At the 2016 WCRI Annual Issues & Research Conference, Alex Swedlow from California Workers’ Compensation Institute (CWCI) discussed their studies around medical review and medical dispute resolution in California workers’ compensation. CWCI studies many potential areas of of friction to see the impact this had on state benefit costs. There is almost no correlation between regulatory staff per capita and costs for workers’ compensation benefit delivery. In addition, they also found little correlation between fee schedule rates and claim costs. However, they did find that attorney involvement and other issues have a significant impact on claim costs. In particular, they
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At the 2016 WCRI Annual Issues & Research Conference, WCRI representatives presented a session comparing workers’ compensation outcomes across states. Panelists included: Dr. Sharon Belton – WCRI Dr. Bogdan Savych – WCRI Dr. Vennela Thumula – WCRI The purpose of this study and other similar studies recently conducted by WCRI was to analyze the outcomes reported by injured workers. The study went beyond claims data and involved conversations with over 6,000 injured workers with over seven days of lost time due to a work injury. The interviews were conducted three years post-injury. There were 15 states in the study and
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At the 2016 WCRI Annual Issues & Research Conference, Dr. John Ruser and Dr. Olesya Formenko from WCRI discussed a not-yet published study on the impact that medical fee schedules can have on case-shifting in workers’ compensation. Studies have shown that a fee schedule changes not only change the price paid for services, but it also impacts the utilization of services and the shifting of claims in and out of workers’ compensation. The fundamental purpose of this study was to see to what extent higher workers’ compensation fee schedules influenced a provider’s decision to classify a back injury as work
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Conference Chronicles will be blogging from WCRI’s 32nd Annual Issues & Research Conference on March 10-11, 2016, in Boston, MA. The two-day program highlights presentations of the Workers’ Compensation Research Institute’s latest research findings while drawing upon the diverse perspectives of highly respected workers’ compensation experts and policy makers from across the country. Conference participants will leave with new insights, valuable networking contacts, and a better understanding of key issues in today’s competitive environment. For more information, visit https://www.wcrinet.org/conference.html.

At the 2016 PARMA Conference, David Parker, an attorney with Parker, Kern, Nard & Wenzel, discussed the strategies around defending peace officer presumption claims in California. Under California law, certain “peace officers” and first responders as defined by the statutes receive a presumption of compensability for certain conditions. Defending such cases can be extremely challenging because, absent other evidence clearly demonstrating an alternative cause, the condition is presumed to be caused by work. The presumption laws in California cover the following: Hernia, Heart and Pneumonia – Police, firefighters. Does not include prison guards. Cancer and Leukemia. Includes prison guards. Must
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At the 2016 PARMA Annual Conference, Mark Pew from PRIUM talked about general guiding principles for developing workers’ compensation drug formularies and how this applies to current efforts in California. As has been widely reported, the misuse and abuse of opioids and other prescription drugs has reached epidemic proportions in this country. Between 1999 and 2013, over 175,000 people have died from prescription drug overdoses. Who is responsible for this epidemic? The seven “P’s”; prescribers, patients, pharmacists, big Pharma, payers, politicians and plaintiff attorneys. A drug formulary is an important part of a comprehensive strategy to prevent the overuse of
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At the 2016 PARMA Conference, a panel discussed negative attitudes toward law enforcement and how this impacts jury selection for cases involving police officers. The panel consisted of: David Cannon with Trial Innovations Catherine Mathers with Collins, Collins, Muir and Stewart LLP Shawn Mathers with Sheriff’s Information Bureau Social Media Social media searches can be an important element in selecting a jury pool. Attorneys search social media for comments from potential jurors that are derogatory toward police. This helps them identify which potential jurors they should try to strike from the jury. Comments posted on online news articles are also
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At the 2016 PARMA Conference, Doug McKibbin from Keenan presented a session looking at the Total Worker Health Model.  The Total Worker Health Model is based on creating a healthier workforce with increased productivity which should, in turn, reduce your worker’s compensation and healthcare costs. The session begin with a discussion of the rising healthcare costs in the United States and the corresponding rise in workers’ compensation claim severity. Co-morbid conditions such as obesity and diabetes are leading to poor employee health and corresponding high costs. Population Health Management looks at the total costs of poor employee health, including workers’
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At the 2016 PARMA Conference, Jeff Rush from California Joint Powers Insurance Authority (JPIA) and DeAnn Wagner from York Risk Services Group discussed how identifying the root cause of the workers’ compensation claims leads to a better approach with loss control measures, increased accountability and improved enactment of safety protocols and policies. Generally, there are three causes to every accident: the immediate cause, the contributing cause and the root cause. For example, if an employee slips on a wet floor and fractures their arm, the immediate cause was the fall, the contributing cause was the wet floor, but the root
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At the 2016 PARMA Conference, a panel discussed the interaction between workers’ compensation and disability accommodation. Many of the facts in this presentation apply to California law on these issues.  The panel was: Anthony Carlton from Chula Vista Elementary School District Marc Liebowitz from Laughlin, Falbo, Levy & Moresi LLC Robert Cutbirth from Tucker Ellis In recent years, there has been a significant increase in litigation involving the interplay between workers’ compensation and leave of absence programs. Attorneys are not only filing disability accommodation claims but are also filing retaliation claims associated with workers’ compensation cases. This increase in litigation
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