Report: California Comp Virus Claim Volume Plummeted in February

The wave of COVID-19 claims that hit the California workers’ compensation system at the end of 2020 has subsided for the time being as the number of claims reported to the state Division of Workers’ Compensation for February fell to the lowest level in a year, an analysis by the California Workers’ Compensation Institute Shows.

The CWCI report shows the projected ultimate claim count for February came in at 4,533 cases, down nearly 90% from the record 43,158 claims projected for December.

The figures from CWCI’s COVID-19/Non-COVID-19 Interactive Application show that after surging to an all-time high in December, the monthly COVID-19 claim count fell by more than 50% in January, a decrease that coincided with the steep drop in new coronavirus cases in the state.

Study Shows NASIDs Growing in California Workers’ Comp

A new study shows that nonsteroidal anti-inflammatories (NSAIDs) now account for more than one-third of all drugs dispensed to injured workers in California, triple the proportion for opioids.

A study from the California Workers’ Compensation Institute released on Wednesday also shows that although most NSAIDs that are used are inexpensive, and utilization has been flat since the state’s evidence-based prescription drug formulary took effect in 2018, NSAIDs’ share of the total drug spend has soared from 14.2% to 23.5%.

The surge was largely driven by increased payments for two low-volume, high-priced drugs that are exempt from prospective utilization review and that lack price controls, according to the CWCI study.

California School Employee Arraigned for Workers’ Comp Fraud After Virus Diagnosis

Stephanie Medrano, 33, of West Covina, Calif., was arraigned on Tuesday on multiple counts of grand theft and insurance fraud after allegedly making misrepresentations following a COVID-19 diagnosis in an attempt to collect more than $33,000 in undeserved workers’ compensation insurance benefits.

The California Department of Insurance launched an investigation after receiving a claim of suspected fraud from Medrano’s employer, the Baldwin Park Unified School District, on Aug. 21, 2020. The investigation reportedly revealed Medrano made multiple misrepresentations in order to extend a workers’ comp claim submitted to her employer after she was diagnosed with COVID-19.

California Construction Worker Charged with Workers’ Comp Fraud

Jose Zepeda, 45, of Fresno, Calif., self-surrendered this week on multiple felony counts of insurance fraud and attempted perjury after filing a workers’ compensation insurance claim and allegedly misleading the insurance carrier regarding his employment status in order to collect disability benefits he was not entitled to receive.

According to an investigation by the California Department of Insurance, Zepeda was injured in August 2017 while employed by a local construction company. Zepeda began collecting disability benefits because his employer could not accommodate his work restrictions. The insurance company handling Zepeda’s workers’ comp claim reportedly instructed him to notify them if he found new employment because that would affect the benefits he was receiving.

New Wave of Virus Claims Hit California Workers’ Comp

A California Workers’ Compensation Institute analysis of claims reported to the state Division of Workers’ Compensation as of Jan. 11 shows that the number of COVID-19 claims in the California workers’ compensation system more than tripled between October and November, then jumped another 64.2% to a record 23,483 claims in December.

A new CWCIU projection shows that the December total could climb to 37,573 cases once claims that are yet to be filed or still under investigation are added to the tally.

California Workers’ Comp Hospital Stays From 2010 to 2019 Examined

A new study from the California Workers’ Compensation Institute shows the steep drop in the number of inpatient hospitalizations involving injured workers in the state over the past decade was largely due to the ongoing decline in spinal fusions and a more recent decline in lower extremity joint surgeries.

The CWCI study reviews discharge data compiled by the state Office of Statewide Health Planning and Development on 35.9 million inpatient hospital stays from 2010 through 2019 paid by workers’ compensation, Medicare, Medi-Cal and private insurance, to identify workers’ comp inpatient trends and to compare the volume and types of California inpatient hospitalizations covered by workers’ comp to those covered by the three other systems.

California Governor Signs Workers’ Comp Law Protecting Workers from Virus

California companies must warn their workers of any potential exposure to the coronavirus and must pay their employees workers compensation benefits if they get sick with the disease under two laws that Gov. Gavin Newsom signed last week.

Newsom, a Democrat, signed the laws over the objections of business groups, who have said they are “unworkable.”

One of the laws makes people who have the coronavirus eligible for workers compensation benefits. It takes effect immediately and applies to all workers in the state, but it treats first responders and health care workers differently than other employees.

Report: COVID-19 Workers’ Comp Claims on The Rise in California

The number of California workers’ compensation claims for COVID-19 continues to climb, according to a new report compiled by the California Workers’ Compensation Institute.

Data from the Division of Workers’ Compensation shows that as of Aug. 10, there were 9,515 claims reported for the month of July, bringing the total for the year to 31,612 claims, or 10.2% of all California job injury claims reported for accident year 2020. Those claims include 140 death claims, up from 66 reported as of July 6.

California Governor Announces Workers’ Comp Presumption for COVID-19

California Gov. Gavin Newsom today announced that workers who contract COVID-19 while on the job may be eligible to receive workers’ compensation.

The governor signed an executive order that creates a time-limited rebuttable presumption for accessing workers’ comp benefits applicable to Californians who must work outside of their homes during the stay at home order.

Report on California Workers’ Comp Shows Steady Independent Medical Review Activity

More than 15,400 independent medical reviews a month are issued in California’s worker’s compensation system, according to a new report from the Department of Industrial Relations.

The DIR this week issued a progress report on the its independent medical review program. IMR is the medical dispute resolution process for the state’s workers’ comp system that uses medical expertise to obtain consistent, evidence-based decisions.

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