Today’s issue of WorkCompRecap features CWCI’s recent release of a new analysis of a proposal to alter California’s 104-week cap on temporary disability (TD) benefits by excluding TD paid or due during the resolution of medical disputes if a utilization review (UR) treatment denial is overturned by independent medical review (IMR) or the Appeals Board.
CWCI’s study started with 178,956 claims with 2015 to 2017 injury dates, of which nearly a third had paid TD days, representing the proportion of all claims for which claims administrators would need to develop new tracking systems and protocols to identify and monitor claims that could be covered by AB 1213. CWCI determined that claims likely receive a nominal increase in their total TD benefits under AB 1213 made up just 0.3% of the original sample. The study notes that the current language however would create costly new requirements for oversight and compliance for claims administrators, further increasing California’s average loss adjustment expense, which has historically been the most expensive in the country.