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Castillo: On the Backs of Injured Workers

By Michael Castillo

Thursday, July 11, 2019 | 342 | 0 | min read

The Workers' Compensation Insurance Rating Bureau (WCIRB) released its 2018 California Workers' Compensation Losses and Expenses report last week, showing another win for insurers as medical payments and losses declined, by roughly $100 million.

Michael Castillo

Michael Castillo

Overall, medical payments and expenses declined, to $4.6 billion in 2018 from $4.7 billion the prior year, with the ratio to earned premiums falling 10%, to 82% of earned premium in 2018, down from 92% in 2017, further padding profits.

The WCIRB estimates an underwriting profit of $3.2 billion, or 18% of premium, in 2018 compared to $1.4 billion, or 8% of premium, in 2017.

Medical payments made to treat injured workers were down in every category except one: "other."

One bright spot were payments made directly to injured workers, which increased to $1.47 billion in 2018, up from $1.34 billion in 2017.

What does this tell us?

Medical claims are being denied and delayed to reduce costs, hampering a worker's ability to get the treatment needed to get back to work.

What's even more interesting is that, as we previously reported (multiple times), the WCIRB has put a target on cumulative trauma claims as the definitive issue affecting workers' compensation costs.

Yet, according to its own numbers, total reported losses on permanent disability claims associated with carpal tunnel/repetitive motion, other cumulative injuries and psychiatric and mental stress injuries (also a form of cumulative trauma) accounted for only a combined total of 15% of losses.

Estimated costs per claim were also significantly lower for these injuries compared with specific slip-and-fall or back injuries, and the percentage of cumulative injury claims represented only 4.2% of all claims. Add in claims for strain from repetitive motion, at 4.6%, and we're still looking at less than 10% of all claims.

We could continue to delve into the numbers, but you can read the report for yourself.

Our key takeaways: Premiums are down, payments to treat injured workers are down, profits are up.

And it's all being done on the backs of injured workers.

Michael Castillo is communications director for the California Applicants' Attorneys Association. This opinion is republished, with permission, from the CAAA website.

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