Tuesday, June 3, 2008
C.A.: Cap on Worker’s Compensation Benefits Constitutional
By STEVEN M. ELLIS, Staff Writer
The First District Court of Appeal yesterday rejected a workers’ compensation beneficiary’s challenge that a cap on the number of chiropractic, physical therapy or occupational therapy visits the system will pay for is unconstitutional.
Ruling that it could not “second-guess the wisdom of the Legislature in meeting the worker’s compensation crisis in this state,” Div. Four held that the law limiting the number of visits per industrial injury at 24 did not violate a state constitutional mandate that the system make “full provision” for necessary treatment.
Jose Facundo-Guerrero had sought the court’s review after the state Workers’ Compensation Appellate Board upheld a workers’ compensation judge’s determination that he was only entitled to benefits covering 24 chiropractic visits, as specified by Labor Code Sec. 4604.5(d).
The recipient of 76 treatments following an industrial injury he suffered at work, Facundo-Guerrero argued that his chiropractor should direct his treatment, and claimed that the statute violated Art. XIV, Sec. 4 of the California Constitution, which requires the Legislature to implement a “complete system of workers’ compensation” including “full provision for such medical, surgical, hospital and other remedial treatment as is requisite to cure and relieve from the effects of such injury.”
However the Court of Appeal, in an opinion by Presiding Justice Ignazio J. Ruvolo, rejected all of Facundo-Guerrero’s contentions.
“[I]t is abundantly clear that as a matter of law, Section 4 neither restricts the Legislature’s ability to limit the number of chiropractic treatments for which the workers’ compensation system must be financially responsible, nor does it expand an injured worker’s constitutional rights to include an entitlement to receive unlimited treatments…” he wrote.
Ruvolo also swept aside Facundo-Guerrero’s assertions that the statute—which allows employers to approve payment for visits beyond 24—violated due process by not affording workers a right of judicial review of the decision, and that it violated the equal protection rights of chiropractic patients and beneficiaries injured after Jan. 1, 2004.
“A disagreement with an employer’s refusal to approve excess treatments does not give rise to a legally cognizable ‘dispute,’” he said, noting that adjudication by a neutral party was not necessary because the decision does not turn on the worker’s need for the treatment, or any other factual determination.
Ruvolo similarly rejected Facundo-Guerrero’s equal protection claim, pointing out that it was not subject to heightened scrutiny because chiropractic patients and post-Jan. 1, 2004 workers’ compensation beneficiaries are not suspect classes triggering higher scrutiny under equal protection analysis.
“The Legislature’s decision to reduce the unlimited availability of chiropractic treatments to workers’ compensation claimants is rationally related to that effort,” Ruvolo concluded.
Justices Timothy A. Reardon and Patricia K. Sepulveda joined Ruvolo in his opinion.
The case is Facundo-Guerrero v. Workers’ Compensation Appeals Board, A119814.
Copyright 2008, Metropolitan News Company