Are Workers Comp Medical Payment Amounts Dropping?

Orange County Lawyers Discuss
Drops in Workers Comp Medical Payment Amounts

In 2013 California Senate Bill 863 was enacted in an attempt to make wide-ranging changes to California’s workers’ compensation system. The bill sought to increase benefits to injured workers, while also implementing some cost-saving efficiencies that would save insurers money.

So, have these changes actually helped workers compensation claimants? Or have the “cost saving measures” outweighed the supposed increase in benefits? In this article our experienced Orange County Workers Compensation lawyers take a look at the data.

According to a new report from the Workers Compensation Research Institute (WCRI), medical payments for workers’ compensation claims that were for more than seven days of lost time have actually continued to decrease since 2013, in California.

Workers’ compensation claims were for claims of 12 months or more decreased 3% per year in 2012, 2013, 2015 & 2016. And Workers’ compensation claims with 36 months of disability saw a 4% decrease per year in average medical payments made by insurers.

California Workers Comp Benefits Compared to Other States

Before the reforms were enacted, California had higher medical payments per claim than most other states, according to the report from the Workers Compensation Research Institute. However that same WCRI Report shows that after the reforms California’s payment rate was near the median (middle) of other state’s payment rates.

The WCRI California data also found that the costs paid for primary care services increased. However, prices for specialty care decreased after the reforms went into effect.

Other payments for workers comp medical claims decreased post-reform, including payment per claim for ambulatory surgery center facilities and prescription payments per claim

The percentage of claims with hospital services also decreased in California. However, hospital payments per claim remained fairly stable.

Orange County Workers Comp Lawyers Fight Benefits Decrease

These decreases in payment rates are certainly not good news for workers compensation claimants. The effect is, in many ways, the direct opposite of what legislators claimed they were trying to achieve – which was increasing benefits to injured workers.

For this reason, it is more important than ever to make sure you are being represented by a skilled and experienced workers compensation lawyer. When you are disabled “every penny counts” – and our caring and experienced lawyers will aggressively fight to protect your rights and ensure that you receive all of the benefits for which you qualify.

Free Consultation with an Orange County Workers Comp Lawyer: