California Comp Report Shows High Medical and Indemnity Payments for IE and OC

Average medical and indemnity payments on claims were much higher in San Bernardino, Riverside, Orange and Imperial counties than the rest of the state, according to the latest Regional Score Card issued by the California Workers’ Compensation Institute.

The score card is based on data from more than 360,000 claims that resulted in $6.2 billion in payments for medical and indemnity (lost-time) benefits.

It shows that for the 11-year span ending in 2015, Inland Empire/Orange County residents accounted for 19 percent of California job injury claims, but average medical and indemnity payments on the claims accounted for 21 percent of total paid benefits.

The leading injury diagnosis for Inland Empire/Orange County injured workers was minor wounds and injuries to the skin, noted in nearly one out of four claims, but those accounted for only 2.4 percent of the loss payments, as they tend to be relatively inexpensive cases in which the worker is treated quickly and returns to work with no lost time, according to the report.

In contrast, medical back problems without spinal cord involvement, such as sprains and strains, comprised one-in-five claims in the region, but because they often required extended treatment and resulted in lost time from work, they had a much higher average cost and consumed nearly 28 percent of paid losses in the region, the report shows.

Since accident year 2005, average benefit payments on Inland Empire/Orange County claims have exceeded those in other parts of California, whether measured at 12, 24 or 36 months post injury, with the biggest reason being medical payments, which averaged as much as 19 percent higher at 36 months, though indemnity payments also averaged as much as 10.9 percent higher at the three-year benchmark, according to the report.

Topics California Claims