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California Workers' Comp Savings Come at Expense of Claimants

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The year 2013 brought about significant reforms for California’s workers’ compensation systems through a piece of legislation known as Senate Bill 863. This series of reforms made sweeping changes to the system in an effort to cut back on wasteful spending. A recent report issued by the Workers’ Compensation Insurance Rating Bureau estimated that the system has increased benefits for workers while instituting structural changes resulting in nearly $1.3 billion in annual savings.

Report Findings

The report found that the initial goals of SB 863 have been largely successful and for the most part consistent with initial projections. The impacts of weekly minimums have been pretty consistent with initial projections, allowing for most of the other provisions made by these changes to be instituted without much issue. The elimination of duplicate payments for spinal surgical implants was estimated to save about $20,000 per procedure, but in all actuality the savings have been more than $25,000 per instance, a 28% savings.

However, because of the increased number of denied initial claims, the costs of independent medical review requests also jumped way above initial expectations. Roughly half of all independent medical review requests are received as a result denied pharmaceutical benefits.

Where is the Savings Coming From?

However, critics of the bill have been quick to note that the savings have come in the form of benefits being denied to claimants who need them. Because of SB 863, doctors and medical professionals have been much slower to agree to provide treatment for conditions that may have existed for a long period of time, purely because the standards for what is approved and what is not are much stricter.

Unfortunately government officials will likely see the savings implemented by SB 863 (an estimated 7% total savings on the system cost) and consider the reforms a success while many people across the state suffer from their conditions and the financial strain they are placed under as a result of it.

If you or a loved one is suffering from a condition sustained while on the job, get assistance with the financial costs of your medical treatment from a Sacramento workers’ comp attorney. At Smolich and Smolich, we have served Californians in the city of Sacramento and the surrounding areas since 1969. We recognize the importance of helping you obtain the compensation you need, and take pride in providing our detailed knowledge and skill to hard-working individuals.

Get assistance with your workers’ comp claim! Call Smolich and Smolich today at 916.571.0400.

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