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

Audit subjects include insurers, self-insured employers, and third-party administrators selected randomly.  

The bases for the targeting of audit subjects by the Audit Unit are specified in 8 California Code of Regulations Section 10106.1(c), effective January 1, 2003:

Complaints regarding claims handling received by the DWC.

Failure to meet or exceed FCA Performance Standards.

High numbers of penalties awarded pursuant to Labor Code Section 5814.

Information received from the Workers' Compensation Information System (WCIS).

Failure to provide a claim file for a PAR.

Failure to pay or appeal a Notice of Compensation Due ordered by the Audit Unit.

Routine and Targeted Audits

The following chart shows the number of routine audits and target audits and the total number of audits conducted each year.

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