January 9, 2017
CWCI Spotlights San Francisco Bay Area WC Claims Experience
Oakland – A new California Workers’ Compensation Institute (CWCI) analysis finds that San Francisco Bay Area residents account for 17.5% of California job injury claims but only 15.4% of claim costs, and points to several reasons, including faster notifications and less delay in initial treatment, fewer medical visits and lower treatment costs, less attorney involvement, shorter claim durations, and fewer claims resulting in permanent disability.
CWCI’s latest Regional Scorecard offers detailed data from nearly 330,000 claims filed by residents of the 9-county Bay Area for accident year 2005-2015 injuries that resulted in $4.4 billion in benefit payments. Despite having some of the highest wages in the state, which tends to push up average indemnity payments, total benefits (indemnity + medical) per claim paid to Bay Area residents were consistently lower than in the rest of the state, so the aggregate workers’ comp benefits in the region were disproportionately low relative to claim volume. Among key Bay Area claim characteristics that likely contribute to lower claim costs the Score Card found that:
- the time lag to employer notice averaged 4 days less than in other areas, the time lag to claims administrator notice was almost 13 days less, and initial treatment began more than a week sooner;
- only 13% of the Bay Area claims involved PD payments (vs. 15.6% in the rest of the state);
- the attorney involvement rate for lost-time cases was 10 percentage points below the rate in other regions;
- overall claim duration averaged 38 days less in the Bay Area and PD claim duration averaged 77 days less;
- the average number of visits and total paid for radiology, physical therapy and Medicine services (i.e., cardio-vascular, nerve and muscle testing, psych tests, and sleep studies) were significantly less on Bay Area claims.
The distribution of claims by cause and nature of injury was similar in the Bay Area to the rest of the state, though 4.8% of the Bay Area claims cited repetitive motion as the cause of injury vs. only 2.8% of the claims from other regions. The health care, retail, construction, hotel and food service, and transportation and warehousing sectors all accounted for a relatively high share of Bay Area claims, while the manufacturing and agriculture sectors represented a smaller share. The average age and job tenure of Bay Area injured workers was slightly higher than in the rest of the state and females filed a higher percentage of the claims than in other parts of California, but the proportion of claims utilizing translation services was relatively low given the region’s claim volume.
CWCI’s Regional Score Card feature more than 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 compare results for the Bay Area against those for all other regions, and many also show statewide results, offering a wealth of data on workers’ comp experience both for the region and for the entire state. The Regional Score Cards are available to Institute members and subscribers who log on to http://www.cwci.org/. Others wishing to subscribe or to purchase individual Score Cards may do so on CWCI's online Store. The next Score Card in the series will look at claims filed by residents of San Diego County.