AgdaPkt 2004-04-26 - Laserfiche WebLink

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a.,�-�Z WORKERS' COMP from page 1 .. ........ ... ........................... If passed, this emergency legislation will take anotherjob, the employer cannot pay the injured effect immediately after it is signed by the gover- woricer less than 85% of his salary. nor, ln the meantime, April 16 is also the deadline for the governor to submit signatures to place a • Fraud -• Gives immunity to entities that workers' compensation reform package on the appropriately raport suspeded freud activity and November 2004 bailot. He may rescind his other freud provisions. submission of the signatures after Friday if the legislature passes SB 899. • Medical Provider Network —Allows em- ployers to establish medicai provider networks. The text of SB 899 is more than 200 pages, Networks shall be determined through the em- but the major reform issues are bulleted below, ployer or insurer and the doctors in those networks Cities should keep in mind that the package is must adhere to labor code, health and safety code, subject to change. We will make every attempt to and utilization controls. Through this nehvork keep you updated on the Employee Relations process, the injured worker can obtain a first, page on our website (www.cacities.ora/ second and third medical opinion from the medical emnloveerelationsl. A follow-up article will also network. After three opinions, an independent appear in next week's Priority Focus with addi- medical review (IMR) is still available. An injured tional, updated information. worker may utilize their primary care physician a doctor prior to an injury occurring only s/he is a part Major Reform Elements of an employervoffered group heafth plan. • Apportionment — The employer is only • Labor Code 5814 Penalties - The penalty liable for a portion of disability dire�tly caused by only applies to the late payment of the claim. A injury. Any prior permanent disability awards to an ceiling of $400,000 penalty for a"frequency that employee are conclusively presumed to exist at indicates a general business practice" is also the time of the subsequent injury. Accumulation applied. of all permanent disability for any region of the body shali not exceed 100%. • Provision of Medical Care Until Decision - The language in the last sentence of paragraph • Return to Work — Restores user funding (c) indicates the cost is limited to $10,000 until date and specifies use of funding for return to work of acceptance. It doesn't say this is the cost limit if program. Allows eligible small employers (up to case is rejected. 50 employees) to apply for reimbursement for workplace modifications necessary to return • Temporary Disability Limit to 2 years — injured workers to work. This in no way affects 4850 temporary disability. • Carve Out for ADR — the public sector • Treating Physician Presumptions — Re- has been piaced in the design of a"carve out" for peals the rebuttable presumption of correctness for alternative dispute resolutions. a comprehensive medical evaluation by a • RTW Provisions - Return to Work - �f the predesignated personal physician. employer has a job to offer the injured worker and . Medical Fee Schedule — Except under he does not accept it, the permanent disability allowed contracts, would limit the amounts paid for award decreases by 15%. If the employer does medical services to the reasonable maximum not have a job to offer the injured worker, his amounts in the official medicai fee schedule in permanent disability award increases by 15%. If effect on the date of service. Medical providers the employer offers the injured worker the same Would submit an itemization of inedical services "type" ofjob, that injured worker gets 100% of his provided and payment would be made accordingly. salary. If the employer offers the injured worker PAGE 4/PRIORITY FOCUS Visit the League's Official Web Site--www.cacities.org