A few recent regulatory changes regarding Workers’ Compensation and Paid Family Leave go into effect on July 1, 2014. Agencies should update their applicable policies, practices and/or forms accordingly.
Physician Predesignation Requirements Altered
Under Workers’ Compensation regulations, employees may be treated for an industrial injury by a personal physician that the employee has predesignated prior to the industrial injury, provided certain conditions are met. Previously, those conditions were:
- The employee provides to the employer notice of the predesignation in writing before the industrial injury, including the physician’s name and business address;
- The employer provides nonoccupational group health coverage in a health care service plan, group health plan or group health insurance policy; and
- The employee’s personal physician agrees to be predesignated prior to the industrial injury.
To conform with recent Labor Code amendments intended to expedite the Workers’ Compensation process and lower costs, the Division of Workers’ Compensation (“DWC”) slightly revised the requirements for predesignation of physicians. As of July 1, the second condition is no longer that the employer provides nonoccupational group health coverage. Going forward, the employee must simply have health coverage for nonoccupational injuries or illnesses (on the date of the injury) in a plan or policy that meets certain Labor Code requirements.
In line with the above change, the DWC also now requires that the employee’s written notice of predesignation must include information about the plan, policy or fund providing the employee with health care coverage. Correspondingly, the DWC has also revised its predesignation forms 9783 (personal physician) and 9783.1 (personal chiropractor). Agencies that provide these forms to employees should change these forms when they become available. (The DWC does not have the updated forms online as of this blog posting, but they will eventually be available on the DWC website. Check for a 2014 revision date on the form.)
Chiropractic Visits Limited
The DWC also amended its regulations regarding use of chiropractors. As of this July 1, a chiropractor cannot be an employee’s primary treating physician or secondary physician after the employee has received 24 chiropractic visits, unless additional visits are authorized in writing by the employer. However, this prohibition does not apply in cases of postsurgical physical medicine prescribed by a surgeon or designated physician. Note also that a chiropractic visit includes any office visit, regardless of whether the services performed involved chiropractic manipulation or were limited to evaluation and management of the injury.
Paid Family Leave Coverage Expanded
Paid Family Leave (“PFL”) is part of the family temporary disability insurance program of the state disability insurance (“SDI”) system. This program provides employees with wage replacement benefits while they take time off from work to care for a family member. Though the program is titled “Paid Family Leave,” it does not actually entitle employees to leave. Rather, it complements FMLA and CFRA by providing some wage replacement for an employee taking those leaves in some cases.
Under PFL, employees may receive up to six weeks of benefits if they take leave: (1) to bond with a new child, or (2) to care for a family member who has a serious health condition. For purposes of PFL, the term “family member” was previously defined as the employee’s child, parent, spouse, or domestic partner. As of July 1, the term “family member” also includes an employee’s parent-in-law, grandparent, grandchild or sibling.
Note that only those employees who pay SDI taxes are eligible for this benefit, which is funded exclusively through employee contributions. Many public agencies do not pay into SDI, and their employees are not eligible for this benefit.