WORKERS’ COMP: California Workers Aren’t Getting Benefits

      The head of the state Division of Workers' Compensation told a state Senate hearing yesterday that "[i]njured California workers often don't get the timely workers' compensation benefits guaranteed them by law and the situation worsened in 1997." Casey Young, the administrative director of the Division of Worker's Compensation, said "preliminary results from 1997 audits of insurance companies show growing problems" with workers' comp in the state. He said, "The data here presents a pretty dismal picture of what's going on." The Santa Rosa Press-Democrat reports that state Senate Industrial Relations Committee Chair Hilda Solis (D-El Monte) called the hearing to examine how well the state's workers' comp program was working. She plans to "introduce legislation to deal with delays, nonpayments of benefits and failure to notify workers of benefits." She said, "If insurers are not providing benefits, the Legislature has a responsibility to look into it."

Something Wrong Going On Around Here
      According to Young, the 1997 state-mandated audit shows that "19% of the workers who qualified for weekly cash benefits had not received all that was due them, even though the amount was not in dispute." And the 1997 data were even worse than the 1996 results, said Young. "It's going in the wrong direction," he added.

Random Dispute
      The Press-Democrat reports that the Association of California Insurance Companies "strongly objected to the hearing, refusing to testify because, the group said, the hearing was an election-year 'pep rally for our adversaries.'" And some insurance and employer groups say the .5% of claims that the audits looked at is "too limited" a quantity "from which to draw conclusions about workers' compensation." The California Workers' Compensation Institute said in an analysis sponsored by the ACIC that the audit results "are not representative of the workers' compensation system as a whole." The analysis read, "[T]o assume that the ... 1996 audit of claims administrators gives us a true picture of the performance of the workers' compensation system is empirically unfounded and downright dangerous." Young disagreed, saying, "To the extent you're selecting randomly, it should be generally applicable to the universe." The Press-Democrat reports that the state workers' comp division annually examines "about 15,000 claim files" with about half "selected at random" and about half "selected from complaints" (Fricker, 2/12).