Workers’ Compensation Archives

DECEMBER 19, 2016: A new study on California’s workers’ compensation system finds a “strong association” between attorney involvement and the high cost of cumulative trauma claims.

The California Workers’ Compensation Institute study looks at CT claims and identifies characteristics that differentiate CT claims from non-CT claims.

The study finds a strong association between attorney involvement and regional variation in the Los Angeles Basin and the high cost of CT claims.

Cumulative traumas are physical or mental injuries that arise over time from repetitive stress, motion, or exposures, rather than from a specific event or accident.

California’s Workers’ Compensation Insurance Rating Bureau earlier this year reported that CT claims as a percentage of California workers’ comp lost time cases had more than doubled over the past decade, climbing to about 18 percent of all indemnity cases in 2015.

Because CT claims have become a significant cost driver in the system, CWCI initiated a study to gain a better understanding of where these claims come from, identify characteristics and factors contributing to the rapid growth in CT claims and to compare average medical and indemnity benefits for CT and non-CT claims.

Authors of the study used data from its Industry Research Information System database on 41,000 CT claims and 608,000 non-CT claims that received California workers’ comp benefits between 2005 and 2013.

They compared the claim characteristics of CT claims to those of non-CT claims, including the workers’ average age, gender, earnings, and job tenure.

Also studied was: the mix of claims by employer premium, industry and region; the type and nature of injury; notification lag times; level of attorney involvement; presence of indemnity payments; presence of a compensability dispute; and whether or not the injured worker had filed any additional claims.

The study found that CT cases:

  • Were far more likely to have come from the Los Angeles Basin;
  • Were most prevalent in the manufacturing sector;
  • Had a higher proportion of claims involving multiple body parts and mental disorders;
  • Had twice the attorney involvement rate of non-CT claims and 53 percent higher average claim costs.

Workers claiming CT injuries were 10 times more likely to have claimed other injuries against the same employer, according to the study.

Nearly 56 percent of all CT claims in the study population were filed in the Los Angeles County/Inland Empire/Orange County region compared with 36.5 percent of non-CT claims, the study shows.

Limiting the analysis to lost-time cases, the study noted that 91 percent of the CT claims involved an attorney, which was twice the attorney involvement rate for non-CT claims. And while CT claims appeared to have higher medical costs than non-CT claims, that difference disappeared when attorney involvement and region were factored into the equation.

This result confirms a strong association between the higher costs of CT claims in the study sample and the high levels of attorney involvement and the regional variation in the L.A. Basin, the study’s authors note.

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Information courtesy of Insurance Journal

NOVEMBER 9, 2016: California employers have been dealing with the ramifications of legal marijuana for years. Now that voters have passed Proposition 64, legalizing so-called “recreational” marijuana use, employers face a new reality of potentially outdated workplace policies, employee accommodation and the applicability of drug-free workplace guidelines. Workers’ compensation carriers and self-insured employers in particular must begin to consider the impact that Proposition 64 may have on claims processing.

Read the full report from California Workers’ Compensation Institute

 

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JUNE 14, 2016: The Division of Workers’ Compensation (DWC) announces that the 2017 minimum and maximum temporary total disability (TTD) rates will increase on January 1, 2017. The minimum TTD rate will increase from $169.26 to $175.88 and the maximum TTD rate will increase from $1,128.43 to $1,172.57 per week.

Labor Code section 4453(a) (10) requires the rate for TTD be increased by an amount equal to percentage increase in the State Average Weekly Wage (SAWW) as compared to the prior year. The SAWW is defined as the average weekly wage paid to employees covered by unemployment insurance as reported by the U.S. Department of Labor for California for the 12 months ending March 31 in the year preceding the injury. In the 12 months ending March 31, 2016, the SAWW increased from $1,120.67 to $1,164.51—an increase of just under 3.912 percent.

Under Labor Code section 4659(c), workers with a date of injury on or after Jan. 1, 2003 who are receiving life pensions (LP) or permanent total disability (PTD) benefits are also entitled to have their weekly LP or PTD rate adjusted based on the SAWW.

The first quarter 2015 SAWW figures may be verified at the U.S. Department of Labor website, as can the first quarter 2016 SAWW figures.

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California Department of Industrial Relations, established in 1927, protects and improves the health, safety, and economic well-being of over 18 million wage earners, and helps their employers comply with state labor laws. DIR is housed within the Labor & Workforce Development Agency.

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