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Author Topic: WCIRB and C&R Minutes Authority Diminished  (Read 2441 times)
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« on: October 10, 2008, 10:31:50 AM »

In the good old days, auditors had plenty of resources to help them make classification and employment status determinations.  The old manual (pre-open rating, effective 1-1-1995) actually included a section containing the factors used to determine the employment status of contract labor; the Bureau would assist in making employment status determinations (and would find test audit errors on them as well); and the Classification and Rating Committee Minutes were must-read material for keeping up-to-date on the latest decisions since C&R decisions superseded the manual.

Open rating quickly eroded the Bureau’s authority.  Then, as described in the 2/9/1999 C&R Minutes, then Insurance Commissioner Chuck Quackenbush provided notice to the C and R Committee of his intention to adopt regulations on an emergency basis to implement and consolidate the appeals process pursuant to Government code 111346.1(b).

Shortly thereafter, classification and employment status appeals were no longer heard by the C and R Committee but by administrative law judges (ALJ’s) from the CA Department of Insurance (CDI) that preside over trial-like administrative hearings to resolve disputes between the CDI and employers affected by its decisions.  Although the Rating Bureau is not a government agency, it is a quasi-government agency licensed by the CDI, making it subject to Government code 111346.1(b).
Authority for these issues now rests with the CDI and the courts: the Workers Comp Appeals Board (WCAB – for employment status determination of claimants), the Appeals Courts and, of course, the Supreme Court. 

According to the 2/8/00 C&R Minutes, this shifting of the appeals process from the C&R Committee to the CDI resulted in a reduction in the number of appeals brought before the Committee, and that the only appeals appropriately brought before the Committee, “…would involve test audit issues being appealed by the carrier.  The other areas requiring Committee action deal with administrative issues impacting insurers and proposed amendments to plans or endorsement forms.”

Therefore, while posts made on AuditBible may reference C&R Minutes to discuss classification and employment status issues, our readers must keep in mind that the C&R Minutes are no longer authoritative in deciding disputes in these matters.  Nevertheless, C&R’s may provide valuable insight into the rationale intended for the application of classifications and the determination of employment status as long as the information has not become outdated by more recent rule changes, legal decisions, or legislation.  C&R's may not have authority, but they are not without value.

You can access authoritative resources here:

•   Summaries of You must login to view links.
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WCAB case law regarding employment status

•   Searchable Lexis-Nexis database for You must login to view links.
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California Appellate and Supreme Court opinions

•   The You must login to view links.
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CDI’s Index to Precidential Decisions
(we're working on a summary for you on You must login to view links.
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KWA Safety & Hazmat Consultants, Inc. v. SCIF (2002) AHB-WCA-01-22
, which is the only decision regarding employment status so far).
« Last Edit: September 16, 2014, 04:47:02 PM by auditor1, Reason: spelling correction » Logged
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