Scorecard Quantifies Workers’ Compensation Claim and Payment Differences in L.A. County

08.25.2016


The California Workers’ Compensation Institute (CWCI) has debuted a new series of research publications, “California Workers’ Compensation Regional Score Cards,” which use subsets of data from CWCI’s Industry Research Information System (IRIS) database to measure and analyze various aspects of claims experience within eight regions of the state.

Score Cards for each region will profile claimant characteristics and highlight data compiled from claims filed by residents of the region. Exhibits include distributions of claims within the region broken out by industry sector, premium size; claim type (medical-only, temporary disability, permanent disability); common "nature" and "cause" of injury categories; and primary diagnoses. Several exhibits, including the percentage of claims with permanent disability; attorney involvement rates; claim closure rates; the top prescription drugs dispensed in calendar year 2014; breakdowns of medical development by Fee Schedule Section at 12 and 24 months post injury; medical network utilization rates; notice and treatment time lags; and the 12-, 24- and 36-month loss development tables compare the results for the specific region against those for all other regions.

Many of the exhibits also provide the combined statewide results, offering a wealth of detailed data not only on workers’ compensation claims experience for the region, but for the entire state.

The first Score Card in the series, released this week, focuses on accident year 2005 – 2015 claims filed by residents of Los Angeles County who, the data show, account for about a quarter of the claims in the state, but nearly a third of all paid losses. Notably, the Score Card finds a pattern of lower than average first-year payments on the Los Angeles claims, followed by higher losses as the claims age, which tracks with the longer delays in reporting (both to the employer and to the claims administrator), delays in initial treatment, and a higher prevalence of cumulative trauma and non-specific injury claims in Los Angeles County, all of which are documented by the Score Card.

The Institute plans to roll out the Injury Score Card series over the next several months, and all eight Score Cards, along with summary Bulletins, will be posted under Research for CWCI members and research subscribers. The next Score Card will be released next month and will examine claims filed by workers living in the Inland Empire and Orange County.

Source: CWCI

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