Wednesday, May 6, 2015

Interpreters, Fees and Fingers

The showdown on interpreter fees in California typifies why workers' compensation ends up with convoluted rules, ineffective enforcement, and diverts attention away from the main task of taking care of injured workers at a reasonable cost.

DWC proposed late last month, and two years past SB 863's mandate, an interpreter fee schedule.

The rules would create separate reimbursement rates depending on whether the services are provided in a medical or judicial setting, the language being interpreted and whether the interpreter is certified.

Proposed payments for medical appointments are:
  • $52.50 for Spanish language certified interpreters and $82.50 for certified interpreters in all other languages.
  • $25.75 for provisionally certified Spanish language interpreters and $33.25 for interpreters provisionally certified in any other language.
  • An interpreter at a medical-legal exam would be entitled to payment for a minimum of two hours for each exam.
  • An interpreter at a medical treatment appointment would be entitled to a minimum of one hour for each appointment.
The fee schedule rates for hearings and depositions are:

  • $210 for each half day of service – defined as 3.5 hours – and $388 for a full day of service for certified Spanish interpreters.
  • $240 for each half day and $418 for each full day of service for all other certified interpreters.
  • $103 for each half day and $187 for a full day of service for provisionally certified Spanish interpreters.
  • $133 for each half day and $217 for each full day of service for interpreters provisionally certified for any other language.
The rules would define an interpreter provisionally certified for hearings and depositions as an individual who a hearing officer determined is qualified to perform interpreter services. Provisional certification for medical appointments would require the physician to determine the person is qualified to perform interpreter services.

At least based on WorkCompCentral's story this morning, nobody is happy with the proposal. Some say it is discriminatory against Hispanic workers because Spanish is compensated at a lower rate than other languages. Some say there are still loopholes for interpreters to over bill for multiple appearances at a hearing. Still others say the schedule hasn't kept up with inflation, causing in reality a 50% pay cut for interpreters.

And nobody seems happy with workers' compensation judges declaring who is, and who isn't, "certified."

Everybody misses the point.

Fee schedules don't arise out of thin air - nearly universally, fee schedules are the aftermath of perceived abuse. In the case of interpreters, there are likely a couple that indeed abused the freedom of no schedule and loose rules that created an "issue" with certain folks; and perception is a powerful policy driver.

So the response is to create even more rules, more technicalities, more issues.


Guess what will happen? There will still be those who abuse whatever is put out there, and there will be those who don't want to pay.

Nothing will really change.

The solution is very simple: wrap everything into one package at a single price.

What I mean by that is that interpreters should just be paid by the day for whatever service they provide; half day if they can't show that services were tendered on a certain minimum of cases.

For instance, set the daily interpreter rate at $500, regardless of whether the context is medical, legal or both, and regardless of the language required. Assume that in a single day an interpreter should have provided services on six cases - the interpreter would need to note those cases by name, claim number and case number, on the bill. If there's six of them, or more, then the interpreter gets $500. If there's fewer than the interpreter gets the half day rate, or $250. 

And if only one case is serviced, but that case lasts a whole day ... oh well, it all works out in the end and maybe that interpreter won't be available in the afternoon, or a judge could order an override because the interpreter was in fact present all day. There are simple solutions.

Sure, some will fraudulently inflate bills by listing more cases than they tendered services on. That's no different than any other sort of abusive behavior that less scrupulous professionals are going to engage in anyhow.

That's a cost of business, and an enforcement issue for the government.

We're spending all this time, all this money, all this energy arguing and debating about a very small expense. In the meantime people are getting hurt, but not getting the treatment or indemnity mandated by the law which costs the employer more money than it should.

In other words, stop looking at the finger when pointing to the moon....

The DWC will continue to accept comments on the draft fee schedule until Thursday at 5 p.m. Comments can be sent by email to The DWC will review comments and consider whether to make change to the interpreter fee schedule proposal before initiating the formal rulemaking process.

The proposed rules are here.

No comments:

Post a Comment