October 5, 2016
CWCI Score Card Examines Inland Empire/Orange County Work Comp Claims
Oakland – The California Workers' Compensation Institute (CWCI) has issued its second Regional Score Card, offering detailed data on claims filed by workers from San Bernardino, Riverside, Orange and Imperial Counties for job injuries that occurred between 2005 and 2015. The Scorecard, based on data from more than 360,000 claims that resulted in $6.2 billion in payments for medical and indemnity (lost-time) benefits shows that for the 11-year span ending in 2015, Inland Empire/Orange County residents accounted for 19% of California job injury claims, but average medical and indemnity payments on the claims were among the highest in the state, so they accounted for 21% of total paid benefits.
The leading injury diagnosis for Inland Empire/Orange County injured workers was minor wounds and injuries to the skin, noted in nearly 1 out of 4 claims, but those accounted for only 2.4% of the loss payments, as they tend to be relatively inexpensive cases in which the worker is treated quickly and returns to work with no lost time. In contrast, medical back problems without spinal cord involvement (sprains and strains) comprised 1 in 5 claims in the region, but because they often required extended treatment and resulted in lost time from work, they had a much higher average cost and consumed nearly 28% of paid losses in the region. Since AY 2005, average benefit payments on Inland Empire/Orange County claims have exceeded those in other parts of California, whether measured at 12, 24, or 36 months post injury, with the biggest reason being medical payments, which averaged as much as 19% higher at 36 months, though indemnity payments also averaged as much as 10.9% higher at the 3-year benchmark.
The Regional Score Card features two dozen exhibits with data and commentary on a wide range of metrics including distributions of claims by industry; premium size; claim type; nature and cause of injury; and diagnosis. Several exhibits, including the percentage of claims with permanent disability; attorney involvement rates; claim closure rates; top medications dispensed; breakdowns of medical development by Fee Schedule Section at 12 and 24 months; network utilization; notice and treatment time lags; and the 12-, 24- and 36-month loss development tables compare results for the region against those for all other regions, and many also show statewide results, offering a wealth of detailed data on workers’ comp claims experience both for the region and for the entire state.
CWCI Regional Score Cards are available to Institute members and subscribers who log on to www.cwci.org. Others wishing to purchase individual Score Cards may do so by visiting CWCI's online Store. The next Score Card in the series will focus on claims from the agricultural region stretching from Kern County in the south through the Central Valley all the way to Glenn and Butte Counties in the north.