Physical Medicine Cap Is Constitutional

Facundo-Guerrero v. Workers' Comp. Appeals Bd. (2008) 163 Cal.App.4th 640 [73 Cal. Comp. Cases 785]:  In a decision awaited by defendants for nearly five years, the Court of Appeal has upheld the Constitutionality of the 24 vist cap on physical medicine established by SB 228 and codified as Labor Code section 4604.5, subdivision (b).  In this unanimous First Appellate District panel decision certified of publication the injured worker teamed up with the California Society of Industrial Medicine and Surgery, California Applicant’s Attorneys Association, International Chiropractic Association of California and California Chiropractic Association against Argonaut Insurance Company, the California Workers’ Compensation Institute and the California Chamber of Commerce.

The chiropractors argued that the statute limited an employee’s right to treatment in violation of the California Constitution’s creation of a workers’ compensation system with "full provision" of treatment to “cure and relieve” the effects of an industrial injury.  The chiropractors argued that the creation of a cap unlawfully limited treatment.  The Court rejected this argument.  The Court explained that the California Constitutional Amendment creating the workers’ compensation system was designed to ensure the new no-fault system was Constitutional, not to create a new right.  The Amendment explicitly vests the Legislature with the right and power to establish and determine the “contours and content” of the system.  As such, the Legislature was acting within its Constitutional powers in defining a benefit limit.

Next the chiropractors argued that by giving an employer the right to exceed the cap the Legislature unconstitutionally delegated its own power.  The Court rejected this argument.  In doing so it explained that the employer alone has sole discretion to decide whether to exceed the cap.  This decision is not subject to any factual or legal dispute requiring adjudication.  Only an option was given.  Accordingly, there was no delegation of any power. 

Finally, the chiropractors argued that the statute violated equal protection because workers’ injured before 2004 had no cap and/or non-physical medicine treatment has no cap.  The Court explained that since injured workers are not a “suspect class” requiring strict scrutiny, the Legislature only needed to have a legitimate movement purpose of the cap.  The Court concluded it did – to limit out of control medical treatment. 

This case is extremely important for several reasons:

1. 1. The physical medicine cap is law.
3. 2. The Court affirmed that the courts cannot second guess an employers’ decision not to  exceed the cap.
5. 3. The Court continued the recent trend of appellate cases holding that there is  nothing unconstitutional about taking away, limiting or changing an injured worker’s  rights under the Workers’ Compensation system.  The Legislature giveth – the  Legislature may taketh away.  This is extremely important in light of the Vocational  Rehabilitation sunset clause which will be effective January 1, 2009.
   

Opinion Filed June 2, 2008.

To learn more about how we can help you with your case, please contact us today!

Message

Heggeness, Sweet, Simington & Patrico, A P.C.
.........................................
Locations:

San Diego
7071 Convoy Court
Suite 200
San Diego, CA
92111-1023
Phone (858) 874-2100

Riverside
6180 Quail Valley Court
Suite 110
Riverside, CA
92507-0757
Phone (951) 656-1944

Santa Ana
600 West Santa Ana Boulevard
Suite 700
Santa Ana, CA
92701-4555
Phone (714) 550-1133