Medical Access in California Workers’ Compensation Examined

March 7, 2022

A new California Workers’ Compensation Institute study shows injured workers’ overall access to medical care for their initial treatment remained relatively consistent between 2010 and 2020.

CWCI used data from more than 1.5 million job injury claims from accident years 2010-2020 to measure changes in the amount of time that elapsed between an employer’s notice of injury and the first treatment, and the average distance that injured workers traveled to receive their initial care.

Wait times to the first visit were calculated for all types of treatment, with results also broken out for evaluation and management visits, physical medicine visits, and for the five most heavily utilized workers’ comp surgical services.

CWCI calculated the average distance to the first treatment for all claimants in the study sample, with more detailed results comparing average distances traveled by workers living in urban, suburban, and rural areas of the state.

The average wait time from employer notice to the initial treatment showed some variation across the 11-year span, ranging from a low of 3.3 days for 2011 claims to 4.4 days for claims from 2020, but the median number of days to first treatment showed no change, as the median values across all 11 years indicated initial care rendered on the same day that the employer was notified of the injury, the study shows.

The average time from the employer’s notice to the first E&M visit also rose slightly over the 11-year span, ranging from 4.1 days for 2011 claims to 5.2 days for 2020 claims, but again the median values for all years indicated that the initial E&M visit occurred on the same day that the employer was notified of the injury, according to CWCI.

The average wait time for some specialty services showed greater variation over time. The average wait time to a first PM visit rose from 31.8 days for 2010 claims to 37.5 days for 2015 claims, but then trended back down to 31.2 days by 2020. The median number of days to first PM visit showed a similar pattern, climbing from 15 days to 20 days between 2010 and 2015, then falling back to 15 days by 2020, according to CWCI.

Most of the increase in the number of days to the first PM visit began in 2013, coinciding with legislative reforms and emergency regulations impacting workers’ comp medical provider networks and the utilization review process.

CWCI has published more details on its study, “Can Access to Medical Care in California Workers’ Compensation Be Improved?


Topics California Claims Workers' Compensation Talent

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