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SELECTED INDICATORS IN WORKERS’ COMPENSATION:   A REPORT CARD FOR CALIFORNIANS

Medical-Legal Expenses  

Reform legislation changes to the medical-legal process were intended to reduce both the cost and the frequency of litigation.  Starting in 1989, legislative reforms restricted the number and lowered the cost of medical-legal evaluations needed to determine the extent of PD. The reform legislation also limited workers’ compensation judges to approving the PD rating proposed by one side or the other (“baseball arbitration”). In addition, the Legislature created the qualified medical evaluator (QME) designation and increased the importance of the treating physician’s reports in the PD-determination process.  

In 1995, the Commission on Health and Safety and Workers’ Compensation (CHSWC) contracted with the Survey Research Center at University of California, Berkeley, to assess the impact of the workers’ compensation reform legislation on the workers’ compensation medical-legal evaluation process.  

This ongoing study determined that during the 1990s, the cost of medical-legal examinations dramatically improved.  As shown in the following discussions, this is due to reductions in all the factors that contribute to the total cost.

Permanent Disability Claims

The following chart displays the number of PPD claims during each calendar year since 1989. Through 1993, the WCIRB created these data series from Individual Case Report Records submitted as part of the Unit Statistical Report.  Since that time, the series was discontinued, and estimates for 1994 and subsequent years are based on policy-year data adjusted to the calendar year and information on the frequency of all claims, including medical-only claims, that are still available on a calendar-year basis.

Medical-Legal Examinations per Claim

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