John Rosenbaum Law Offices

The battle around Assembly Bill 1465 is heating up with many insurance and employer groups waging a full-blown scare tactic assault to prevent the establishment of a statewide MPN. Their main contention is that the current system of piecemeal MPNs is working, reduces costs and provides adequate care for injured workers, but as we pointed to last week, those claims are simply false. What it actually boils down to is control.... Gregory Grinberg, managing partner of Gale, Sutow & Associates’ S.F. Bay South office (an employer defense firm) confirmed as much in a piece published to their blog and in Work Comp Central last week. The employer’s control of medical treatment through an MPN will be effectively eliminated, as an injured employee can treat in the CAMPN (California MPN), and the employer will have no control over who is in the CAMPN, he wrote. Essentially, they want to control where an employee can be treated so they can deny and delay care in hopes of saving a buck. The irony is that the current system actually leads to increased costs. The California Workers’ Compensation Institute (CWCI) did a comprehensive study of MPNs and found that they generated a negligible 2% in savings, said Jacob Rosenberg, MD, Medical Director of IPM Medical Group and President of the California Society of Industrial Medicine and Surgery (CSIMS). Those savings were more than offset by added frictional costs to the system, as a Journal of Occupational and Environmental Medicine (JOEM) study concluded. Worse still, a recent study by the WCIRB demonstrated that delays in medical treatment, often the result of the broken MPN system, were a significant driver of downstream costs to employers, said Daniel Rosenberg, Director of Revenue Cycle for Integrated Pain Management for IPM Medical Group, and a CSIMS member. Injured workers who don’t receive treatment within the first 30 days are 40% more likely to have permanent disability awarded. While employer groups assert they simply want to control the quality of care being received through MPNs, the current system is broken, says Daniel. There is no way to determine what MPN covers an injured worker, and a recent study of pain management MPNs revealed that the majority of providers listed are retired, moved out of state, or are no longer accepting workers comp, he said. Yet injured workers are forced to stay within these invalid MPNs, delaying their care for months on end. Jacob noted that employers put their trust in carriers to curate networks of quality, affordable, providers, but the networks have broken that trust by chasing short term rate reductions at the expense of long-term cost savings, and ethical medical care. Let’s not mince words: fixing the MPN system is a humanitarian issue, said Jacob. A vote for AB 1465 is a vote for efficiency, and human decency. https://ww3.workcompcentral.com//21944e00c879354a26fbb0fcd

While the effort to decrease delays in obtaining medical care for injured workers through legislation has only just begun, the constant refrain from the insurance and employer groups that the sky is falling has started early and gotten even more preposterous. CAAA-sponsored Assembly Bill 1465, introduced by Assemblymembers Eloise Reyes (D-San Bernardino) and Lorena Gonzalez (D-San Diego), would create a statewide Medical Provider Network (MPN) to allow injured workers the a...bility to seek medical care without the delays of the current piecemeal MPN system. A coalition of employer and insurance groups assert there is no reason to establish a statewide MPN because their current MPNs often rife with denial of care in order to save a buck are working just fine. But if the statistics are any indication, that’s simply not true. The delays in medical care under the current system often lead to permanent disability for workers who are unable to obtain care in a timely manner. A recent study released by the Workers’ Compensation Insurance Rating Bureau (WCIRB) confirmed this, showing that in a group of workers studied who didn’t receive treatment within 30 days, 71% of the claims had permanent disability awarded. Alternatively, claims which received timely medical treatment in the first 30 days, only 51% of the claims had residual permanent disability. What’s worse is that a WCRI study released in 2018 showed California’s worker’s compensation system being ranked as the slowest from injury to date of treatment for everything except the initial medical exam. They also claim the creation of a new statewide MPN system, labeled CAMPN under the bill, would override the employers’ MPN systems another false claim. The statewide MPN would simply allow the injured worker the option of choosing a treating physician in either network, allowing more freedom and giving the employee the ability to choose a doctor or specialist in their area so they wouldn’t have to travel hundreds of miles to find one under the employer’s restrictive MPN. The evidence clearly shows the system is rife with delay. While advocates for injured workers and other labor groups seek to help workers and establish a system that works for the employee, business and insurance groups continue their campaign of smoke and mirrors so they can continue to generate record profits while absolving themselves of their obligation to protect their injured workers.

National Farmworkers Awareness Week takes place at the end of March each year, this year celebrated March 25 through March 31. While some victories have recently been won in instilling greater protections for workers in light of the COVID-19 pandemic, other challenges remain. The United States Supreme Court is set to hear arguments today on a case that threatens to take away access to worksites from union organizers. After a hard-fought battle led by Cesar Chavez and the farm...worker movement, California became the first state in the nation to allow farmworkers collective bargaining rights in 1975. Organizers have been granted access to worksites to encourage their fellow fieldworkers to unionize for better pay and working conditions. In 2015, two separate growers in Fresno and Dorris, Calif., took issue with United Farm Worker organizers entering their property to speak with workers, and in 2016, sued the California agricultural relations board on the grounds that the access rule was unconstitutional and a taking of private property. The case has now made its way all the way to US Supreme Court after a group of mostly conservative judges on the 9th Circuit Court encouraged them to hear the case. The Los Angeles Times quoted Mario Martinez, general counsel for the United Farm Workers, as saying the access rule is needed now more than ever to protect farmworkers, many of whom are undocumented and afraid to speak to anyone for fear of losing their jobs. Farmworker activists now fear the access rule could be struck down. The hearing comes as the U.S. House of Representatives passed a bill last week creating a pathway for citizenship for millions of farmworkers and Dreamers, though it faces tough odds of making it through an evenly divided and filibuster-controlled Senate. Still, it’s a sign of hope for the future of many families living in uncertainty while continuing to put food on the tables of families throughout the nation. Farmworkers continue to put their lives on the line in the face of the ongoing pandemic, working in overcrowded conditions while dealing with the usual threat of hazardous pesticides. To help protect the health and safety of these workers, the Association of Farmworker Opportunity Programs is again running their National Long Sleeve Shirt Drive. While the pandemic has greatly reduced the capacity to donate shirts to local drop-off sites, including CAAA’s, the organization is offsetting this obstacle by running A Shirt for a $1 campaign and will donate a brand new, long sleeved shirt to a farmworker for every dollar donated. While farmworkers have been essential to our food supply and our economy long before the pandemic thrust them into the spotlight, the fight for their safety and wellbeing continues. We hope the US Supreme Court and US Senate land on the right side of history.

HELPING HANDS The last year has been hard on a lot of people, especially for women and women of color, though everyone has been impacted by the pandemic in one way or another. Californians have a wealth of resources available to them to help navigate challenging situations, but many might not know where to begin. For California’s injured workers, we at California Applicants’ Attorneys Association are a resource, both to help find legal representation and to find local organi...zations offering help in times of need. CAAA’s Women’s Caucus has pulled together a community resource guide, housed on the CAAA website, featuring both statewide and local organizations and services broken down by county to help people find support in their local regions. In addition to CAAA’s community resource guide, Californians can find a number of helpful tools and links by visiting the websites of their local legislative representatives. Many California legislators have some form of resource repository on their websites, offering links to statewide and local assistance programs, said Assemblymember Cristina Garcia, Chair of the California Legislative Women’s Caucus and representative for California’s 58th Assembly District in Los Angeles County. As representatives for the people, our main goal is to help our constituents, especially those who have fallen on hard times and might need some additional support, she said. Women, and particularly women of color, have been disproportionately impacted by the ongoing pandemic, with many forced out of their jobs or faced with the tough decision to go to work or take care of their families. The Legislative Women’s Caucus has several resources listed on our website aimed at connecting women, and really anyone in need, to assistance programs to fit their specific needs. We appreciate the efforts in helping to get the word out so more individuals, especially those hardest hit like women of color, are aware of the support systems available to them. Assemblymember Garcia encouraged people to visit the websites of their local representatives, visit the Legislative Women’s Caucus website and share the resources with anyone who might need assistance. I have always prided myself on my availability to help those in need whether friends, clients, or just plain folk that need a helping hand. Please feel free to reach out!!! To find your local representative and visit their website, go to findyourrep.legislature.ca.gov.

Today marks the start of Women’s History Month, a time to celebrate the heroic women who’ve pushed boundaries to champion female empowerment, gender equity and equality. While great strides have been made, gender bias and discrimination are still prevalent, including in workers’ compensation. It pains us to say that many in the community still utter the phrase workman’s comp. As for injured working women, gender discrimination is still alive and well. Doctors may legally re...duce disability compensation to women for such factors as degenerative changes, pregnancy, osteoporosis and osteopenia - even if these conditions were asymptomatic before the work injury. Women who contract breast cancer as a result of their working environments will receive less benefits than a man who contracts testicular cancer from those same environments. California Applicant Attorneys Women’s Caucus formed several years ago to fight gender bias in workers’ compensation and in the workplace, working with lawmakers to craft legislation to tackle such issues. Applicant attorneys are again sponsoring legislation to end discrimination in apportionment. That bill, Senate Bill 788, was introduced on February 19 by Senator Steven Bradford (D-Gardena), and would prohibit doctors from using gender, marital status, sex, sexual identity, sexual orientation, race, religious creed, age, national origin or genetic characteristics in disability ratings. While we aim to correct this injustice in workers’ compensation, we again must look at inherent bias in ourselves and in the workplace, this time with regard to gender. The pandemic has brought to light the vast inequities plaguing women in our economy, particularly women of color who are often forced into lower-wage jobs that lack benefits such as paid sick leave or family leave. Due to such disparities, January’s employment numbers show women leaving the workforce in droves, with 275,000 exiting that month, adding to the 2.4 million who’ve left the workforce since February of 2020, compared to 1.8 million men. It’s a trend experts say will harm working women and families for years. This Women’s History Month, we must renew our resolve to continue efforts that elevate women, promote equal pay and reduce disparities to hopefully make gender bias a thing of the past.

February is Black History Month, and while we honor the accomplishments of courageous leaders of the past, we must acknowledge present inequities and continue the work to purge racial bias from our workers’ compensation system and from ourselves. To address a small piece of the inequities in our system, CAAA has focused legislative efforts on correcting the injustice of using race and other genetic factors in apportionment of disability, and we’ll be bringing that to the fore...front again in 2021. After being put aside last year in light of the COVID-19 pandemic, Senator Steven Bradford (D-Gardena) has again agreed to carry a bill that would prohibit consideration of race, religious creed, color, national origin, age, gender, marital status, sex, sexual identity, sexual orientation, or genetic characteristics to determine the approximate percentage of the permanent disability caused by other factors" before and after the industrial injury. Similar legislation has made it through the legislature in the past, only to be vetoed by the governor at the time. We’re hoping for a different outcome this year. As we look at making fixes to the system, we must also look at addressing inherent biases in ourselves. The 21-Day Racial Equity Habit Building Challenge, conceived and published by diversity expert Eddie Moore, Jr. in 2014, presents an opportunity to challenge our own notions of social justice, including those of us who believe we’re already allies in the ongoing movement for equality. Several Sections of the American Bar Association have advocated for their members to participate in variations of the challenge over the last year. As members of the workers’ compensation community, we encourage you to take the challenge as well, whether in 21 days or over the course of several months, however long it might take to complete. Borne of an economy flush with systemic racism, people of color are often forced into more dangerous lower-wage jobs, and therefore, are more likely to be injured on the job. As attorneys who represent these injured workers, it’s imperative to address racial bias in the workers’ compensation system and ourselves to help make the ideal of equal justice under the law a reality.

We’ve railed against the higher financial costs brought on by delays in medical care as evidenced in a report published late last year, but make no mistake the highest costs are being paid by the injured workers who end up with a permanent disability because their medical care was delayed. https://www.caaa.org/ This is the story of a woman who sadly lost her life last year as a result of having her surgery denied by utilization review. The woman suffered a work injury that... resulted in severe back pain for which her doctor had recommended surgery. Having been denied the medical treatment she needed, she continued to work because she couldn’t afford to take time off, relying on pain medication to get her through the long and arduous days. Then UR started to deny her the medication that was getting her through the day. But one can find fentanyl on the street and fentanyl can get you through a work day. Her attorney continued to advocate for her care, sending her to an Agreed Medical Evaluator for an update on her condition in hopes of finally getting her surgery approved. Nine months after having her treatment denied, she was found on the floor of her kitchen. She had found fentanyl on the street and she overdosed. We hope that had she received the surgery when her doctor originally recommended the treatment, she wouldn’t be dead today. This isn’t a story that needs to be repeated. Access to medical treatment for injured workers has been under attack for years in California, with hurdles such as utilization review being thrown up as road blocks and causing serious delays, permanent disability and death.

Jobs held by women accounted for all jobs lost in the U.S. in December, further widening the earnings gap and highlighting the disproportionate impact the pandemic is having on women, and particularly women of color. According to the latest report from the Labor Department released in January, the U.S. had a net loss of 140,000 jobs for the month of December. An analysis from National Women’s Law Center (NWLC) painted an even bleaker picture. Women actually accounted for over... 111% of jobs lost during the month of December, losing 156,000 jobs while men gained 16,000. More telling is the impact the pandemic is having on women of color, many of whom are more likely to work in industries that lack paid sick leave or the ability to work from. According to the NWLC, 154,000 Black women left the workforce in December, the largest single-month drop since the beginning of the pandemic in March and April of 2020. The unemployment rate for black women in December was 8.4%, meaning more than 1 in 12 Black women aged 20 and older were out of work. While the rate was down from 9% the previous month, it was still over 1.7 times higher than the pre-pandemic level of 4.9 percent in February 2020. More than 1 in 11 Latina women were unemployed in December for an unemployment rate of 9.1%, also more than 1.7 times higher than the 4.9 percent unemployment rate in pre-pandemic February 2020. The unemployment rate for white women was 5.7%, lower than the unemployment rate for white men at 5.8%. The December numbers capped a disastrous year for working women who’ve accounted for over half 55% of the 9.6 million jobs lost in 2020. The NWLC pointed out that nearly 2.1 million working women, including 564,000 Black women and 317,000 Latinas, left the labor force between January and December. Lest we remind you, with women earning roughly 80 cents for every dollar a man earns, and even less for working mothers and women of color, the disparity in job losses and earnings lead to even greater disparities in lifetime earnings and in benefits earned under California's workers' compensation system. Equity in employment has always been an issue, now clearly exacerbated by COVID-19. As pandemic conditions allow, focusing on stimulating growth in industries largely dominated by women and most impacted by the pandemic, which include education, hospitality, and retail, will be imperative and should be a priority for lawmakers and employers everywhere.

The first official legal challenge to Proposition 22 has been filed with the California Supreme Court, and Workers Compensation Applicant Attorneys have joined in the effort in hopes of restoring access to workers’ compensation for thousands of gig workers throughout the state. On January 12, the Service Employees International Union (SEIU), along with a small group of app-based drivers, filed an emergency petition in the California Supreme Court requesting that Prop 22 be in...Continue reading

As we head into the third full week of 2021, here’s a roundup of some of the new employment laws that you may or may not know went into effect at the beginning of the year. First up, on the worker protection front is the new law requiring employers to track and notify employees of potential COVID-19 exposure. Under AB 685, employers must notify employees within one business day of possible exposure to COVID-19 within the workplace and must also notify local public health offi...Continue reading

Fatal occupational injuries in California rose again to their highest level in 11 years, recording over 400 deaths for the second year in a row and further exposing the inequities faced by Latinx and older workers. The Bureau of Labor Statistics (BLS) reported in December there were 451 job-related deaths in 2019, up from 422 in 2018 and the second year in a row to record over 400 deaths since 2009 when 409 fatal injuries were reported. It’s the highest death tally since 465 ...occupational fatalities were reported in 2008. Transportation incidents continued to be the leading cause of death with 141, followed by violence by other persons or animals with 94 and slips, trips and falls with 88. Latinx and Hispanic workers again accounted for the bulk of deaths in California nearly half at 47%, up from 43% in 2018 and a stark contrast to the 20% recorded nationally. Workers aged 55 and older accounted for over a third at 35%, up from 32% in 2018. With these statistics continuing to increase for Latinx and older workers, it’s clear more must be done to protect these employees with education and outreach targeted to their demographics. Increasing safety precautions and training should be a top priority for employers. The rate of fatal workplace injuries per 100,000 also increased to 2.5, up from 2.3 in 2018, but still below the national rate of 3.5. The agriculture, forestry, fishing and hunting category had the highest incidence rate at 13.9, followed by transportation and utilities with 7.5 and construction with 6.5. Nationally, the BLS reported there were 5,333 deaths in 2019, the highest national total since 2007, and noted that a worker died every 99 minutes from a work-related injury. Texas had the highest total of deaths at 608, followed by California at 451 and Florida with 306. With the COVID-19 pandemic further exacerbating the inequities Latinx and older workers face, it’s more important than ever to hold employers accountable to instill protections, increase educational outreach and reduce their occupational death rates. Dying on the job is a fate no worker should suffer. We must do better.

https://fivethirtyeight.com//once-you-get-the-covid-19-va/