LETTERS
Workers’ Comp
Within the next few days, the Workers’ Compensation Conference Committee will decide whether to reform the workers’ compensation system to provide desperately needed relief to California businesses. The Orange County Business Council urges OCBJ readers to press the conference committee members for significant reforms,without linkages to mandatory, employer-paid health insurance.
Calls and e-mails are needed now to:
Senate President Pro-Tem John Burton at Senator.Burton@sen.ca.gov; Senator Richard Alarcon at Senator.Alarcon@sen.ca.gov; Senator Chuck Poochigian at Senator.Poochigian@sen.ca.gov; Assemblymember Fabian Nunez at Assemblymember.Nunez@assembly.ca.gov; Assemblymember Juan Vargas at Assemblymember.Vargas@assembly.ca.gov; and Assemblymember Ken Maddox (does not use e-mail) at fax (916) 319-2168.
Tell the legislators that “significant” workers’ compensation reforms must include:
& #149; Improvement in the definition of workplace injuries to reduce fraud and over-utilization.
& #149; Medical fee schedules for outpatient facilities to control costs.
& #149; Permanent disability reform, to reduce awards to those able to return to work within short periods of time and to increase benefits for those unable to return to work.
& #149; Dispute resolution alternatives that diminish the need for legal representation.
Increased workers’ compensation costs represent a threat to our companies’ future and to jobs in California.
Stan Oftelie
President & CEO
Orange County Business Council
The dysfunctional workers’ compensation system, once only an employers’ problem, has become a taxpayers’ problem. It exacerbates the hostile business climate that is destroying tax-paying businesses or driving them out of the state.
Golly, it must be a real problem. It suddenly caught the eye of the state Legislature and Gov. Davis, who have ignored the problem for years but now promise to fix it. Nothing like a recall campaign to focus the mind. The Orange County Taxpayers Association (OCTax) hopes their reformist zeal will last beyond the Oct. 7 recall election.
Legislative leaders have hinted that they may consider such reforms only in conjunction with the creation of some other mandated program such as mandatory, employer-paid health insurance.
OCTax would oppose such a condition for two reasons. First, workers’ compensation reforms are so needed that they can and should stand on their own merit; second, to reduce the cost of one program, only to introduce another equally expensive one, would do nothing to improve the California business climate.
Reed Royalty
President
OCTax
San Juan Capistrano
At $15 billion yearly, the California worker’s compensation industry has exploded, with employer costs headed for highest in the nation and rising at twice the rate of general health premiums. Yet regulatory inefficiency and outright fraud drain resources, so that worker benefits rank in the lower third of states, while payments to providers rank 48 out of 50 states.
Experienced doctors are second-guessed by insurance adjustors, while legitimately injured workers experience severe delays in receiving treatment and benefits. A corrosive tension exists between suspicion and waste, over-treatment and under-treatment. Unfortunately, bad reform proposals,such as switching medical payments to Medicare levels or blocking surgeons from treating their own patients in their own surgical facilities,abound.
What would work? California Insurance Commissioner John Garamendi correctly targets insurer practices, obsolete regulations and excessive medical and legal costs. To create solutions, doctors, unions, insurers, attorneys, and government must sit at the same table.
Among the needed reforms:
& #149; Fair rates to providers.
& #149; Reining in excessive charges by some chiropractors, physical therapists, and outpatient surgi-centers.
& #149; Higher overall fees for applicant attorneys, but capped per client, rather than paid as a percentage of the worker’s recovery. This would discourage fraudulent claims and prolonged litigation.
& #149; A ban on self-referral for attorneys.
& #149; Outcome-based incentives for vocational rehabilitation.
& #149; Better professional standards for insurance adjustors, case managers, disability raters and judges.
& #149; Better funding for workers’ compensation courts to reduce backlogs. A user-fee system could save money for employers, insurers and attorneys by speeding up case decisions.
& #149; Simplified, Internet-based filing procedures. They could eliminate the need for attorneys in minor cases.
Dr. James Santiago Grisolia
(Grisola is communications chair for the San Diego County Medical Society and a qualified medical evaluator for the California Division of Workers’ Compensation.
