Wednesday, September 7, 2011

Sausage Making Comes to a Close

Workers' compensation is a statutory creature, born of the political process.

The political process is messy, with constituencies, stakeholders and interested persons having their say in the construction of laws ultimately ending up with some compromise, or bullying, into positions that define the next generation of either spending or making money - at least in the realm of workers' compensation laws.

I'm reminded of this insanity as we close into the final week of legislative activity for many states as bill upon bill are moved around legislative committee, getting amended, voted on, suspended, etc.

Oft attributed to Otto von Bismarck (who coincidentally is also attributed with introducing the first workers' compensation concepts into society), is the saying "law is like sausage, it is best to avoid seeing it made." Indeed, it's not a pretty process and the machinations of a legislature in action at the final hour can make one queazy! But if there's one positive attribute to this crazy process, is that if you're interested and paying attention the process can either help laws pass, or inhibit forward their movement.

We are seeing this in the final hours of the California legislature where there are several bills that are intended to chip away at the laws passed upon the domination of the Schwarzenegger Administration in 2004.

Our Western Bureau Chief, Greg Jones, summarized the state's pending workers' compensation bills in this morning's top story and it highlights how the political process can work for or against the passage of laws. Three of the most controversial bills are up for vote in the Senate, and must return to the Assembly for passage because of amendments that occurred in the Senate [comments in brackets are my personal votes]:

AB 1155 (Alejo, D-Salinas) proposes to change the apportionment law to eliminate discrimination against naturally predisposing conditions in certain classes of people defined by age, gender, race, etc. [AGAINST]

AB 375 (Skinner, D-Berkeley) would create a new presumption of injury for nurses with blood borne diseases. [AGAINST]

AB 947 (Solorio, D-Santa Ana) would extend temporary disability status where surgery occurs after 104 weeks of TD benefits have been exhausted, provided the delay is not caused by a worker's failure to undergo recommended treatment and the surgery was delayed as a result of a treating physician recommending a less invasive treatment initially. [AGAINST]

There are other bills pending Senate vote involving a loan from the Uninsured Employer Benefit Trust Fund to start up another state agency within the Division of Industrial Relations [AGAINST]; one that would require the Department of Workers' Compensation come up with ANOTHER booklet explaining workers' compensation to injured workers (heck - they should just use the WorkCompCentral Flowchart!) [AGAINST]; change reimbursement rates for compound drugs [FOR]; require utilization review only by California licensed physicians [FOR].

Physician lobbyists will be watching closely Senate Bill 923 (DeLeon, D-Los Angeles), which would require the Division of Workers' Compensation to adopt a fee schedule using the resource-based relative value system (RBRVS), which is on the Assembly Floor for a vote [FOR].

It appears that Senate Bill 863 (Lieu, D-Torrence), which would require liens be in writing and would create a three-year filing window for services provided before July 1, 2012, and an 18-month window for services provided after that date is dead and that Senate Bill 432 (DeLeon, D-Los Angeles), which would require hotels to use fitted sheets and provide housekeepers with long-handled cleaning tools is likewise going no where this legislative session.

While many of us may only be concerned with the final outcome, it is important to see how these laws take shape and understand who is positioning to benefit from them. The political process, like sausage, blends all of the parts together to present the final form. Sometimes its good sausage, sometimes it isn't.

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