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Young: 2018 California Workers' Comp Quiz

By Julius Young

Thursday, January 18, 2018 | 0

Every new year I kick off January with a quiz on likely developments in California workers’ comp. Readers can test their insight into probable 2018 happenings in the comp world by taking the following test.

Julius Young

Julius Young

Note that in some cases there may be more than one correct answer. Ready to get out your crystal ball and play?

1. As California elects a new governor in November 2018, the following will apply:  

  • a) Workers’ comp will hardly be mentioned in the gubernatorial campaigns and debates.
  • b) Applicant attorneys and labor unions will not reach a consensus of who they want to support as two Democrats face off in the top-two runoff election.
  • c) Even after the election, both employer and worker advocates will be unsure what the new governor has in mind on workers’ comp.
  • d) The new governor will attempt to keep some of the Brown administration team in place on comp issues.
  • e) Major candidates will attend industry conferences and lay out their vision for workers’ comp beyond 2018.

2. The most significant workers’ comp appellate case of 2018 will be:

  • a) Some case that remains obscure at the start of 2018.
  • b) King v. CompPartners, now pending at the California Supreme Court.
  • c) County of San Diego v. WCAB (Pike), dealing with the receipt of total disability and 4850 benefits after five years from the injury where the 104-week cap was not exceeded.
  • d) A case involving challenges to provider suspension under Division of Workers' Compensation rules.

3. At the end of the 2018 California legislative session we will see that:

  • a) The legislative year was a dud, with some smaller bills being the only result.
  • b) A year of great turmoil as employers attempt to put limits on cumulative trauma claims.
  • c) Issues and bills concerning immigrants and undocumented workers were prominent.
  • d) Heated debate over a single-payer health plan for California had potential long-term implications for the future of the comp system.
  • e) A big turnover in key legislators occurred after ongoing controversy about sexual harassment in the Capitol.
  • f) Requirements that carriers send injured workers an explanation of treatment bills summary were debated.
  • g) Gov. Jerry Brown is still active with a veto pen.
  • h) Bills to address gender issues in workers’ comp and apportionment to genetic causation are signed into law.

4. Regarding workers’ comp rates:

  • a) There will be increasing calls for giving the insurance commissioner more authority to regulate rates, since the gap between advisory “pure premium” rates and actual charged rates is significant.
  • b) Rate regulation will be a non-starter that attracts no attention.
  • c) Workers’ comp “pure premium” rates will continue to fall.
  • d) Rates will bottom out and start to climb.

5. The new prescription drug formulary, which went into effect Jan. 1, will:

  • a) Cause lots of controversy with attorneys, unions and the media getting pushback from workers cut off meds.
  • b) Will go relatively smoothly as most doctors adapt to the new system.
  • c) Will by the end of 2018 drastically reduce the number of utilization review/independent medical review disputes.
  • d) Will be largely ignored by a subset of doctors who treat on liens and do in-office dispensing.
  • e) Will (in concert with new Medical Treatment Utilization Schedule guidelines adopted in 2017) result in significant cost savings.

6. On the subject of the $120 million 'Return to Work' fund:

  • a) A bill will pass that requires $120 million to be distributed each year.
  • b) The governor will sign the bill.
  • c) The governor will veto the bill.
  • d) Efforts to require the $120 million to be distributed die in the Legislature.

7. As 2018 ends and 2019 is on the horizon, we will hear more about:

  • a) Immigration enforcement at or near Workers' Compensation Appeals Board offices.
  • b) The “Noodle Group” and efforts to capitalize on the last year of a friendly Brown administration.
  • c) The California Labor Federation’s agenda for California workers’ comp going forward after Brown.
  • d) Struggles between “business Democrats” and “Democratic progressives” in the Legislature that may affect future legislative battles.
  • f) Legal challenges to provider suspensions under the anti-fraud bills of 2016.
  • g) Whether workers’ comp should pay for wearable medical technology.

8. By the end of the Brown administration, the governor and his administration will:

  • a) Fill all the WCAB commissioner slots.
  • b) Leave some WCAB commissioner slots unfilled.
  • c) Have troublesome issues with the State Auditor’s office.
  • d) Tout workers’ comp as one of its great success stories.
  • e) Propose one last significant reform.
  • f) Unveil significant findings based on data mining efforts.

9. Trends that will be apparent by the end of 2018:

  • a) Growing employer concern and unhappiness over increases in employer assessments.
  • b) Medical costs trending upwards.
  • c) Problems in the qualified medical evaluator system will become more pronounced.
  • d) New strategies by lien mills working to milk the system.
  • e) Group health care markets/Covered California are stable despite Trump’s attacks on the Affordable Care Act.
  • f) The group health care market is destabilized as Trump loosens the employer mandate.

10. On the regulatory front, by the end of 2018 we will see:

  • a) New QME billing rules.
  • b) Markedly declining lien filings as the 2016 anti-fraud provisions finally make a big impact.
  • c) A handful of regulations in process that are unfinished by the end of Brown’s term.
  • d) A victory lap by the Brown people, who announce that all regulatory reform is completed.
  • e) Increased talk about whether and how California workers’ comp should pay for medical marijuana.

And let’s close with a bonus. Is there a “Black Swan” event or trend that you predict?

If you want to play, send me your answers to jyoung@boxerlaw.com.

Julius Young is a claimants' attorney for the Boxer & Gerson law firm in Oakland. This column was reprinted with his permission from his blog, www.workerscompzone.com.


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