Research
Integrating COVID-19 Presumptions into California Workers’ Compensation
A CWCI Report examines the historic role of WC presumptions, the current and proposed COVID-19 presumptions, and results of a survey detailing characteristics and outcomes of initial COVID-19 claims.
IMR Decisions, January 2014 Through March 2020
The number of IMR determination letters in California workers’ comp fell 11.3% in 2019, led by a sharp decline in prescription drug disputes, with initial data from 2020 showing the decline is continuing.
California Workers’ Compensation Prescription Drug Trends.
A CWCI Research Update Report provides new data on prescription drug utilization and reimbursement trends, based on 5.85 million prescriptions dispensed to California injured workers from 2011 through June 2020. The report looks at changes in the distribution of prescriptions and payments by therapeutic drug group; details opioid utilization trends for AY 2007 -2018 claims at 24 months post injury using four different metrics; and measures pre- and post-formulary shifts in the mix of prescription drugs and payments among the formularys drug categories.
Trends in the Utilization and Reimbursement of Professional Medical Services in California Workers’ Compensation, 2013-2018
CWCI’s analysis of changes in the volume and reimbursement of California workers’ comp professional medical services from 2013-2018, which includes the 4-year transition to the RBRVS fee schedule that began in 2014. The study reviews data from nearly 36 million medical services rendered to injured workers during that period to measure shifts in the mix of services and payments across and within 9 major services categories, and discusses the underlying changes to the fee schedule that affected those moves.
The Impact of Declining Opioid Use on Lost-Time Claim Development and Outcomes in California WC
A 30-page CWCI Report to the Industry details CWCI research that quantifies the declining prevalence of opioids in workers comp lost-time claims, the impact on average benefit payments and average days away from work, and in light of the opioid trends, estimates projected costs for 2010-2017 claims at 10 years of development.
Post-Reform Medical Service Approval Rates in California WC
A new CWCI study on California workers comp medical care approval rates shows 94% of all treatment services performed or requested for injured workers in the first 10 months of 2018 were either approved or approved with modifications, though outcomes varied by type of service.
