California Workers’ Compensation Institute News

Report Shows Steep Drop in California Workers’ Comp IMRs in 1st Half Year

The number of independent medical reviews used to resolve California workers’ compensation medical disputes fell sharply in the first half of 2020 as the pandemic took a toll on the state’s economy with statewide unemployment spiking to a record level …

California Workers’ Comp Self-Insured Claims Flat in 2019, But Incurred Losses Rose $35M

California workers’ compensation private self-insured claim frequency was relatively stable in 2019 as the incidence of medical-only and lost-time claims registered only marginal declines after increasing in 2017 and 2018, according to a California Workers’ Compensation Institute review of the …

California Workers’ Comp Direct Written Premium Continued to Fall Last Year, Report Shows

California workers’ compensation total direct written premium continued to decline in 2019, falling 7.0% to a five-year low of $11.42 billion, as nine out of the state’s 10 largest insurer groups wrote less premium in 2019 than in 2018, a …

Study Examines Impact of California Workers’ Comp Formulary

Since California implemented its workers’ compensation formulary last year, an increasing share of drugs prescribed to injured workers are either “Exempt” from prospective utilization review or “Not Listed” in the formulary, while “Non-Exempt” drugs that require UR before they can …

Report: High Volume, Low Costs For Comp Claims in Northernmost California

California’s northern most counties accounted for 1.1 percent of the state’s workforce but 3.3 percent of the job injury claims, according to a report from the California Workers’ Compensation Institute. CWCI’s regional score card provides data on claims filed by …

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

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 …

Report: Most California Workers’ Comp Medical Review Decisions Upheld

An examination of California workers’ compensation independent medical review decisions shows roughly nine-in-10 of disputed medical service requests reviewed by an IMR physician agree with the utilization review determination that the service is not medically necessary. The IMR and UR …

Study: Formulary Could Save California Workers’ Comp $124M-$420M

Adopting a state-mandated workers’ compensation prescription drug formulary similar to systems in place in Texas and Washington could reduce California workers’ comp pharmacy payments by between $124 million and $420 million per year, a California Workers’ Compensation Institute study shows. …

California Workers’ Comp IMR Working: Study, Government

A key part to California’s sweeping workers’ compensation reform is working, according to a new study and the people running the system. More than 95 percent of workers’ comp medical treatment requests are approved following the utilization review and independent …

Injured Workers Opioid Use on Rise in California, Washington

Editor’s Note: This is part of a team report on opioid use by injured workers. For the national story read: Opioid Epidemic Plagues Workers’ Comp Washington and California are among states in the U.S. Western Region that have publicly struggled …