Tuesday, June 18, 2013

Glad I Don't Have That Job

The hornet's nest that was started with the $120 million excess disability fund created by SB 863 in California is finally starting to take shape, and as many figured, this last minute, ambiguous provision raises more questions than it satisfies.

SB 863 says eligibility to the fund is to be determined by the director of the Department of Industrial Relations and that any director determination shall be subject to review at the trial level of the Workers’ Compensation Appeals Board “upon the same grounds as prescribed for petitions for reconsideration.”

WorkCompCentral reported this morning that a budget trailer bill, AB 76, now awaiting Gov. Jerry Brown's signature, limits application of the fund to injuries on or after Jan. 1, 2013, allows for the carryover from one year to the next any unspent money in the account, but doesn't restrict that money to only financing the fund, doesn't dictate what happens when the fund goes short, and doesn't set up an allocation system to prevent first in line preferential treatment.

The fund measure is part of a much broader budget bill, affecting the Water Code, Public Utilities Code, Harbors and Navigation Code, as well as the Labor Code, setting up partisan political fighting.

AB 76 passed through the full Senate on Friday, 23-11 with all Republicans opposed. The Assembly then followed with a 53-25 vote, with Republicans opposing the measure again.

What's funny to me is that Republican leader Bob Huff of Diamond Bar told the Senate, “Colleagues, ask yourself how comfortable you are with a final product produced by three people in a closed room that neither you, nor your constituents have had a chance to review.”

I thought that's how most legislation goes through the legislature...

California's lawmakers have given the director of DIR an incredible amount of power, and responsibility, since neither SB 863 nor AB 76 give her much direction in terms of operating procedures and rules for the fund.

Employer advocates are concerned that the fund will be volatile, since there are no rules regarding excess monies or fiscal shortages.

Employee advocates worry that allocations can't be firmly projected setting up first come, first served disputes.

The arguments are uniquely aligned - the number of cases that will qualify for the fund from one year to the next is obviously not fixed and there is no way to predict exactly how many are to get how much year in and year out.

The DIR is currently waiting for a Rand Corp. wage-loss study before it sets the criteria for workers to receive payments from the fund. Assuming timely release of that report, DIR hopes to get draft regulations out by the end of summer.

The Rand researchers are smart people. It will be interesting to see how they put the numbers out there that will allow some sort of reasonable predictability to fund allocations, and to annual employer assessments.

Both sides are rightly concerned that fund monies will end up the fodder of future legislatures looking to plug budget gaps, and the director will not be able to override such legislative raids with her rules in such situations.

In the grand operational scheme of things, the fund doesn't represent a whole lot of money. But to injured workers with significant wage loss, the fund may make a huge difference.

The DIR, and in particular its leader, Christine Baker, have a very difficult, delicate task ahead. I expect the regulatory process enabling the $120 million excess disability fund to be particularly contentious.

Baker is a strong leader. Implementation of the fund is going to be a huge challenge.

And in all of the SB 863 drama, the how and what of such regulations will likely be the defining moment of Baker's career.

I'm glad I don't have that job.

Monday, June 17, 2013

We Can't Make the World Right But Can Do the Right Thing

Yesterday was Father's Day. Most consider the day a tribute TO fathers. I prefer to celebrate with tributes FROM a father. That's how this Father's Day weekend played out for me.

I told my Dad, who will be 91 this year, is in excellent physical health, and is incredibly sharp of mind, a couple of years ago that when I grow up I want to be a philanthropist.

I still do. But I'm still growing up and philanthropy requires a certain status in life, and a certain level of financial success, both of which I have yet to attain, but the goal of being a philanthropist drives me every day.

So charity is as close as I can get at this stage in my life, in particular if it is to help children or animals.

So many children and so many animals are without - without good homes, without basic needs, without love or attention. Some have been through such difficult times and just need some generosity.

I was fortunate this past weekend to give a little back to this world that has been so kind to me by using the gifts of my success to transport a couple of children who had sustained burn injuries from Champ Camp to their homes using my airplane.

Champ Camp is a week-long, residential summer camp experience for child burn survivors ages 5-16. It's free to all burn survivors and the camp usually hosts about 130 children.

Arrisa and Daniel - my two Champ Camp passengers. 

A lot of these kids don't have transportation to the camp, which is in Wonder Valley in Sanger, California (near Fresno), because they come from families without the means to get them there.

That is where Angel Flight West comes in.

Angel Flight West is a nonprofit, volunteer-driven organization that arranges free, non-emergency air travel for children and adults with serious medical conditions and other compelling needs.

Because of Angel Flight West, many kids that wouldn't get a break from their difficult daily lives would not be able to enjoy the camaraderie of other children with similar issues. Being with others that share the common thread of burn trauma is hugely restorative to these kids - it literally changes their outlooks on life because know that they are not alone.

It was a long day of flying. My assistant and I had to go from Oxnard, where my plane is hangared, to Fresno to pick up my passengers, then to San Diego's Montgomery Field, then back to Oxnard.

We covered just shy of 600 nautical miles on Saturday with about 4.5 hours of flight time, 3 take offs and, fortunately, 3 uneventful landings!

My passengers were delightful, very polite, and very appreciative. Both had obviously enjoyed their time at Champ Camp, coming back with various projects that they had completed at camp. And both had unbelievably bright outlooks on life despite the trauma of their injuries.

The boy passenger, interested in aviation (like a lot of 15 year old boys!) asked a couple of questions about my aircraft and he was completely non-plussed when I explained that it was, "a 1979 Beech Bonanza A-36 with a Continental IO-520 fuel injected 6 cylinder engine rated at 285 horsepower that had been rebuilt by Victor Aviation in Palo Alto, the same shop that builds all of NASA's piston aircraft engines...".

He liked that. It was factual and satisfied his curiosity.

The girl wasn't as interested in aviation, but she was curious why the passengers faced rearward. She was okay when I told her that we could put the seats facing forward but that would reduce the amount of room in the back of the plane.

When we dropped the boy off in San Diego, he said to the girl that he hoped to see her back at Champ Camp next summer. That touched me. Their only real connection was this Angel Flight, and their common injuries. Champ Camp gave both of them a bigger, brighter outlook on life.

Then that evening, just as I was about to serve up dinner, the doorbell rang. It was Ella and Eligh - a couple of the neighborhood kids. They are 8 and 6 years old respectively. I can't say that they come from the best family background...

They come over to visit us often. They like our great dane puppy, and are fascinated with our 26-toed cat, and of course are always more than happy to sample the fresh chocolate chip cookies my wife makes or help out with projects in the garage.

Both kids had obviously been crying. Their eyes were puffy and swollen from tears. I don't know what kind of trauma they were subject to, but I guess it doesn't really matter - they just needed a short period of stability and safety. And they also wanted some pasta...

So they shared the dinner table with my wife and I - a couple of unexpected, albeit delightful, guests who were so happy to sit at a family dinner table and share their days with some adults they trusted.

I'll be 54 this year. I often find myself a bit weepy with sentiment thinking about the plight of those who are put into difficult circumstances through no fault of their own.

I felt like a father on Father's Day because some children touched my heart. I honestly can say that there is no greater gift a father could experience.

The little world of workers' compensation has its own charity for children, Kids' Chance.

Kids' Chance creates and supports programs that provide educational opportunities and scholarships for the children of workers seriously injured or killed on the job.

We can't make the world "right," but as individuals we can all do right things for the world. If that guides us in our daily work, workers' compensation will achieve its original goals.

Friday, June 14, 2013

What Value In Progress Reports?

Alex Swedlow, president of the California Workers' Compensation Institute, noted researcher and all around great guy, challenged me yesterday at the annual WCIRB meeting in San Francisco: What is the single medical billing procedure that is the most common in California's workers' compensation system?

Physical therapy? Nope.

Prescription drugs? Not close.

Laminectomy? Please...

How about progress reports?

Yep, progress reports.

And what is the most frustrating, and burdensome procedure for physicians in workers' compensation?

Progress reports (Alex didn't tell me that - I've garnered that from years of talking with physicians).

Why is the industry so focused on medical reporting, and in particular the ubiquitous progress report? Simply because it is mandated in the Labor Code and regulations.

Take a look at the Treating Physician's Progress Report, PR-2 - what do you see?

First off, a request for lots of unnecessary, redundant, and valueless information. For example, why, if we know the injured worker's name and claim number, do we need to know his address, date of injury, date of birth, occupation, phone number, etc.?

Why do we need to know all of the same information about the claims administrator? Who gets this report? The claims administrator - do you really think that the claims administrator doesn't know who he, she or it is?

And why is the employer's phone number required? The employer doesn't want to be bothered - this is a matter that's being handled by the claims administrator.

Note in the grey box at the top - the options for the reason for this report. The very first option is, "Periodic Report (required 45 days after last report)".

Talk about a cost driver! Why does the law mandate a report every 45 days regardless of status? What value is derived from this activity other than billing for an office visit and preparation of a report that calls for lots of redundant, time consuming, valueless information? Why must the patient information and claim administrator information be included every single time a progress report is submitted and what is so magical about 45 days?

The report then asks for subjective complaints, objective findings, diagnosis, and treatment plan - the use of additional pages in narrative format is encouraged.

What is the purpose of this form? What value is derived from mandating this reporting? The content of the form does not drive statistical understanding of cost drivers in workers' compensation because the data on the form doesn't go beyond the claims adjuster or, perhaps now, independent medical review.

Data on a claims progress is kept in other, more accessible, less burdensome and more easily understood format.

I think about when I was practicing workers' compensation law and rifling through files getting an understanding of a claim and the medical condition and history of an injured worker. I never, ever, paid much attention to the progress report because there simply wasn't any valuable information provided. The progress report did not help me manage the claim - in particular the mandatory 45 day reporting which basically was always a status quo report.

Everything in the progress report is transmitted to the claims administrator in different fashions via more efficient communication systems.

There is always much consternation about the cost of the medical component to workers' compensation. The negotiators of the latest California reform put a lot of effort into medical treatment controls and now we have independent medical review, bill review, limitations on treatment protocol, etc.

But no one has taken a look at the ponderous reporting requirements in workers' compensation and whether any of this mandatory report writing returns any value to the system.

I suspect that we'll see some research in the future on this cost aspect - but is that even necessary? Why not just tackle the issue now?

A lot of time is spent in the legislature about restricting continuous trauma claims from workers with minimal contact with the state, about funding prescription drug monitoring programs, and excess disability slush funds.

Not much time is spent looking at existing procedures and systems to question whether any of this is really necessary in order to administer claims and whether any of these activities returns value to the system.

Time to start...

Thursday, June 13, 2013

Work Comp Is Like the Weather

A friend of mine quipped the other day that workers' compensation is like the weather - everyone complains about it but no one does anything about it.

At dinner last night another workers' compensation acquaintance commented that workers' compensation is such a dysfunctional system that one really need not go far at all to find some element of abuse, failure or leakage.

Then this morning I read the latest edition of the Workers' Compensation Executive and the lead story that State Compensation Insurance Fund's downsizing was so dramatic that claims administration services incurred 300,000 penalties last year for a total of $21,858,570.

That's a lot of claims adjuster positions...

According to the story, most of the penalties were late payments to providers.

I hear and read complaints all of the time about late payments, and underpayments, to providers so this news is not surprising.

Worse is that there were 7,849 instances of penalties for failure to properly compensate injured workers, resulting in $1,989,629 in penalties last year.

The cycle continued into this year with the carrier reporting that for the first four months of 2013 it had incurred another 2,122 penalties for late payments to injured workers.

And those are only the ones that were caught or reported.

Observers note that the issue is the downsizing of the claims departments at SCIF. Last year the carrier famously announced a sharp consolidation of its offices, reduction in work force and liquidation of properties or termination of leases.

As a consequence the carrier, according to the report, has increased the work loads of remaining adjusters who are still tackling with computing systems that require more labor and effort beyond the adjusting of claims.

Unfortunately I don't see what SCIF is doing as anything that any other business in a similar situation wouldn't do. In grand truth, it makes better business sense to incur these penalties because it is cheaper than fully staffing across the state in multiple offices. It may not be in keeping with the carrier's mandate, but, as they say, "business is business."

The real shame is the complete ineffectiveness of the penalty system that has become the primary enforcement tool against carriers since Labor Code 5814 was eviscerated in 2004.

LC 5814 was gutted in response to the perception that applicant attorneys were using the section to unfairly, and unreasonably, gain profit against carriers for simple mistakes.

Before the section was amended the penalty enforcement section was interpreted as being applicable to every single instance of error, and thus there was the potential of a compounding effect on penalties. The complaint by the payer sector was that simple mistakes that would normally cost a dollar would get pumped up by the use of this section and cost five dollars, or more.

The legislature was persuaded that there was sufficient enforcement capabilities within the Division of Workers' Compensation Audit Unit to keep carriers on the straight and narrow.

But this has not turned out to be the case. The fact is that the Audit Unit itself is understaffed, and inadequately armed, to be of any threat to a payer.

I'm not saying that carriers see Audit Unit penalties as just a cost of doing business - but certainly the risk of an audit and penalty order isn't as threatening as a huge, compounding penalty under the pre-2004 section 5814.

The tendency in workers' compensation reform is to over-reform, to swing so far from the middle in a reaction to a perceived injustice that the exact opposite occurs.

Workers' compensation may be like the weather in that everyone complains about it. But unlike the weather, people have the power to do something about it.

Reform will cycle through again - this seems to be an immutable fact about workers' compensation. And in the next cycle you can bet that there will be a push to build stronger private-based penalties into the Labor Code.

Wednesday, June 12, 2013

Medical Board's Review of Review Physicians

One of the big controversies that has surrounded utilization review (UR), and now independent medical review (IMR) is whether the physicians conducting these reviews were engaged in the "practice of medicine" and thus subject to review, and possible discipline, from the medical board in the state where the case originates.

At least in California, the Medical Board has recently opined that UR and by extension IMR is the practice of medicine subject to review by the board.

The California Medical Board has been under review by the legislature recently on allegations of lax enforcement against physicians.

As part of the review legislators specifically asked the board whether it felt it had powers over UR and IMR physicians.

As a consequence of a treating doctor's complaint to Assemblyman Henry Perea, D-Fresno, the legislator initiated an inquiry into the board's position on the issue.

After informal discussion failed, Perea sent a letter to Dr. Sharon Levine, president of the Medical Board at the time, asking whether the board considers UR the practice of medicine and how it arrived at its conclusion that it has no oversight of UR doctors.

The letter in addition asked whether contracts with insurance carriers, specifically in this case the State Compensation Insurance Fund's (State Fund) letter to its medical provider network physicians (MPN) requiring physicians to agree not to prescribe more than a 60-day supply of compound drugs or opioids without prior approval as a condition of enrolling in its network.

Medical board staff counsel issued an internal memo opining that historically the board did not investigate complaints that are “not based upon an attempt to leverage the outcome of a UR treatment decision or compensation claim, but rather to ascertain whether the standard of care is being followed.” The April 10 memo says the board classifies such complaints as “non-jurisdictional.”

The memo also details how the Labor Code trumps other law and that the Workers’ Compensation Appeals Board “has exclusive jurisdiction over any controversy relating to or arising out of the medical treatment of an injured employee.”

The Medical Board's response to Perea was that it considers utilization review to be practicing medicine and also states that it will “not automatically deem UR complaints non-jurisdictional” and that “a physician is not insulated from potential discipline from the board simply because he or she is under contract to a (workers’ compensation) insurer, private or otherwise.”

There is renewed interest in requiring UR and IMR physicians to be licensed in the state as a consequence because then the Medical Board would then have disciplinary jurisdiction over such physicians.

In 2011, Gov. Jerry Brown vetoed AB 584, which would have required work comp UR physicians to be licensed by the Medical Board of California.

This year, Sen. Jim Beall, D-Campbell, introduced SB 626, which included provisions requiring all doctors doing utilization review and independent medical review be licensed in California. Beall pulled his bill in April and plans to pursue it again in 2014.

But in the meantime, while the Medical Board undergoes its review, Sen. Curren D. Price, D-Los Angeles, who is chairman of the Senate Business, Professions and Economic Development Committee, has filed SB 304, a bill that would transfer medical board investigators to the state Department of Justice and give the department the authority to investigate and discipline doctors.

Price has been critical of the Medical Board's investigation, enforcement and discipline record.

The question is whether the Medical Board's current position, that it will investigate complaints that a utilization-review physician has fallen short of established standards of care, something it has previously not done, is in response only to attacks on its survival, or because the board truly feels it has a duty to the public to do so.

Either way, the board is in a tough position. It is basically admitting ipsa loquitur to a failure in the recognition of its duties in the past.

Sometimes workers' compensation drama occurs outside the direct workers' compensation world but can have far reaching impact. How the Medical Board review drama plays out will steer how the industry conducts UR and IMR going forward.

Tuesday, June 11, 2013

How A Federal Take Over Could Occur

Last week I wrote about the expanding influence, and perhaps, jurisdiction of the federal government over our lives, and in particular (of course) workers' compensation.

Yesterday I argued that California Assembly Bill 1309 was bad law and should not get to the governor's desk.

The two may come together - when we look at the various legal and legislative/ regulatory actions going on regarding professional athlete injuries and the politics across the nation concerning the limitation of jurisdiction - we see argument why workers' compensation may need uniformity and consolidation; ergo, federal control.

I'm not saying I'm in favor of a federal take over of workers' compensation, but look at these facts and tell me whether or not, if you were a federal legislator, you would be inclined to mandate a federal system of workers' compensation, at least for professional sports that cross state lines whether via live participation or virtually via television or other media, and other migratory industries.

After arbitrator Michael H. Beck on Dec. 12 issued a decision saying football players signed contracts agreeing to file work comp claims in the state where the team was located, rejecting the player's arguments that the order violated a federal court ruling stating that there needs to be an opportunity to demonstrate where the injuries occurred, a federal judge has granted a hearing on a proposed order that would overturn Beck's decision.

In July, a federal judge in Philadelphia is expected to rule on whether former players can sue the National Football League about concussion-related injuries. An estimated 4,300 former players have filed lawsuits that have been consolidated in the U.S. District Court for Eastern Pennsylvania but the NFL seeks dismissal on the argument that the suits are preempted by the collective-bargaining agreement between the league and the NFL Players Association.

In April, Arizona Gov. Jan Brewer signed a bill similar to California's AB 1309 that prohibits people working for employers in the state from filing work comp claims for injuries sustained while working temporarily in another state.

Other states have also passed laws limiting the ability of professional sports athletes to seek redress in states other than that of the players' contractual domicile, most recently Florida and Tennessee.

Then on Thursday a district court judge in Washington, D.C., allowed Bryan Namoff, a former soccer player to proceed with a $12 million civil suit against his former team for medical negligence alleging his former team, D.C. United, allowed him to play too soon after a head injury.

Judge Natalia M. Combs Greene said D.C. United didn’t have insurance and wasn’t exempt from suit as a consequence.

“The liability of D.C. Soccer is clearly outside the coverage of the WCA,” she wrote. “D.C. Soccer failed to secure workmen’s compensation insurance coverage for Namoff and the WCA grants an employee the right to bring a case at law against an employer who fails to secure such coverage.”

Don't forget the disparity between state jurisdictions on how to handle the ongoing issue of opioids and other prescription drugs.

Some states have drug monitoring programs, others don't. Some states restrict drug repackaging, most others don't.

The migration of drugs across state lines occurs as soon as a neighboring state implements restrictions that impede the prescription, procurement, delivery or ingestion of drugs.

Where's the Food and Drug Administration in all of this?

And don't forget the financial impact of big insurance across state lines, in particular when an insurance company is "too big to fail" and the federal government is inclined to bail that company out, all while evidence mounts that there was surreptitious use of questionable financial instruments to avoid premium taxes and other state obligations.

Still to this day, there are fights between states regarding failed workers' compensation carriers - New York's Liquidation Bureau has filed a petition in New York Supreme Court seeking to be appointed ancillary receiver of Ullico Casualty Co. while in Illinois the Circuit Court of Cook County has refused to stay proceedings involving Ullico despite a Delaware court order to the contrary.

Fights between jurisdictions, big money on the line, worker rights over safety and benefits, inconsistency in awards or order enforcement, migratory claims and drugs - the list can go on why some federal lawmakers may want to carve out certain jobs and industries and make them subject solely to federal jurisdiction.

Combine the above with a federal agency examining workers' compensation across the nation, a federal insurance oversight office, and overall expansion of the federal government and it's not hard to see how a federal take over of at least a portion of state workers' compensation systems could occur.

I'm not saying this is inevitable, desirable or reprehensible. I'm just saying ...

Monday, June 10, 2013

AB 1309 Fails the Common Sense Test

The California Society of Industrial Medicine and Surgery and the California Neurology Society have come out to formally oppose California Assembly Bill 1309.

AB 1309 is the professional sports athlete exclusion bill that would remove the ability of designated professional athletes in football, basketball, baseball and hockey from utilizing California's continuing trauma theory if the athlete can not prove sufficient contacts within the state, as prescribed by the bill.

The bill is promoted by Assembly Member Henry Perea (D-Fresno). Perea says the ability of professional athletes not based in California is a "loophole" in the state's workers' compensation laws. He is joined by Senator Ted W. Lieu (D-Torrance) as a principal co-author and Senator Mark Wyland (R-Escondido) who has also agreed to co-author the bill.

Perea says that AB 1309 "would set clear jurisdictional standards on claims from professional athletes and close the loophole that currently allows out-of-state players to file cumulative trauma claims in California, regardless of whether they played for a California team or ever actually entered a California field to play. It would also close the loophole that allows out-of-state athletes to place 100 percent of the cumulative trauma liability on California-based teams despite having played a minimal amount of time for that team – while playing for multiple non-California teams in subsequent years."

Perea says that the "loophole" fails the "common-sense test."

The irony is that AB 1309 itself fails the common-sense test.

First off, AB 1309 targets ONLY professional football players, hockey players, baseball players and basketball players. What about other professional athletes? How about motocross racers? What about jockeys? Why not professional cheerleaders? And why are the coaches, assistant coaches, managers and back office people still able to avail themselves of this "loophole"? All of these workers cross state lines and may file for benefits, including continuous trauma injuries, in California without restriction.

What is most despicable about this proposed law is that it is SO arbitrary and discriminatory.

The ONLY difference is that the pro athletes get REAL, life altering injuries - particularly football players that the NFL would just like to keep quiet so that this modern day version of the Roman gladiator entertainment factory remains anesthetically pleasing to the consumers so they will continue to purchase ridiculously priced tickets and support outsized television commercial contracts.

The single biggest threat to the NFL now is the growing recognition that the sport considerably shortens athletes' lives and contributes substantially to organic brain disease. Constant sustained head trauma is the single most life-altering injury these athletes face, and it is a tragedy that the NFL would like to keep away from the public the fact that so many end up with dementia, Alzheimers, Parkinson's and other serious maladies tied directly to continuously sustained brain trauma.

The argument for this ridiculous bill is that athletes rarely step into this state. That argument is absurd.

Every time a television broadcast of an NFL game occurs in California before MILLIONS of California based fans those athletes have stepped into this state.

Every time an NFL game is broadcast into the television sets of California fans to entertain the masses the NFL receives MILLIONS of dollars in television broadcast rights.

And the same can be said for every other state too.

The NFL has no problem taking revenue from broadcast rights where their employees are placed virtually into this state across millions of television sets, but apparently does not like to recognize the fact that the millions of dollars received in broadcast rights would not exist but for the fact that they are placing their athletes into California.

There is no difference between playing a game live or via television where the same net result is that millions of people contribute millions of dollars in revenue for that entertainment.

Forum conveniens is a long standing, time honored legal principal that should not be discounted. Just because California offers a legal remedy that other states don't recognize does not mean that it is out of line, out of touch, irresponsible, or wrong.

Just the opposite - California's long standing tradition of being non-traditional, thinking outside of the box, leading the way, has created the most resilient, most robust, most diverse economy of the United States and one of the most vigorous economies of the entire world.

Why would 38 million people live here otherwise, and why would California have the greatest concentration of wealth in the world? Because California does things differently and the state traditionally recognizes the contribution of working people regardless of their income, their status, their location, their domicile.

Perea says that "the bill would not limit the ability of professional athletes or any other worker to file for cumulative trauma benefits in their home state or principal state of employment."

Hey, that's a great argument ... NOT! Because no other state recognizes "cumulative trauma benefits" like California does; because no other state recognizes the contribution of PEOPLE, aka The Working Class to its economy (and yes, despite large salaries for very short careers, professional athletes are largely working people putting their bodies on the line for the entertainment of the masses).

If California politicians had ANY balls (and there aren't too many of them left in the legislature) then this state would set a precedence and tell the NFL, "No F*cking Legislation" that would alter this state's long standing tradition of recognizing that employers need to own up to their use of workers in hazardous occupations no matter where they live.

California's great economy is built on one simple fact: that as a world class economy we rely on the sweat equity of everyone that contributes.

When the NFL is in town (whether in person, on television or any other medium), the town spends. It's okay if the NFL and the other sports franchises return the favor. They can afford it. The workers' compensation obligation to California's workers is particularly acute when an employer takes so much money from willing consumers.

The NFL and other professional sports franchises owe it to their workers to protect them, regardless of their incomes, regardless of their status, regardless of their jobs.

To allow otherwise is an affront to the working people of this state.