Workers Comp Zone



Take a look at this California workers’ comp  flow chart that surfaced a few years back:


I’m not sure who drew the flow chart, but at times I’ve considered having it blown up and framed to celebrate the various absurd features of the system.

Being a worker or an attorney caught in the system was sometimes was like being in a briar patch.

The flow chart was  titled “Under the New W.C. Legislation” and refers to the California’s system several reforms ago….. but…….

Since then has the California workers’ comp system been simplified and streamlined? Can it be?

The flow chart contains a warning: “Do not be misled by the disarming simplicity of this process. When the new Rules, Regulations & forms are promulgated, this could become relatively complicated.”

Of course the irony is that the system was horribly complicated when the chart was drawn. And further attempts to simplify have often led to more complications.

A July 2015 assessment of the SB 863 workers’ compensation reforms has just been released by the DIR/DWC (more on that in upcoming posts), and  Appendix B to the July 2015 assessment lists the status of SB 863 regulations.

Around 15 sets of regulations (all dealing with different topics and many of which are very lengthy) have either been promulgated or are nearing completion. That doesn’t include WCAB regs, OSIP regs, or regs regarding the $120 million Return-to-Work Supplement Program. Many went through multiple iterations before final adoption. I have binders with regs that are one or two versions behind.

The sheer size of this undertaking, dictated by the SB 863 changes, was daunting.

Getting and staying on top of all of this remains daunting even for the most experienced judges and attorneys. But these regs are critical to how workers’ comp medical treatment and indemnity benefits are now administered and delivered to workers.

God help the new adjuster who must quickly jump into claims handling under all these regs.

I occasionally serve as a workers’compensation judge pro team in Oakland when assigned judges are ill or on vacation. And I can tell you that based on my experience when viewed from the bench, many of the workers’ comp stakeholders are far from being on top of understanding and complying with various post SB 863 regs.

There’s also confusion at the top. The WCAB has issued conflicting panels on several issues, including the effect of a late IMR determination by Maximus (the Arredondo case and the Saunders case). In preparing for a case law update presentation at last week’s CCWC Disneyland conference, it struck me how many of the last year’s important WCAB panel decisions turn on interpretation of regulatory minutiae.

So are we back to the “Briar Patch” of the flow chart pictured above?

Maybe some enterprising stakeholder with graphics skills can update the chart.

Til then, if you are involved in California workers’ comp, better immerse yourself in this stuff. Failing to do so will be at your peril.

Stay tuned.

Julius Young