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Garamendi’s Alternate Plan
By Robert Warne - February 10, 2004

Even though the Assembly Insurance Committee is scheduled to vote tomorrow on Governor Arnold Schwarzenegger’s workers’ compensation reform package and the Senate has agreed to give the bill some attention later in the month, there’s not a lot of hope that the bill will remain intact as it winds though the Legislature.

So with a ballot battle brewing on the horizon and lawmakers riding their brakes on the governor’s plan like an evening commute on the 880 or 405, Insurance Commissioner John Garamendi offered up the details of his alternate work comp reform route today.

The plan, the Department of Insurance reported, focuses on eliminating the "culture of distrust" between employers and injured workers, was presented today at a press conference at the Science Center Elementary School in Los Angeles. Garamendi said that his plan will serve as a bridge to span the gap between labor and business on the issue.

"This proposal can eliminate the gridlock that threatens to stall meaningful reform to address California's broken workers' compensation system," said Garamendi. "We cannot afford to stand by while an impending political train wreck bears down on California's employers and injured workers. The California economy cannot afford to wait any longer."

Partial highlights of the Commissioner's plan include:

  • Creation of an independent medical examiner (IME) to resolve disputes over treatment in permanent partial, and total disability cases
  • Require employers to deliver immediate benefits for injured workers, allowing the employer additional time - up to one year - to dispute claims
  • Through the utilization of effective and efficient medical treatment require physicians to use the descriptions and procedures of AMA guidelines. Collect medical billing data to identify medical billing and treatment abuse by providers
  • Make uninsured employers subject to felony charges, as opposed to the current misdemeanor charges
  • Change the system to encourage employees and employers to work toward returning injured workers to the job faster
  • Add two additional voting members to the State Compensation Insurance Fund Board. Clarify the Insurance Commissioner's authority over State Fund
  • Address the irrational penalty structure on refused or delayed benefits
  • Regulate minimum loss cost insurance rates to stabilize the market and pass through reform savings to policyholders
  • Establish a pilot program for qualifying carve-outs to integrate health and disability benefit delivery

"These reforms will inject predictability and bring stability to California's workers' compensation system and help lure more insurance companies into the California market," said Garamendi. "The current system breeds litigation. My proposal fosters cooperation and removes the distrust that contributes to this problem."

Garamendi is happy with the reforms that were signed into law last year but he knows that more needs to be done.

"The second half of reform is essential to California's economic recovery," concluded the commissioner.

 
 

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