California lawmakers have proposed a number of bills during the current legislative session that would make thousands more employees eligible for post-traumatic stress disorder presumptions.

There are currently at least five legislative proposals that would make nurses, law enforcement employees, first responders, lifeguards and prison employees eligible for presumptions, stating that post-traumatic stress disorder is compensable. The bills reflect lawmakers’ growing concerns that first responders are experiencing PTSD and need mental health treatment.

Here are summaries of the current proposals:

• Assembly Bill 1145 — This bill would create a new PTSD presumption for state medical providers who work for the Department of Corrections and Rehabilitation, the State Department of Developmental Services and the State Department of State Hospitals. This includes registered nurses, psychiatric technicians and other medical and social service providers.
• AB 597 — The original version of this bill was going to add public safety dispatchers, paramedics, emergency medical technicians and more firefighters to the current PTSD presumption. However, lawmakers amended this bill on Feb. 23 to remove public safety dispatchers from the proposal.
• AB 1107 — This bill would add more employees from the Department of Corrections and Rehabilitation and California State University Police Departments to the PTSD presumption. This bill would primarily impact employees who are responsible for law enforcement activities, such as transporting inmates.
• AB 1156 — This proposal would create a presumption for employees at acute care hospitals who provide direct patient care. This presumption would presume that infectious diseases, orthopedic injuries, PTSD, cancer, and various respiratory diseases are work-related.
• AB 699 – This bill would expand existing presumptions for full-time members of the City of San Diego Fire-Rescue Department’s Boating Safety Unit and also extend the time frame for them to file for these presumptions. It would expand the list of presumptions to PTSD or exposure to biochemical substances.

At this point, none of the proposals are close to becoming law. They would have to be approved by both the Assembly and the Senate, and then Gov. Gavin Newsom would have to sign them into law. To be clear, all of these bills have to pass through multiple committee hearings and a number of votes before they would even reach Newsom’s desk.

In prior legislative sessions, Newsom and his predecessor, Gov. Jerry Brown, vetoed similar measures citing fears that such presumptions could dramatically increase costs for employers, third-party administrators and insurance companies. It’s worth noting that many first responders are employed by state and local governmental entities, so if their costs go up, then the taxpayers will ultimately have to foot the bill.

Other bills

There are also a number of other legislative proposals that could affect the California workers’ compensation system. They include:

• AB 489 — This bill would extend carriers’ ability to use debit cards to pay for indemnity benefits. The debit card statute is currently set to expire on Jan. 1, 2024, if it is not extended.
• AB 621 — This bill would add more workers from the Department of Forestry and Fire Protection to the group of employees who are exempt from death benefit caps.
• Senate Bill 697 — This is a study bill that would require the Division of Workers' Compensation to perform a “value of care” review. If implemented, this would impact how payers reimburse medical providers for workers’ compensation treatment.
• SB 631 — This bill calls for a comparative analysis of how benefits are provided to men and women.
• SB 636 — This proposal would mandate that psychologists are licensed in California and would require California licensing for utilization review physicians performing UR services on cases involving private employers.
• AB 1213 — This proposal states that when an independent medical review decision or the Workers' Compensation Appeals Board overturns a denial of medical treatment, TD would also be owed until the care is authorized.
• AB 1278 — This bill permits applicants to request that an electronic medical provider network notice be sent to treating providers.
• SB 391 — This bill adds peace officers with the Departments of Fish and Game and the Department of Parks and Recreation to the skin cancer presumption.

Conclusion

Lawmakers are clearly attempting to make more governmental employees eligible for PTSD and other presumptions. That being said, we haven’t seen a push for an omnibus reform bill, which is interesting because lawmakers have previously hinted that major workers’ compensation reforms could lie ahead after Newsom won reelection in 2022.

One reason for that could be the budget deficit fight that landed on Newsom’s desk, which has led politicians from both parties to rush to protect funding for their most important stakeholders and projects.

Regardless of the politician, political climate or political trends, disputes about how to handle a budget deficit cannot be ignored and can eat up a lot of a governor’s time. Once the budget situation is resolved, we could see more interest in workers’ compensation reforms.

John P. Kamin is a workers’ compensation defense attorney and partner at Bradford & Barthel’s Woodland Hills location. He is WorkCompCentral's former legal editor. This entry from Bradford & Barthel's blog appears with permission.