January 23, 2017
CWCI Score Card Looks at Why San Diego Work Comp Claims Cost Less
Oakland – The California Workers' Compensation Institute (CWCI) has published its fifth Regional Score Card, providing detailed data on claims filed by workers from San Diego County for job injuries that occurred between 2005 and 2015. The Score Card, which features data from more than 154,000 claims that resulted in $1.83 billion in payments for medical and indemnity benefits shows that for the 11-year period ending in 2015, San Diego County residents filed 8.1% of California job injury claims, but because the average amount of indemnity paid per claim was among the lowest in the state, they accounted for only 6.2% of paid benefits.
The Score Card identifies several characteristics that differentiate San Diego claims from those in the rest of the state, including the mix of claims by industry, which revealed that a high proportion of claims from the region involve health care, hotel and food service, and retail workers, and that San Diego County has the highest percentage of claims filed by women in the state. In addition, compared to nearby regions such as Orange County, the Inland Empire, and Los Angeles where claim costs are higher and claim durations are longer, San Diego claims are more likely to be medical-only cases and less likely to result in permanent disability; fewer of them involve attorneys; and the time lags between the injury date and the employer and claims administrator notification, and the initial medical treatment is less – all factors that are associated with less expensive claims. The San Diego claims also involved fewer visits for evaluation and management and Medicine Section services (which include cardiovascular, nerve and muscle testing, and psych testing and psychotherapy). At two years post injury, average amounts paid on the San Diego County claims were less than in other regions across six major treatment categories, with the biggest differences being in the amounts paid for Medicine Section services ($151 less); radiology ($57 less) and physical therapy ($42 less). Comparing AY 2011 – 2012 paid losses at 36 months post injury, the Score Card found that average benefit payments on the San Diego claims were more than 10% less than in the rest of the state, as average medical payments were $17,786, or 9.9% less, and average indemnity payments were $14,575, or 10.3% less.
CWCI’s Regional Score Cards include more than two dozen exhibits with data and analyses on a wide range of metrics, including claim distributions by industry; premium size; claim type; nature and cause of injury; and diagnosis. Several exhibits compare claim results for San Diego against those for all other regions, and many also show statewide results, offering a wealth of data on workers’ comp experience for the region and for the entire state. 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 the Central Coast, ranging from Ventura County in the south to Santa Cruz County in the north.
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