SB 899 Implementation Schedule

Effective April 19, 2004:

• Requirement to provide medical treatment upon filing of a claim(up to $10,000) even if claim is disputed.

• Pre-designation of a qualified personal physician(no previous "qualifications" requirement)

• Use of the new maximum medical fee schedule

• Eliminates the presumption of correctness of pre-designated physician

• Strengthens guidelines for "medically necessary" treatment

• Temporary disability capped at 104 weeks(no previous cap)

• Apportionment of injuries for multiple employers or prior medical conditions changed.

• Vocational Rehabilitation re-instated.(voucher system)

• Prior disability awards cannot be "stacked"

• Injury and Illness Prevention Program (IIPP) needed for employers over 200% Experience Modification

Effective July 1, 2004:

• Return to work($2,500 to eligible employers who provide return to work)

• If employer does not offer regular or modified work, Partial Disability (PD) payments increased by 15%

• If employer does offer work for 12 months, PD payments are decreased by 15%

Effective January 1, 2005:

• Medical provider networks authorized(gives employer huge control)

• Streamlined Agreed Medical Evaluations will be from the assigned panel.

How will these changes effect California Employers?

• More important to report claims immediately

• Must clarify if pre-designated physician is "qualified"

• Emphasizes "return to work" programs

• Medical provider networks must be set up by January 1, 2005 in conjunction with the carrier

• No requirement to have IIPP audited if Ex Mod not over 200%

This new reform while it is still being interpreted and analyzed, should result in a significant cost savings to employers. The biggest single cost reducer should be the fact that the injured worker will be treating with employer-selected physicians who can facilitate appropriate medical treatment, reduced periods of disability and more realistic permanent disability awards.

last updated: May 28, 2004

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