Since 2014, the percentage of indemnity claims involving a major surgery in the first two years has declined one percentage point per year, falling from 28% of the 2014 claims to 23% of the 2019 claims, according to a study released Monday by the California Workers’ Compensation Institute.
The study tracked treatment patterns in the California workers comp system for non-COVID claims, finding that medical services have “stabilized” in recent years, with only “minor” changes in the utilization rates and volume of services rendered to injured workers within the first two years for lost-time claims between 2014 and 2021.
Other findings included that across the six-year span of the study, surgical claims averaged about seven to nine more evaluation and management visits in the first two years than claims without major surgery.
The study also found that the share of claims that had physical medicine, or physical therapy or rehabilitation, services in the first 24 months showed little change, even after the pandemic was declared. Claims with major surgery have consistently averaged about 26 physical medicine visits in the first two years, more than twice the average for claims without major surgery.
In examining mental health, researchers found that 5% to 6% of the claims without major surgery and 6% to 7% of the surgical claims received mental health services in the first 24 months of treatment. And though the percentage of claims with mental health services “showed little change after the pandemic was declared,” the average number of mental health visits within 24 months increased in the two most recent years.
This article was first published in Business Insurance.
