1. Type your name*

2. Type your job title*

3. Type your organization name*

4. Type your email or phone*

*mandatory

 5. Please feel free to make changes to the letter below.

The Honorable Joe Coto California State Assembly State Capitol, Room 2013 Sacramento, CA 95814 Fax: 916-319-2123 SUBJECT: AB 338 (COTO) – TEMPORARY DISABILITY AND UTILIZATION REVIEW - OPPOSE I OPPOSE your AB 338 (Coto), which would raise workers’ compensation costs by increasing the cap on temporary disability benefits to 156 weeks. Additionally, AB 338 (Coto) would penalize employers who seek to apply evidence-based medical treatment guidelines in their claims administration process by using utilization review. It is clear that the current 104-week cap on temporary disability presents some very real problems and we must OPPOSE your AB 338 (Coto) because of the significant harm it will cause to multiple aspects of recent reforms. I oppose increasing the cap on temporary disability to 156 weeks. Evidence suggests that a prompt return to employment after an injury reduces an injured worker’s long-term wage loss. With the implementation of evidence based medical treatment guidelines injured workers are getting appropriate medical treatment and returning to work at a higher rate than prior to reforms. The Division of Workers’ Compensation recently released data showing that there was a 5% increase in the numbers of injured workers who are returning to work within 20 months of their injury. The 104-week cap on temporary disability, in conjunction with other aspects of recent reforms, is having the desired effect. Increasing the cap to 156 weeks would have the effect of undermining incentives to return to work that exist in the current system. AB 338 (Coto) also creates a number of situations in which the cap on temporary disability benefits would not apply, effectively increasing the duration of temporary disability benefits even past 156 weeks. One of the ways this is done is by extending the cap by the duration of time that passes when an employer lawfully objects to medical treatment pursuant to labor code section 4062, but is unsuccessful in that objection. This effectively means that an employer who objects to a medical determination would be penalized for objecting to medical treatment using the Qualified Medical Evaluation process, but an employee who uses the same labor code section in the same way would not face a similar penalty. The effect of this provision would be to punish an employer for using one of their only tools for objecting to potentially inappropriate medical treatment. The bill also provides for an extension of the cap when an employer does not communicate a utilization review decision in a timely fashion in accordance with labor code section 4610, or when treatment submitted for review in accordance with Section 4610 is ultimately approved. These provisions would punish an employer for the legal application of utilization review, which is the only way an employer can force medical providers to adhere to evidence-based medical treatment guidelines when requesting treatment. In addition to the problems described above, AB 338 (Coto) would create a situation where claims administrators will have to keep complicated records of when an employee’s temporary disability benefits should be applied to the cap. In the event that the claims administrator is off by even one day in their record keeping, they could be subject to penalties for inappropriately denying benefits even though the intent was not to do so. In essence, AB 338 (Coto) would further complicate the administration of workers’ compensation claims and create more chances for costly litigation. I OPPOSE the approach represented in AB 338 (Coto). Without exception this legislation will undermine utilization review, provide an uneven and unfair dispute process where employers have their hands tied, create record-keeping requirements that would subject employers to new penalties, and increase confusion and litigation in the workers’ compensation system.

6. Click "eMAIL!" and we will send your letter!