Compared with their counterparts in other large states, California workers are off work longer and have higher rates of temporary and permanent disability, even though their injuries aren't any more severe. In addition, the state's supposedly "no-fault" system is said to be choked with litigation and riddled with fraud and abuse.
The legislators chose to focus mainly on medical costs, garnering much of the projected savings by capping fees paid for some services and limiting injured workers' usage of others.
One of the most unexpected areas to take a financial hit was outpatient surgical centers, which would see their fees capped at 120% of the Medicare reimbursement rate, a move that is projected to save the workers' comp system more than $900 million a year. The industry, a big campaign contributor, had lobbied hard in the Legislature, leading many to believe that surgical centers would be spared.
They and other medical providers Wednesday uniformly expressed disappointment with the reforms, predicting California's injured workers would be denied treatment and prescriptions.
California's chiropractors are especially concerned about a 24-visit cap per injury included in the new reform. At present, there are no limits on the number of times injured workers can visit a chiropractor. The result is that workers' comp patients in California visit their chiropractors an average of 34 times, twice as often as injured workers in other large states.
"We are very disappointed with this cap on chiropractic care," said Wayne Whalen, a chiropractor in Santee and past-president of the California Chiropractic Assn., a trade group with 4,000 members. "We are very concerned for the thousands of injured workers who cannot tolerate medication and are not surgical candidates [and] who rely on chiropractic care to keep them on the job, such as firemen and police officers."
Although injured workers would be able to receive more than 24 chiropractic treatments if insurers approved the visits, Whalen believes that is problematic. "We are concerned that insurance companies will be calling all of the shots," he said.
Pharmacists also are worried, because prescription drug reimbursements would be capped at Medi-Cal levels. "We're really disappointed with this," said Bill Bradley, spokesman for the California Pharmacists Assn., a trade group with 5,500 members.
Bradley said workers might find it difficult to get prescriptions filled, as studies done by his group show that 65% of independent pharmacists would be unable to fill prescriptions at such low prices.
But the industry group taking the biggest hit is the vocational rehabilitation industry, whose piece of the workers' compensation pie is effectively being wiped out under the proposed legislation.
While lawmakers inside the Capitol congratulated themselves on the creation of workers' comp reform package, several hundred injured workers and their retraining counselors protested on the Capitol steps.
They came from all over the state, some boarding buses in Los Angeles at 3:30 a.m., to urge the Legislature to vote down the bill because it would seek to save $1.2 billion by eliminating the vocational rehabilitation program that gives injured workers as much as $16,000 to use for counseling, retraining and living expenses.
The legislative proposal would instead give workers a voucher based on the severity of their injuries. A worker classified as being less than 15% permanently disabled, for example, would get a $4,000 voucher and a worker determined to be more than 50% permanently disabled would get $10,000.
Ingrid Quinonez, president-elect of the Organization of Bilingual Rehabilitation Assn., whose members help non-English-speaking workers, said the rally was organized to show lawmakers "this is who they're hurting when they pass legislation without enough information."
She said the proposed voucher would be useless to workers because they wouldn't have the guidance of counselors.
"What they're doing is shifting these individuals to ... welfare lines," she said, scanning a big crowd that carried a "Voc Rehab Works" banner. "These people already have the benefit. But if they didn't think it was important, they wouldn't be here."
The crowd included a security guard who hurt his knee falling down stairs, a raisin picker whose ankle was run over by a truck and a 64-year-old man who hurt his back packing oranges.
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Highlights of reform bill
The proposed legislation to reform California's workers' compensation system is projected by its authors to save $5 billion to $6 billion annually. The key components of the bill:
Outpatient surgical centers: New fee schedules that would pay the Medicare reimbursement rate plus 20%. Annual savings: $932 million
Pharmaceuticals: Fee schedules linked to the Medi-Cal reimbursement rate. Annual savings: $407 million.
Chiropractor and physical therapists: Visits to each capped at 24. Currently there are no limits. Annual savings: $1.1 billion.