Q4, 2016 – March 27, 2017
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Research DWP/Loss Data Update… WCIRB’s quarterly summary of loss & premium experience through 3Q ’16 which shows DWP gross of deductible credits through Sept totaled $14.1 billion, up 5% from the total for the same 9-month period of 2015. The projected average rate on WC policies for 3Q ’16 fell to $2.65/$100 of payroll, 7% below the rate for the first half of this year, and 13% below the rate charged rate for the first 6 months of 2015. Meanwhile the projected indemnity claim frequency through 3Q ’16 was down 1.5% from the prior year, after only a 0.2% decline between AY 2014 and AY 2015. Executive Briefing (12/21/16) (members only) Cumulative Trauma in California Workers’ Compensation… A CWCI analysis that provides background information along with detailed data and graphics on cumulative trauma (CT) claims in the California workers’ compensation system. CT claims are physical or mental injuries that arise over time from repetitive stress, motion, or exposures, rather than from a specific event or accident. The study identifies characteristics that differentiate CT claims from non-CT claims, and finds a strong association between attorney involvement and regional variation in the Los Angeles Basin and the high cost of CT claims. Spotlight Report (12/19/16) (members only) Bulletin (12/16/16) (members only) News Release (12/19/16) (public) Executive Briefing (12/21/16) (members only) Working Through The Haze: Implications of Medical Marijuana for the California Workers’ Compensation System. A white paper that examines the intersection of workers’ comp with medical and recreational marijuana laws in California, in other states, and at the federal level. Issues discussed include the developing trend toward compelled compensation in various jurisdictions; questions surrounding the compensability of work injuries suffered by medicinal and recreational marijuana users; the applicability and enforcement of drug-free workplace policies; and the potential for retaliation and discrimination claims. The report also reviews the ongoing debate over the medical efficacy of marijuana; the use of marijuana and its derivatives as an alternative to more powerful opioids; obstacles such as the lack of uniform dosage levels, standardized delivery methods, and FDA oversight; and the question of how medical marijuana may fit with an insurer’s obligation to provide injured workers with reasonable and necessary medical treatment to cure and relieve the effects of their work injury. Report to the Industry (11/09/16) (public) News Release (11/9/16) (public) Executive Briefing (11/18/16) (members only) California’s Work Injury & Illness Rate. The state recently released initial results of the US Bureau of Labor Statistics’ (BLS) 2015 Survey of Occ. Injuries & Illnesses (SOII) for Calif, which showed the work injury & illness rate for nonfatal work injuries and illnesses was unchanged last year, holding at a 14-year low of 3.8 cases per 100 full time employees (FTEs). Executive Briefing (11/18/16) (members only) California Workers Comp Regional Score Card: The Central Valley. The third in CWCI’s series of Regional Score Card series provides detailed data compiled from 344,000 AY 2005-2015 job injury claims filed by workers living in California’s long farm belt, which stretches 450 miles from Kern County in the south to Glenn and Butte Counties in the north. While agriculture is the largest industry, the Score Card shows the area has a diverse economy including 5 of the 20 largest cities in the state. Central Valley residents filed 18.1% of all California workers’ comp claims, but accounted for only 15.0% of paid losses, and highlights factors that make Central Valley claims different by providing data comparing key aspects of claims from this region to those from other parts of California. Regional Score Card (10/31/16) (members only) Bulletin (10/31/16) (members only) News Release (11/9/16) (public) Executive Briefing (11/18/16) (members only) Regional Distribution of Claims With Lien Payments. Data from the Institute’s IRIS database on a subsample of claims with records of lien payments finds that while L.A. County accounts for 25.6% of all Calif WC claims and 31.9% of all loss payments; when it comes to claims with lien payments, L.A. County accounts for 46% of the claims and 55.5% of all lien dollars paid. Another 25.4% of the “lien claims” were from the neighboring Inland Empire/Orange Co., and those claims accounted for 24.4% of the lien dollars. Executive Briefing (10/7/16) (members only) WCIRB’s summary of Calif WC insurer experience through 2Q 2016. WCIRB estimates that insurers’ AY combined loss and expense ratio showed a relatively small change last year, but hit an 8-year high as the estimated ultimate total loss (avg. ultimate indemnity + medical + allocated loss adjustment expense) on an AY 2015 indemnity claim is projected to be $82,859, up 3.6% from the projected level for AY 2014 indemnity claims, while indemnity claim frequency for AY 2015 is projected to be 0.2% below the AY 2014 level, but 14% above the frequency for 2009. Executive Briefing (10/7/16) (members only) California Workers Comp Regional Score Card: Inland Empire/Orange County. Regional Score Card (10/5/16) (members only) Bulletin (10/5/16) (members only) News Release (10/5/16) (public)
Legal Gage v. WCAB. A Court of Appeal Ruling that LC Section 5814 penalties may be imposed against public employers who unreasonably delay advance disability pension payments due under LC 4850.3 and LC 4850.4. Significant Decision (12/22/16) (members only) King v. CompPartners. The Institute brief in support of the defendant in the case where the plaintiff is seeking to establish that a patient/physician relationship existed between the worker and the UR/URO physician. CWCI Amicus Brief (12/6/16) (members only)
Statutory/Regulatory Tighter Audit Standards for 2017. Gov. Brown signed SB 482 which will require doctors to check the state prescription drug monitoring program (CURES) at least 24 hours before prescribing a Schedule II, III or IV controlled substance to a patient for the first time. The bill also requires doctors to check CURES at least once every four months when continuing to prescribe a controlled substance. Executive Briefing (12/21/16) (members only) Executive Memo (12/21/16) (members only) Medical Mileage Change for 2017 Travel. The mileage rate paid to injured workers for travel related to medical care or evaluation of their injuries will drop to 53.5¢/mile for medical travel on or after 1/1/17, regardless of the injury date. Bulletin (12/21/16) (members only) Executive Memo (12/13/16) (members only) News Release (12/13/16) (public) Executive Briefing (12/21/16) (members only) Reminder: SJDB Voucher Payment Reporting. WC claims administrators must report Supplemental Job Displacement Benefit payments to the WC Information System. Executive Briefing (12/21/16) (members only) User Funding Rates for 2017. The Department of Industrial Relations (DIR) issued the 2017 assessment rates that California employers will pay to cover workers’ compensation user funding (the Workers’ Compensation Administration Revolving Fund), the Uninsured Employer Benefits Trust Fund, the Subsequent Injury Benefits Trust Fund, the Occupational Safety & Health Fund, the Labor Enforcement and Compliance Fund, and the Workers’ Compensation Fraud Account. Bulletin (11/22/16) (members only) Executive Memo (11/22/16) (members only) News Release (11/22/16) (public) CWCI Webinar: 2016 Legislative Review. CWCI scheduled a free, 90-minute, webinar to bring our members up to speed on the pending changes, review the technical aspects and practical implications of SB 1160 and other 2016 worker comp bills, and to confirm the implementation timeframes. Executive Briefing (11/18/16) (members only) AB 1160 Addresses UR and Liens. Executive Briefing (10/7/16) (members only) Are Off-Label Rx Drug Requests About to Spike? Late amendments to SB 1160 included a huge new section detailing the legislative intent of the provisions related to fraudulent liens. The bill was approved by both chambers and sent to Gov. Brown, as was AB 1244 (Gray) which would require the DWC to suspend the rights of a provider convicted of health care fraud from participating in WC & prohibit convicted providers from pursuing lien payments. Executive Briefing (10/7/16) (members only) No Pamphlet, Posting Notice or Claim Form Changes for 2017. None of the WC statutory changes enacted this year will require revisions to the posting notices, new hire pamphlets or claim forms, which were changed when the benefit notice regs were updated a year ago, so you may continue to use the current versions of the new hire pamphlets (CCR §9880); WC posting notices (CCR §§9881 – 9881.1); DWC-1 claim form/Notice of Potential Eligibility (CCR §10139); or benefit notice letters (CCR §§9810-9815). Executive Briefing (10/7/16) (members only) Other CWCI Hotlinks Update. Quarterly listings of all CWCI publications, including publication dates, brief summaries of each topic and the various formats in which the information is available (e.g., research report, Bulletin, Executive Briefing, news release), so users can choose the level of detail they want to view. Listings include live links so users can click into the CWCI website to access specific documents quickly and easily. Hotlinks Q3/16 (11/1/16) (members only) |