The workers’ compensation system in California has been the center of passionate debate as well as legislative activity over the last several years. It is worth mentioning that the most significant changes in the history of California workers comp started in 2003. It was when the state adopted various evidence-based medicine guidelines with the application of these medicine guidelines via a compulsory utilization review process; it also involved the repeal of vocational rehabilitation.
These reforms were quickly followed by a new approach to the evaluation of permanent disability and the adoption of employer-selected medical provider networks. Another round of comprehensive reforms was passed in 2012.
In 2019, two changes will change the future of workers’ compensation for California employees. First is the introduction of new software by State Compensation Insurance Fund and second is the Assembly Bill 5 that will help gig workers in receiving the benefits they deserve.

UR Connected
California’s State Compensation Insurance Fund is working hard to fix many issues in workers’ compensation, while better delivering on the intent. This is to ensure that patients quickly get the right care. The Fund is getting its house in order by launching the UR Connected program.
In case you suffer an injury on your job in California, then you fully understand the numerous delays and challenges that are involved in getting the suitable treatment you need to get back on your feet. The good news is that there have been a few important improvements implemented by one of the biggest workers’ comp insurance companies in California, State Compensation Insurance Fund (SCIF).
The state fund is launching new software this summer which would allow workers’ compensation treating medical doctors and registered nurse and physical therapists in California to receive authorizations for patients’ medical treatments electronically and in real-time as compared to waiting several days for manual approvals.
The UR technology will launch this summer; it will have a convenient web-based portal. This will allow medical providers to connect with State Fund quickly. State Fund is all set to revolutionize healthcare delivery in California workers’ comp with this unique end-to-end solution. The software is known as UR Connected and was developed by SCIF. It will link directly to information systems of medical providers to allow personnel the option to approve treatment on the spot or send the request to Utilization Review.
It is worth pointing out that this could considerably improve the time it takes for injured workers in California to receive the treatment they need and help get injured employees back to work as soon as possible. This software lets them obtain authorizations for patient treatments in real-time – via their electronic medical records in the system, instead of waiting several days for a decision to come through fax.
UR Connected is a great solution as it integrates with and effectively leverages existing information systems that are present in the medical providers’ offices. As a result, neither the medical providers nor their personnel need to go offline and fill out extensive paperwork in order to request approvals for patient treatment.  Conexia is the software company that created UR Connected for State Fund.
SCIF is paying Conexia to help make sure the UR Connected system is smoothly and seamlessly adapted to a variety of information systems that hospitals, doctors, and other kinds of medical practitioners use in California. They are hoping to get large groups as well as high-volume practitioners set up with this system as soon as possible. This is a step in the right direction.
Keep in mind that about 11{ba1297414c305310634ceaacbc930b3ec0c2222b554b4377f4b115a3fab9e862} of California workers have workers compensation via the State Fund. This agency processes tens of thousands of patient claims on an annual basis for its 103,000 clients. In addition, note that right now, it has around 85,000 open claims; roughly 7,200 of these claims are in the 4-county Sacramento region.
Through key access points, like direct integration services as well as a web-based portal, many medical providers in the state will be able to connect with State Fund easily. This is a first for workers’ compensation providers in California.
Apart from all of the benefits that UR Connected would deliver to both patients and doctors in California, this system will also help improve the claims efficiency of State Fund and with time, help direct more dollars towards patient care in the State. A spokesperson for State Fund’s medical claims division stated that as this technology is more widely adopted, some staff in the State Fund will get slightly different assignments; however, that State Fund is not foreseeing any layoffs.
There is no denying that effective medical management starts with the injured worker’s first visit for treatment of a work injury. In this regard, the Utilization Review Program will help establish a suitable treatment plan in order to enable much quicker recovery and return to work for injured employees in the state.
However, according to Arjuna Farnsworth, here are several possible down sides to the State Compensation UR technology. Since 2013 neither medical evaluators nor work comp judges have had jurisdiction over faulty or wrongful medical treatment denials. All treatment disputes are supposed to be resolved by Independent Medical Review (IMR). The problem is that IMR is a rubber stamp for the Insurance industry’s UR denial process with a 96{ba1297414c305310634ceaacbc930b3ec0c2222b554b4377f4b115a3fab9e862} uphold rate.
The only manner of conferring jurisdiction back into court of medical treatment disputes is when the Utilization Review denials fail to meet strict timelines set by the labor code.
A cynic might suggest that SCIF is trying to remove timeliness objections. Nothing in the software guarantees approval of the treatment requested by medical professionals. It just eliminates the delays the actually sometimes benefit injured workers.

Assembly Bill 5
The state of California has taken a huge step in rewriting the rules of the big gig economy. Recently, the state Assembly passed an important bill that will make it harder for companies in California to label employees as independent contractors rather than employees. This is a common practice in the state that has allowed many businesses to skirt both federal and state labor laws. This bill will now go to the California Senate.
This year over 2,000 new proposals were introduced for California’s legislative year, including AB 5. It is one of the few bills that could significantly affect both workers and businesses over defining who is an independent contractor.
This sweeping bill has new standards that define whether workers are independent contractors or employees. It upends the way workers are treated in many industries from trucking, ride sharing to the burgeoning gig economy. It is likely that hundreds of thousands of contractors in the state, ranging from Amazon and Uber drivers to exotic dancers and manicurists, would become employees under the new bill. Keep in mind that the California bill, called AB5, will expand a groundbreaking decision by California Supreme Court last year that was known as Dynamex.
Also, the adult entertainment industry is very prominent in California’s worker classification debate, mainly due to high-profile litigation asserting that many exotic dancers in the state are misclassified as independent contractors. As a result, they face substantial abuses.
It is worth mentioning that the ruling, as well as the bill, instructs businesses in the state to use the “ABC test” for figuring out whether a worker is a contractor or employee.
Remember that to hire a contractor, companies have to prove that the worker in question is:
Is free from the control of the company
Is performing work that is not central to the company’s business
Has or runs an independent business in that industry.
In case they do not meet all these three conditions, then these workers will have to be classified as employees instead of independent contractors. It is worth mentioning that the bill would place the court’s Dynamex decision firmly into state labor law, and thus shield it from being overturned by any future court decision.
That being said, as now written, the bill will also carve out some exemptions for some types of non-employee workers, like insurance and real estate agents, barbers, hair stylists, and investment advisors. A few other professions that the bill exempts are doctors, lawyers, dentists, architects, engineers, direct sellers, and accountants.
AB 5 was carried by Assemblywoman Lorena Gonzalez; she is a San Diego Democrat.  Keep in mind that lobbyists for many economic sectors in the state are petitioning Lorena Gonzalez for exemptions before this bill reaches the desk of Gov. Gavin Newsom; however, she seems unlikely to bend much further.
Organized labor in the state strongly backed the bill. This is because the bill has the potential to create new employee classes who could become union members. This will set a standard that allows workers in California to succeed and enjoy the basic benefits and legal protection all employees should have.
Not everyone is in support of this bill. Regional Government Services and many other local government groups in the state fear that widespread application of this ruling will increase their costs while discouraging local agencies in California from using contract workers. It is just as employers view the Dynamex decision, making their operations less flexible and more expensive.
Remember that California is home to a lot of companies that have given rise to the gig economy. While Silicon Valley is definitely a key political force in California’s capital so, too, is labor. This bill comes as a couple of companies, such as Uber and Lyft, are facing increasing pressure.
Drivers for these companies staged protests and went on strike in major cities earlier this month. This was done to draw attention to precarious and insecure working conditions and the financial pressures of being involved in gig work.
The path that California chooses is likely to shape worker classification policy throughout the country. In this regard, an innovative approach, which helps reconcile the competing demands of flexibility and innovation with a little guarantee of basic employee protections and benefits, has the potential to revolutionize employment and labor law for the coming decades.