrative director that
are substantially similar to the requirements set forth in Section
1367.04 of the Health and Safety Code. The administrative director
shall adopt a fee schedule for qualified interpreter fees in
accordance with this section. Upon request of the injured employee,
the employer or insurance carrier shall pay for interpreter services.
An employer shall not be required to pay for the services of an
interpreter who is not certified or is provisionally certified by the
person conducting the medical treatment or examination unless either
the employer consents in advance to the selection of the individual
who provides the interpreting service or the injured worker requires
interpreting service in a language other than the languages
designated pursuant to Section 11435.40 of the Government Code.
(h) Home health care services shall be provided as medical
treatment only if reasonably required to cure or relieve the injured
employee from the effects of his or her injury and prescribed by a
physician and surgeon licensed pursuant to Chapter 5 (commencing with
Section 2000) of Division 2 of the Business and Professions Code,
and subject to Section 5307.1 or 5703.8. The employer shall not be
liable for home health care services that are provided more than 14
days prior to the date of the employer's receipt of the physician's
prescription.
SEC. 3. Section 4903.07 of the Labor Code is amended to read:
4903.07. (a) A lien claimant shall be entitled to an order or
award for reimbursement from the employer of a lien filing fee or
lien activation fee, together with interest at the rate allowed on
civil judgments, only if all of the following conditions are
satisfied:
(1) Not less than 30 days before filing the lien for which the
filing fee was paid or filing the declaration of readiness for which
the lien activation fee was paid, the lien claimant has made written
demand for settlement of the lien claim for a clearly stated sum
which shall be inclusive of all claims of debt, interest, penalty, or
other claims potentially recoverable on the lien.
(2) The defendant fails to accept the settlement demand in writing
within 20 days of receipt of the demand for settlement, or within
any additional time as may be provide by the written demand.
(3) After submission of the lien dispute to the appeals board or
an arbitrator, a final award is made in favor of the lien claimant of
a specified sum that is equal to or greater than the amount of the
settlement demand. The amount of the interest and filing fee or lien
activation fee shall not be considered in determining whether the
award is equal to or greater than the demand.
(b) This section shall not preclude an order or award of
reimbursement of the filing fee or activation fee pursuant to the
express terms of an agreed disposition of a lien dispute.
SEC. 4. Section 4903.8 of the Labor Code is amended to read:
4903.8. (a) (1) Any order or award for payment of a lien filed
pursuant to subdivision (b) of Section 4903 shall be made for payment
only to the person who was entitled to payment for the expenses as
provided in subdivision (b) of Section 4903 at the time the expenses
were incurred, and not to an assignee unless the person has ceased
doing business in the capacity held at the time the expenses were
incurred and has assigned all right, title, and interest in the
remaining accounts receivable to the assignee.
(2) Paragraph (1) does not apply to an assignment that was
completed prior to January 1, 2013, or that was required by a
contract that became enforceable and irrevocable prior to January 1,
2013. This paragraph is declarative of existing law.
(b) If there has been an assignment of a lien, either as an
assignment of all right, title, and interest in the accounts
receivable or as an assignment for collection, a true and correct
copy of the assignment shall be filed and served.
(1) If the lien is filed on or after January 1, 2013, and the
assignment occurs before the filing of the lien, the copy of the
assignment shall be served at the time the lien is filed.
(2) If the lien is filed on or after January 1, 2013, and the
assignment occurs after the filing of the lien, the copy of the
assignment shall be served within 20 days of the date of the
assignment.
(3) If the lien is filed before January 1, 2013, the copy of the
assignment shall be served by January 1, 2014, or with the filing of
a declaration of readiness or at the time of a lien hearing,
whichever is earliest.
(c) If there has been more than one assignment of the same
receivable or bill, the appeals board may set the matter for hearing
on whether the multiple assignments constitute bad-faith actions or
tactics that are frivolous, harassing, or intended to cause
unnecessary delay or expense. If so found by the appeals board,
appropriate sanctions, including costs and attorney's fees, may be
awarded against the assignor, assignee, and their respective
attorneys.
(d) At the time of filing of a lien on or after January 1, 2013,
or in the case of a lien filed before January 1, 2013, at the
earliest of the filing of a declaration of readiness, a lien hearing,
or January 1, 2014, supporting documentation shall be filed
including one or more declarations under penalty of perjury by a
natural person or persons competent to testify to the facts stated,
declaring both of the following:
(1) The services or products described in the bill for services or
products were actually provided to the injured employee.
(2) The billing statement attached to the lien truly and
accurately describes the services or products that were provided to
the injured employee.
(e) A lien submitted for filing on or after January 1, 2013, for
expenses provided in subdivision (b) of Section 4903, that does not
comply with the requirements of this section shall be deemed to be
invalid, whether or not accepted for filing by the appeals board, and
shall not operate to preserve or extend any time limit for filing of
the lien.
(f) This section shall take effect without regulatory action. The
appeals board and the administrative director may promulgate
regulations and forms for the implementation of this section.
SEC. 5. Section 5410 of the Labor Code is amended to read:
5410. Nothing in this chapter shall bar the right of any injured
worker to institute proceedings for the collection of compensation
within five years after the date of the injury upon the ground that
the original injury has caused new and further disability. The
jurisdiction of the appeals board in these cases shall be a
continuing jurisdiction within this period. This section does not
extend the limitation provided in Section 5407.
