Workers Comp Zone


At a September 27 CHSWC, RAND researcher Kandice Kapinos PhD presented preliminary slides on a study of injured worker medical treatment access. The slides, titled “Access to Medical Treatment for Injured Workers in California: Year 2 Report” can be seen at the link below:

The study, commissioned by the DIR as required by Labor Code Section 5307.2 was done by looking at a survey of workers’ comp treating physicians and an analysis of data from MPNs, using WCIS data.

While I recognize that this is a preliminary presentation and that the report has not yet gone through “quality assurance” protocols, the physicians study results are troubling.

A survey of 3,000 physicians was undertaken. Out of 3,000, 2,308 did not respond. 445 queries were returned due to bad addresses. 247 physicians are said to have completed the study. with 225 being deemed eligible. That is only 7.5% of the total sample.

Getting a return of 225 responses out of the universe of workers’ comp treating doctors seems pretty low.

Be that as it may, slide 6 of the study is interesting. 37% of the surveyed physicians said they would only accept referred patients. 27% accepted all. 15% would only accept established patients. 4% only take certain cases/diagnoses. 5% either have other limitations or accept no workers’ comp patients. 12% take them only if covered by an MPN.

Most applicant attorneys believe it is getting harder to identify doctors who will treat workers’ comp injuries, particularly within certain medical specialties and within some geographic regions of the state. Anecdotally, many of the attorneys complain that the list of treatment options is meager on many of the networks. They note that even when doctors are listed the providers often won’t take cases or create roadblocks to seeing patients. This may take the form of doctors requiring referral by another physician or the doctor’s office requiring that records be sent for review so the physician can determine whether he or she is interested.

Given the small sample size, it may be hard to make definitive conclusions, but this study seems to give credence to the argument that there are barriers to getting many doctors to accept new cases for treatment.

Stay tuned.

Julius Young