March 17, 2010
CWCI Scorecard Examines Workers' Comp Claims Experience in California's Long-Term Care Industry
A new California Workers' Compensation Institute "Industry Scorecard" offers a detailed look at work injury claims experience in the California long-term care sector - an industry that employs thousands of workers in nursing homes, homes for the aged, alcohol and drug recovery facilities and other residential care facilities across the state. The Score Card, the last installment in a 9-part series, reflects data derived from 54,432 job injury claims filed by long-term care workers for job injuries occurring between 2000 and 2008. Aggregate medical and indemnity benefit payments on those claims totaled more than $561 million.
The Score Card found that for the 8-year period ending in 2008, long-term care workers accounted for 2.4% of California's job injury claims, but because of the mix of injuries, the relatively low wages within the sector, the geographic distribution of the claims (a relatively high percentage of which involve claimants in less expensive areas of the state), and the high proportion of claims that close quickly, these claims consumed only 2.1% of the state's workers' compensation benefit payments. On the other hand, the Score Card reveals that while average paid losses on long-term care clams have consistently remained well below the average for all claims in California, they have moved up sharply since bottoming out in 2005. For example, the latest data show that following enactment of the 2004 workers' compensation reforms signed by Governor Schwarzenegger, average first-year payments on long-term care claims for 2005 injuries fell to $7,396 ($3,889 medical + $3,507 indemnity), but by 2007, that average had jumped to $9,435 ($5,287 medical + $4,148 indemnity) - a 2-year increase of nearly 28% that pushed average benefit payments on these claims well above the pre-reform levels. Furthermore, the latest data show that as with lost-time claims from all industries, average benefits paid on lost-time claims in this sector increase significantly between the end of the first year and the end of the third year, nearly tripling in some recent years.
In addition to tracking average payments for 2000 through 2007 long term care claims at 12-, 24- and 36-months post injury, the Institute's latest Score Card includes a profile of claimants within this sector, claim distributions based on job classification and the claimants' county of residence, the nature and cause of injury, the primary diagnosis, and the amount of premium paid by the employer. The Score Card also shows the claim closure rates at 12, 24 and 36 months post injury across all 8 years of the study for all claims and for lost-time claims. Pre- and post-reform claim and payment distributions by type of claim (med-only, temporary disability, permanent disability, and death) are shown, as are pre- and post-reform attorney involvement rates for permanent disability claims, with comparative distributions shown for all California work injury claims.
The Industry Score Card Series and summary Bulletins are available to CWCI members and research subscribers who log on to CWCI's web site, www.cwci.org. Anyone wishing to subscribe may do so by visiting CWCI's online Store. In addition to the new Score Card on long-term care, prior Score Cards review claims experience in major California industries, including construction, agriculture, restaurants, professional and clerical, mercantile, durable and nondurable goods manufacturing, and trucking.