As we all know by now, SB 863 brings many changes to workers’ compensation law in California. On September 19, 2012, Governor Jerry Brown approved and signed SB 863 resulting in a large number of changes which will take effect on January 1, 2013.

The following is a list of some new, amended, or repealed Labor Code sections, regardless of date of injury, which will take effect on January 1, 2013 along with a very brief summarized description of each change.

  • 139.2(h)(1) – For pro per cases, the Medical Unit is to give preference in sending QME panels. Also, applicant may choose QME if panel is not issued 20 days from request (changed from 15), if within a reasonable geographic area.
  • 4061(d)(1) – For pro per cases, either party may seek one supplemental report to correct “factual errors” within 30 days of receiving panel requests. If employer seeks supplemental report, a notice must be provided to the applicant regarding availability of I&A officers.
  • 4062.2(b) – Eliminates need for to propose AMEs prior to seeking a panel of QMEs.
  • 4062.2(c) – Eliminates need for negotiation of AME after panel of QME’s received.
  • 4062.2(f) – Allows use of AME at anytime, possibly even after QME evaluation has occurred.
  • 4062.3 – Communication with AME is distinct from QME. Communications with a QME must be served on opposing party 20 days in advance but no time limit is given for communications to AME.
  • 4062.3(f) – Tries to limit improper ex parte communications with AMEs and QMEs.
  • 4064(c) – For pro per cases, defendant may be liable for attorney’s fees to combat the filing of a DOR (changed from the filing of an Application).
  • 4600(c) – Limitation on Chiropractor as treating physician to 24 sessions.
  • 4600(d) – Slight changes for pre-designation of treating physician for industrial injury.
  • 4600(g) – Codifies applicant’s right to an interpreter for PTP appointments.
  • 4600(h) – Codifies applicant’s right to a Home Health Care but with limitations.
  • 4603.2(b)(1) – Requires new reporting and itemization by Home Health Care services.
  • 4603.2(b)(2) – New service requirements by medical providers to employer. Also, changes “working days” to “days”.
  • 4603.2(e)(1) – Along with 4622(b), if a bill is reduced in payment by the employer, a request for a second review must be done within 90 days or lien is waived.
  • 4604.5(c)(2) – If payment or authorization is given by employer for additional chiropractic, occupational therapy, or physical therapy beyond the 24 allowed by code, it is not considered a waiver of the limit for future visits.
  • 4605 – Non-MPN reporting may not be the sole basis for an Award.
  • 4610(g)(7) – UR review is unnecessary if employer disputes body part for which treatment is sought.
  • 4616(a) – Goal that at least 25 percent of MPN physicians treat for non-occupational injuries is deleted.
  • 4616(g) – Notification is required for parties buying or selling MPN services.
  • 4616.3(b) – A failure to provide proper notice of MPN is not a basis for an employee to treat outside the MPN unless it results in a denial of medical care.
  • 4620(d) – Codifies applicant’s right to an interpreter at a Med-Legal evaluation.
  • 4650(b)(2) – Absent an award, PD payment is not required if applicant has returned to work and certain conditions are met.
  • 4658.5(d) – If a voucher is issued on or after January 1, 2013, a time limit is placed (Two-years after voucher provided or Five-years after date of injury, whichever is later).
  • 4658.5(e) – Employer is not responsible for injuries occurring during usage of voucher.

This list is not exhaustive. There are also many new changes which are slated to take effect on January 1, 2013 which will require further administrative action first. Some changes will not take effect until January 1, 2014. Also, a whole other list exists for changes made for injuries occurring on or after January 1, 2013. Please read future articles for more information on these changes.