Workers Comp Zone



The big California Workers’ Comp & Risk conference began today at Monarch Beach in  “OC”. It’s one of the most prominent yearly conferences on California workers’ comp.

Yours truly was on the kickoff panel, titled “The State of California Workers’ Compensation and What’s On the Horizon for 2016”. Moderated by Mark Walls of Safety National Insurance, the panel also included David North, the CEO of Sedgwick, Kevin Confetti from University of California, Ann Schnure of Macy’s, Dawn Watkins from the LA Unified School District, and defense attorney Richard Jacobsmeyer.

Walls posed the following questions:

-How does California compare to other states in terms of costs and cost drivers?

-Why are formularies and treatment guidelines necessary?

-Has SB 863 been successful in its goal of increasing benefits to workers, decreasing system complexity, and lowering employer costs?

-In what areas do you  feel workers’ comp needs to improve? what can we do better?

-Where do you see workers’ compensation in 10 years? How are we going to evolve?

That’s an ambitious agenda for a session lasting little more than an hour. Distilling complex answers during the dynamic panel conversation into a workable single blog post isn’t feasible.

In addition to the topics listed above we touched on topics such as the following:

-why workers comp claims seem to be handled differently in the LA area than other California regions;

-why there are so many cumulative trauma claims;

-why medical providers bill some employers far more than is allowable;

-how to look at the recent high profile allegations of abuse of the system by doctors and lawyers;

-the difficulty in recruiting, training and retaining competent claims adjusters;

-how employers can better manage claims to get workers returned to work and avoid the litigation process;

-whether the UR/IMR process is succeeding or failing;

-whether the comp system will continue to see gradual change or whether we are really on the road to some system integrated with group health/24 hour care;

-whether various forms of bad behavior such as “pay to play” are plaguing TPAs and claims outfits to the detriment of employers;

-the increasing cost of cost containment and frictional costs;

In various coming posts I’ll work some of the discussions into my observations on these topics.

I’ve previously advocated for more applicant attorneys and worker advocates to attend these sort of employer conferences. Too often applicant attorneys talk to ourselves and don’t interact with the concerns and perspectives of the employers and carriers who pay the bills.

The applicant bar has found itself excluded from the table at the last several rounds of reform negotiations. Mingling with payers and presenting the applicant point of view in session panels may not achieve definitive results, but it does create a dialogue that may be useful in “keeping things real”.

Meanwhile, up in San Francisco the California Court of Appeals, First District was slated to hear arguments today in the Stevens case on the constitutionality of Independent Medical Review……

So stay tuned.

Julius Young