Research

A CWCI study reviews statutory, regulatory and judicial changes to the California workers' comp medical-legal process over the past quarter century, provides updated data on the quantity, mix and cost of medical-legal services following the 2002-04 reforms, and generates benchmark data for future research on the impact of the 2012 reforms, which introduced IMR as the new means for resolving treatment disputes.

New CWCI research that tracks average California workers' comp medical loss, indemnity benefit and medical cost containment (MCC) payments on AY 2005 – 2014 lost-time claims finds mixed results, with more developed data on older claims showing paid medical losses and indemnity leveling out or declining, and less developed data on newer claims indicating that average amounts paid in the early stages of a claim are on the rise.

A new analysis of California workers' comp IMR decisions from Q1 2016 shows little change in the number of IMR determinations, the percentage of UR modifications and denials upheld by IMR physicians, the types of medical services reviewed, and the high concentration of disputed medical service requests linked to a relatively small number of physicians.

A detailed analysis of changes in the utilization and reimbursement of California workers' comp physician and non-physician medical services during the first 2 years of the transition to the RBRVS fee schedule, which began in January 2014.

L.A. County residents account for 25.6% of all claims in the state, but 31.9% of workers' comp loss payments. What makes L.A. claims different? The Regional Score Card provides detailed data comparing key aspects of Los Angeles County Claims to those from other regions of California.

Inland Empire/Orange County residents account for 19% of all California workers' comp claims and 21% of paid losses. The regional Score Card provides detailed data comparing key aspects of Inland Empire/Orange County claims to those from other regions.