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Friday, August 18, 2017

WCIRB: State's Loss Adjustment Expenses Are 'Off the Charts'

  • By Elaine Goodman
  • State: California
  • Topic: Top
  • - Popular with: Employer
  • -  5 shares
California’s workers’ compensation system stands out in many ways from systems in other …

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George Corson Aug 18, 2017 a 1:08 pm PDT

Close the Post-Termination Cumulative Trauma Claim loophole, and save the system. I agree that 3% of them are valid and should probably recover; the problem is the 97% which are filed as misguided severance packages. The medical liens typically dwarf the nuisance closure value, both sides need Attorneys, they are almost always denied, and they bloat the WCAB litigation Calendar.

I think that one move would bring CA more in line with the averages.

Joel Thomas Aug 18, 2017 a 2:08 pm PDT

Would you be willing to give up the exclusive remedy on Post Term. cases? If so I am in agreement. If not the savings to the employer is still substantial to have them covered under the workers' comp system.

Stuart Baron Aug 18, 2017 a 4:08 pm PDT

I agree with George. CT claims are killing the system. I continue to propose that the date of injury now set forth in LC5412 be moved back to LC5411 where it was up to 1973 when CAAA had it moved. I continue to wonder at where in the great scheme of things CT became a disease...

Frank Silva Aug 19, 2017 a 3:08 pm PDT

Denial of care costs like UR and IMR result I. Higher losss. The PD I creates with the denial of care.

Charles Cleveland Aug 19, 2017 a 9:08 pm PDT

I disagree with George and Stuart on this. CT claims are not killing the system and this is just another drumbeat for more takeaways from injured workers. The largest single WC $$ driver is cost containment both in its own expense and abuse but in the secondary effects it causes. Rampant utilization review and independent medical review results in a higher medical, temporary and permanent indemnity costs. The delays alone in the delivery of care result in injured workers with longer periods of temporary disability and higher permanent disability rates due to the 91 .6% denial of care/medical treatment. The war on liens has driven most doctors from the system and I have a difficult time daily finding physicians who are willing to see injured workers due to the mountain of paperwork and abysmal reimbursement rates. Before any takeaways are made in continuous trauma claims, cost containment and medical care delivery should be a priority first.

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