Each year I start the year with a quiz on likely happenings in California workers’ comp during the coming year. This post contains my 2016 California workers’ comp quiz.
Don’t be shy. Get out your crystal ball and your best soothsayer hat. E-mail your answers to me (at firstname.lastname@example.org). Time will tell, but in some instances there may be more than one correct answer.
1. In 2016 in the courts a) The California Supreme Court will agree to hear an appeal in Stevens on IMR constitutionality; b) The Supreme Court will refuse to hear Stevens; c) The 3rd DCA in Ramirez will uphold the constitutionality of IMR; d) In Ramirez the Court of Appeal will find the IMR statute unconstitutional.
2. In 2016 there will be intense interest in a) more NPR/ProPublica stories featuring injustices to California workers; b) allegations of prominent attorney involvement in referral schemes linked to fraud allegations; c) workers’ comp claims of the San Bernardino massacre victims; d) high profile audit penalties assessed against insurers and TPAs; e) turnover of leadership at the DWC; f) none of the above; g) the administration of the $120 million Return to Work Fund.
3. Workers’ comp rates in 2016 will: a) remain relatively stable, with average charged rates increasing only in single digits; b) spike into double digits; c) be the subject of legislative oversight hearings on why monies paid for cost containment continue to climb; d) be a contentious issue as industry and public WCIRB members clash over rate filing recommendations; e) decrease as more projected savings under SB 863 materialize.
4. 2016 will be the year that: a) the courts begin to define “catastrophic” for purposes of exceptions to the ban on psyche, sex and sleep PD ratings for post 1/1/13 specific injuries; b) lien filings begin to increase again substantially; c) the courts clarify whether Ogilvie rebuttal testimony by a vocational expert in pre 1/1/13 cases can be used in cases where the worker is amenable to some rehabilitation and thus less than 100%; d) the courts clarify whether the system will pay for medical marijuana in some instances;e) courts define the employment status of workers in the on-demand sharing economy; g) a major civil disaster creates many comp claims; h) none of the above.
5. In 2016 at the WCAB we will see: a) the same personnel at the end of 2016; b) Gov. Brown make at least one additional appointment to the WCAB; c) increasing use of deputy commissioners as panel participants; d) several en banc decisions; e) no en banc decisions; f) substantive law conflicts between WCAB panels depending on the makeup of the panel; g) at least one departure from the current board.
6. Legislatively, 2016 will feature the following: a) various applicant attorney sponsored bills eventually die, lacking DWC support; b) employer side attempts to limit cumulative trauma claims; c) new versions of bills vetoed by the governor over the past several years; d) increasing legislative leadership in comp under the new Assembly Speaker Rendon; e) a big legislative yawn; f) focus on the operation of the $120 million Return to Work Fund; g) bills to define a new type of employment status for workers in the on-demand, sharing economy.
7. In the world of California politics, workers’ comp will be: a) an issue of little interest and no consequence; b) an issue that begins to attract attention from likely 2018 Gubernatorial candidates; c) an issue that rises in public awareness after one of the events listed in question #2 or #3 above
8. An emerging focus in California workers’ comp will be: a) the extent of any cost-shifting between comp and group health or the ACA; b) regional differences in claims between different parts of California; c) increasing use of electronic records in the comp system; d) how to reduce the volume of UR & IMR disputes; e) the extent to which benefit increases promised under SB 863 did or did not materialize; f) alternatives to comp such as opt-out or 24 hour care; g) the extent to which race and language issues affect injuries and claims
9. The most controversial DWC regulatory action will be: a) chronic pain and opioid guidelines; b) home health care provider fee schedule; c) proposals for amended IMR regs; d) huh? there will be little controversy generated as a result of regulatory action; e) proposals to modify the scheme for distributing $120 million RTW fund; f) the design of the prescription drug formulary; g) efforts to regulate telemedicine;
10. Emerging trends appear to be a) use of drones for sub rosa surveillance; b) increasing unavailability of QMEs in a number of medical specialties; c) reduction in the number of ancillary service providers such as interpreters and copy service shops; d) increasing disputes over second panel QMEs; e) the number of IMRs peaks and then begins to decline; f) the number of IMR requests continue to climb; g) a noticeable generational shift in the judicial corps and the applicant and defense bar begins to take shape; h) at the end of 2016 it is apparent that little if anything changed in the comp system; i) expanded efforts to sue rogue UR and IMR providers on civil tort theories.
Bonus points to any reader who accurately predicts any “Black Swan” events that have a major impact on California workers’ comp.
If you missed it, scroll down to see my last post on the “Top Ten 2016 Events in California Workers’ Comp”.
Here is a link to last year’s 2015 quiz: