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Oakland, CA – Proposals to cut the amount of time California workers’ compensation claims administrators have to investigate work-related injuries and determine employer liability may be easier said than done given existing statutory and regulatory time frames for the various steps within the process, many of which claims organizations do not control, according to a new analysis by the California Workers’ Compensation Institute (CWCI).
The length of a workers’ comp investigation varies depending on the type of injury reported, circumstances surrounding the injurious event, witness availability, the cooperation and availability of the parties involved, the number of issues and medical conditions asserted, and the availability of documentation. The CWCI study notes that reducing compensability determination time frames would make it hard to fully investigate claims, especially those that are litigated or denied. Currently under consideration by the California Legislature, SB 1127 would reduce the investigation period for claims where workers are given a presumption of compensability to 75 days from the employer notification of injury, while the investigation period for other claims would remain at 90 days. The CWCI analysis examines the underlying issues associated with this and other recent proposals to reduce claim investigation time frames and uses data from 459,195 non-COVID-19 claims and 17,135 COVID-19 claims to assess the impact of the proposals. Key findings include:
The study’s findings show that reducing investigation timelines as proposed in prior and current legislation would create compensability determination thresholds that are unnecessary for accepted claims and unrealistic for litigated and denied claims. CWCI has released its analysis of the impact of reducing compensability determinations in an Impact Analysis report that is available for free to the public and can be found under the Research tab at www.cwci.org.