California Report Shows Lower Bay Area Workers’ Comp Claims Costs

A report out today shows that San Francisco Bay Area residents account for 17.5 percent of California job injury claims but only 15. percent of claim costs.

The report by the California Workers’ Compensation Institute points to several reasons for this including: faster notifications and less delay in initial treatment; fewer medical visits and lower treatment costs; less attorney involvement; shorter claim durations; fewer claims resulting in permanent disability.

The CWCI report examines data from nearly 330,000 claims filed by residents of the nine-county Bay Area for accident years 2005 to 2015 for injuries that resulted in $4.4 billion in benefit payments.

Despite having some of the highest wages in the state, which tends to push up average indemnity payments, total benefits per claim paid to Bay Area residents were consistently lower than in the rest of the state, so the aggregate workers’ comp benefits in the region were disproportionately low relative to claim volume, according to the report.

Claim characteristics authors of the report believe likely contribute to lower claim costs in the region:

• The time lag to employer notice averaged four days less than in other areas, the time lag to claims administrator notice was almost 13 days less and initial treatment began more than a week sooner;
• Only 13 percent of the Bay Area claims involved PD payments compared with 15.6 percent in the rest of the state;
• The attorney involvement rate for lost-time cases was 10 percentage points below the rate in other regions;
• Overall claim duration averaged 38 days less in the Bay Area and PD claim duration averaged 77 days less;
• The average number of visits and total paid for radiology, physical therapy and medicine services were significantly less on Bay Area claims.
• The distribution of claims by cause and nature of injury was similar in the Bay Area to the rest of the state, though 4.8 percent of the Bay Area claims cited repetitive motion as the cause of injury vs. only 2.8 percent of the claims from other regions.

The Regional Score Cards are available to Institute members and subscribers who log on to the CWCI’s website.

Related:

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• California Workers’ Comp Bureau Issues Report on 3Q Insurer Experience
• Study: California Medical Payments Per Comp Claim Decreased After Reforms
• Report: California Workers’ Comp Reforms Saving $1.3B Annually
• Another Report Shows California Workers’ Comp Reforms Working
• Report: Workers’ Comp Reform Saving California’s System $770M