California workers’ comp laws: new bill to address mental health disability ratings
By Stephen M. Pfeiffer, PhD
Last fall, the state legislature passed California workers’ comp laws that eliminated disability ratings for workers with mental injuries secondary to their physical injuries. The bill, SB863, was designed to cut insurance costs and increase disability payments to injured workers; but as noted in a previous column on the subject, these cuts came at the detriment of fair treatment for workers with psychological disorders, and raised concerns within the field about false promises to all workers across the board. Now, a new bill has been introduced in an attempt to remedy these concerns. Known as SB626, the bill is intended to return fairness and transparency to the California workers’ comp process. Read on to learn more about this proposed legislation, and find out what you can do to support its passage.
Proposed changes to the California workers’ comp system
In a summary published by the office of Senator Jim Beall (D), one of the bill’s sponsors, SB626 is described as a measure intended to mitigate “several dramatic but unnecessary changes” to the California workers’ comp system that “adversely affected injured workers’ ability to access quality medical care and to receive full disability benefits.”
SB626 would reverse SB863’s elimination of mental health disorders from consideration in workers’ comp disability ratings. It would also require each worker’s employer or insurance company’s review doctor to have the same license as the Independent Medical Review doctor, and would eradicate previous rules keeping IMR doctors anonymous. The bill includes provisions for judges to overrule any decisions reached by IMR doctors if necessary.
SB863 results in many negative effects to the California workers’ compensation system. However, I believe the psychiatric limitation is among the more pervasive, as there is a much longer history of compensable psychiatric conditions within the system. In the section of the bill in which psyche injury secondary to physical injury is eliminated, there exists also the elimination of sleep and sex dysfunctions from consideration. Limitations on the ability to claim a psychiatric injury were instituted beginning two decades ago and now require predominant causation, six months of employment prior to the claim, and exclusions for lawful and good faith personnel actions.
The section affecting psyche PD (permanent disability rating) in SB863 does specifically provide that the exclusion affects only the ability to obtain PD and not medical treatment for psychological conditions. This was an addition added at the eleventh hour and was no doubt intended to keep Labor interests from mutiny with the elimination of those impairment conditions.
It is my opinion that limiting injured workers’ access to ratings for psychological disabilities is simply discriminatory, and does a disservice to those who sustain work-related psychological injury as a result of physical injuries or trauma. Changes such as those outlined in SB626 are necessary in order to maintain a fair and effective workers’ compensation system, and to that end I believe the bill represents an important adjustment to the current law.
To learn more about SB626, SB863, and the medical and legal communities’ work on behalf of equitable workers compensation laws in California, contact me via email at firstname.lastname@example.org, or go online to www.pfeifferphd.com.