Research
Injury Scorecard – Other Non-Specific Diagnoses of Musculoskeletal Systems
The enclosed Score Card is the seventh and last in the ICIS injury series and provides detailed data and graphics on California work injury claims involving other non-specific diagnoses of musculoskeletal systems. Based on CWCI Industry Claims Information System (ICIS) data, these injuries are among the most common diagnoses in California workers' compensation, and although many of these injuries appear relatively simple, they tend to be marked by high levels of physical therapy and chiropractic manipulation, delays in initial treatment and claim closure, a high rate of attorney involvement, and 1 out of every 7 results in a permanent disability.
Medical Utilization & Reimbursement Outcomes for Accident Years 2002 – 2006 Claims
This study presents data on associations between the California workers' compensation medical reforms implemented in 2004 – most notably, mandatory utilization review, the ACOEM guidelines, and the 24-visit cap on physical therapy and chiropractic care – and changes in the amount of treatment provided to injured workers, and the associated medical reimbursements.
Temporary Disability Outcomes; Accident Years 2002 – 2006 Claims Experience
This study analyzed changes in temporary disability (TD) outcomes following implementation of SB 899 – the workers' compensation reform legislation signed by Governor Schwarzenegger in 2004 which established a maximum of 104 weeks of paid TD within two years of the first TD payment for most injuries.
Medical Provider Networks and Medical Benefit Delivery; Accident Years 2002 – 2006 Claims Experience
This study analyzed medical provider network utilization rates, following the introduction of MPNs in January 2005. Using the Industry Claims Information System (ICIS) database, CWCI compiled first-year medical visit data for a large sample of pre- and post-MPN services and measured changes in the proportion of services rendered by network providers for accident years 2002 – 2006.
Changes in Medical Cost Containment Payments
This analysis shows that recent California workers' compensation reforms may be associated with higher medical cost containment payments. These preliminary findings indicate that increased utilization review resulting from the application of evidence-based medical treatment guidelines has contributed significantly to an observed increase in medical cost containment payment.
Pain Management and the Use of Opioids in the Treatment of Back Conditions in the California Workers' Compensation System
The study analyzed more than 166,000 California work injury claims for back conditions with no spinal cord involvement and found an association between higher levels of opioid use with higher costs and a higher prevalence of other adverse outcomes such as increased likelihood of lost time from work, delayed recovery and more litigation. The study adds to scientific literature that suggests that at higher levels of use, opioids can have an adverse impact on both activity levels and on self-efficacy, and that prolonged administration of pain medication may impede rather than facilitate injured workers' recovery from occupational back injuries.
