Disability Evaluation and Medical Treatment in California Workers' Compensation System

Woman getting CT scan

Background

In the early 2000s, California had the most expensive workers' compensation system in the country. These high costs motivated a number of sweeping reform efforts. Two aspects of the system that were particularly controversial and were targeted with some of the biggest changes were the systems for delivering medical care to injured workers and for evaluating and compensating permanent disabilities. In both cases, the intent of the reforms was largely to contain costs and hopefully improve worker outcomes by eliminating some of the perceived waste and inefficiency that was introduced by the medical-legal process.

Despite these reform efforts, the disability evaluation and medical treatment systems continue to be the subject of considerable controversy. There is uncertainty as to whether the system is accurately measuring the severity of permanent disabilities, and consequently there are concerns that disabled workers are not being fairly compensated. There are also questions about whether the medical treatment provided in California workers' compensation cases meets the standards of best practices in other practice settings, and how effective existing medical networks are at providing efficient, high-quality and affordable medical care.

Goals

This goal of this research is to assess the systems of disability evaluation and health care delivery for workers' compensation claimants in California and identify opportunities to improve access, quality, and efficiency of care for injured workers.

To help address the uncertainty over the issues noted above, the researchers will review the systems of disability evaluation and health care delivery for workers' compensation claimants in California. Building on methods developed in past RAND studies, the researchers will combine empirical estimates of earnings losses with disability ratings to assess the extent to which the current rating system is appropriately identifying the most severely disabled workers.

Additionally, the team will combine qualitative assessments of best practices in medical treatment with empirical analysis of claims data to assess whether medical treatment provided to workers' compensation beneficiaries in California conforms to standard practices in other states, and whether provider networks are effective at providing quality care while containing medical treatment costs.

This project is funded by the California Commission on Health and Safety and Workers' Compensation.

Research Team

Seth Seabury, Co-Principal Investigator
Barbara Wynn, Co-Principal Investigator