California Assembly Bill AB1213

California 2023-2024 Regular Session

• Introduced: 2/16/23
• Refer: 3/2/23
• Report Pass: 4/10/23
• Refer: 4/11/23
• Report Pass: 4/26/23
• Refer: 4/26/23
• Report Pass: 5/10/23
• Engrossed: 5/25/23
• Refer: 5/26/23
• Refer: 6/7/23
• Report Pass: 6/22/23
• Refer: 6/22/23
• Refer: 7/3/23
• Report Pass: 9/1/23
• Enrolled: 9/12/23
• Vetoed: 10/8/23

Caption

Workers’ compensation: aggregate disability payments.

Impact

The primary impact of AB 1213 is expected to benefit injured workers who have faced treatment denials, as it will provide them with additional financial support during the period in which their treatment is under dispute. By excluding these denied payments from the aggregate calculation, employees could potentially receive more compensation than they would have otherwise if the denials had been included. This change aims to enhance the workers' compensation system's responsiveness to the needs of employees requiring medical treatment for work-related injuries.

Summary

Assembly Bill 1213, introduced by Assembly Member Ortega, amends Section 4656 of the Labor Code regarding workers' compensation and aggregate disability payments. The bill states that if a treatment denial proposed by a treating physician is overturned by either independent medical review or the Workers Compensation Appeals Board, any temporary disability payments owed to the employee from the date of the denial until treatment approval will not be counted towards the calculation of total aggregate disability payments. This provision is valid from January 1, 2024, until January 1, 2027.

Sentiment

The sentiment surrounding AB 1213 appears mixed. Supporters argue that this bill acknowledges and rectifies injustices faced by workers when treatment denials result in further delays in recovery and financial hardship. By empowering employees, it reinforces the principle that medical decisions should prioritize patient care over bureaucratic processes. On the other hand, some critics may view the bill as potentially increasing the burden on employers and the state's Workers Compensation system, raising concerns over the financial implications of extended disability payments.

Contention

Notable points of contention revolve around the balance between employer costs and employee rights in the workers' compensation system. While the bill aims to protect workers from the adverse effects of treatment denial, opponents might argue that it could lead to increased premiums for employers and skew the utilization review process. Additionally, there may be concerns about the administrative implications of determining the validity of treatment denials and subsequent appeals, which could complicate the adjudication process in workers' compensation cases.