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OSHA Fines Pauma Valley Zip-Line Attraction $25K for Worker Fatality

A federal workplace safety investigation found that a 34-year-old worker’s fatal fall might have been prevented had the operator of a Pauma Valley zip-line attraction implemented required safety measures.

ABC 10 News of San Diego reported that Joaquin Romero, 34, of Banning, Calif., died of multiple blunt force trauma injuries after he fell from a receiving platform of a zip line while trying to help a rider. The incident occurred at the Zip Zoom Zipline located on the La Jolla Indian Reservation, according to the La Jolla Band Of Luiseno Indians.

According to Fox 5, a witness said Romero was helping a woman get hooked on the platform when she started sliding out on the line. He couldn’t stop her and grabbed onto her harness, which caused them both to slide out about a hundred feet above the ground, according to the witness.

The friend said Romero feared the woman could fall because of the weight, so he made a heroic decision to let go. According to the witness, the woman was not injured.

Cal Fire crews hoisted Romero up in a rescue basket, and he was airlifted to Sharp Memorial Hospital. The county medical examiner said Romero arrived without a pulse. After admission to the hospital, a poor prognosis was given by medical staff and Romero’s family decided to place him on comfort care measures until he was pronounced dead, the ME added.

The zip line course had billed itself as the longest of its kind in Southern California, with lines running across canyons, valleys, treetops and the San Luis Rey River. The three zipline courses at the attraction range from 300 to 2,700 feet in length and reach speeds up to 55 miles per hour. It opened in 2015.

A U.S. Department of Labor Occupational Safety and Health Administration investigation inspectors found La Jolla Zip Zoom Ziplines failed to install a guardrail, safety net or personal fall arrest system. The company also did not train employees on fall hazards and how to recognize them, as required. Additionally, OSHA determined that the company failed to assess the workplace to determine the presence of hazards and did not report a work-related hospitalization within 24 hours.

OSHA cited the company for four serious safety violations and proposed $24,861 in penalties. La Jolla Zip Zoom Ziplines is also accused of failing to train employees about fall hazards and failing to assess the workplace for hazards.

OSHA Area Director Derek Engard said,”La Jolla Zip Zoom Ziplines failed to meet their obligation to protect their employees,” OSHA Area Director Derek Engard in San Diego. “If they had simply provided the proper protective equipment, this senseless tragedy could have been prevented.

The company has 15 business days from receipt of its citations and penalties to comply, request an informal conference with OSHA’s area director, or contest the findings before the independent Occupational Safety and Health Review Commission.

Sports Medicine Director Charged With Sexually Assaulting Athletes

Scott Shaw, 54, the former Director of Sports Medicine and athletic trainer at San Jose State University, has been charged with civil rights violations for engaging in sexual misconduct with female student-athletes under the guise of treating them for their injuries.

The charges allege that between 2017 and 2020, Shaw violated the civil rights of four students who played on women’s athletics teams by touching their breasts and buttocks without their consent and without a legitimate purpose. Shaw, as a state employee for the California State University system, is further alleged to have acted under color of law when he sexually assaulted the victims.

Courthouse News reports that the case has roiled the state-run campus leading to a spate of resignations. Athletic Director Marie Tuite resigned last year after the allegations first surfaced. San Jose State President Mary Papazian also resigned from her post late last year after allegations came from more than 15 female student-athletes. The charges filed on Thursday relate to four of the women who came forward with allegations.

The university has already settled with female student-athletes for nearly $1.6 million after a federal investigation found that university officials failed to properly respond to more than a decade of complaints.

Seventeen student-athletes filed a complaint about Shaw in 2009, but their concerns were not followed up on and the university fired two employees that shared their concerns about Shaw’s conduct with the administration.

The controversy surrounds what Shaw called pressure point therapy for soft-tissue muscle injuries, wherein the doctor forcefully touches multiple points on the human body. Several women claimed that Shaw was using this technique as camouflage to engage in unlimited inappropriate touching of young women without their consent.

USA Today reported that the investigations, conducted by private attorneys under the supervision of the California State University System, determined that Scott Shaw’s physical therapy treatments “lacked medical basis, ignored proper protocols and violated the system’s sexual harassment policies.”

Reporters interviewed four of the 17 swimming and diving athletes who in 2009 said Shaw touched them inappropriately, as well as a water polo athlete and a gymnastics athlete who competed around that time and described similar touching by Shaw.

Shaw resigned his position last August, and now faces a maximum of six years in prison if convicted of all counts. Shaw is scheduled to appear to face the charges in U.S. District Court in San Jose on March 15, 2022.

Anyone with information about this case should contact the FBI at 510-808-2600.

CorVel Critical Incident Stress Debriefing Program in City of Beverly Hills

CorVel Corporation presented its Critical Incident Stress Debriefing program, highlighting positive outcomes with the City of Beverly Hills, at the annual Public Agency Risk Management Association (PARMA) meeting on March 1, 2022, in Anaheim, California.

Critical incident stress debriefing has been around for many years. However, it has recently re-emerged as a tool for employers facing several challenges in our current climate.

Originally designed for responders to traumatic events, critical incident stress debriefing (CISD) is a structured, brief intervention provided in a small group setting immediately following a crisis. It’s designed to help people process the event to minimize symptoms of traumatic stress, depression, and anxiety. Critical incident debriefing typically consists of seven stages, and altogether, it lasts approximately three hours or less.

“Critical incident” is another term for a traumatic event. It includes any occurrence faced by public safety responders, emergency workers, and related personnel that causes distress and disruption to typical psychological or physiological functioning. Critical incidents often involve death or extreme threats to safety, life, and well-being.

It was developed in 1974 by Dr. Jeffrey Mitchell, a former firefighter and paramedic, as one component of a broader critical incident stress management (CISM) program.

During the presentation, Tyla A. DiMaria, RN, Case Management Manager for CorVel, discussed the company’s patient-centered approach that helps employees who have witnessed a catastrophic or traumatic event process the situation, work through the hurdles and develop coping mechanisms to return to work as quickly as possible.

These past two years have put a spotlight on mental health, as people have been dealing with the stresses of illness, death, civil unrest, isolation and so many other difficult situations,” DiMaria said. “We’ve seen a significant increase in depression, anxiety, crippling fear and other mental health issues, especially for essential workers, and these challenges must be addressed and not ignored.”

Last year, CorVel’s program was expanded to address COVID-19 traumatic stress – a syndrome developing due to the significant mental health challenges associated with the pandemic.

During the presentation, DiMaria outlined how the City of Beverly Hills partnered with CorVel to implement a critical incident and COVID-19 traumatic stress debriefing program for city employees, improving return to work and positively impacting overall costs and outcomes.

“We are very proud of our expanded Critical Incident Stress Debriefing program, which places emphasis on the injured worker and their overall wellbeing,” said Karen Thomas, Vice President, Clinical Solutions at CorVel.

“At CorVel, we take a patient-centered approach to claims management to ensure that the injured worker feels supported throughout the process, regardless of the type of illness or injury. By taking a proactive approach to mental health, we can improve outcomes and reduce costs for customers while increasing satisfaction and care for injured workers.”

Santa Paula Doctor and Patient Recruiter Arrested in $30M Fraud Case

Authorities arrested a physician and a marketer on federal charges stemming from a scheme that bilked Medicare out of more than $30 million for medically unnecessary hospice services provided to patients who were obtained through illegal kickbacks.

Dr. Victor Contreras, 66, of Santa Paula, and Callie Jean Black, 63, of Lancaster, are scheduled to be arraigned this in United States District Court.

Antenor and Contreras are charged in the indictment with health care fraud – six counts name Antenor, and Contreras is charged with five counts. Additionally, Antenor is charged with four counts of paying illegal kickbacks for health care referrals, and Black is charged with four counts of receiving illegal kickbacks.

A 14-count indictment also names the former Pasadena resident who controlled the hospices, Juanita Antenor, 59, who remains at large and is believed to be in the Philippines.

According to court documents, Antenor owned a Pasadena hospice company called Arcadia Hospice Provider, Inc., and she controlled a second, Saint Mariam Hospice, Inc., that billed Medicare and Medi-Cal for hospice services for patients who were not terminally ill. In some case, the companies submitted bills for services that were never provided.

Contreras, who was on probation imposed by the California Medical Board while he was part of the scheme, provided fraudulent certifications for some of these patients, including patients he claimed to have examined, but never actually saw, according to the indictment.

Antenor allegedly paid marketers, including Black, illegal kickbacks for the patients referred to Arcadia and Saint Mariam.

From approximately September 2014 until April 2019, Arcadia submitted to Medicare nearly $23 million in claims for hospice services provided to beneficiaries and was paid approximately $18,853,757 for those claims, according to the indictment. Between February 2015 and April 2019, St. Mariam submitted to Medicare approximately $13,742,116 in claims for hospice services and was paid approximately $11,395,849 for those claims. Contreras is linked to about $5.1 million of the total claims paid by Medicare.

Additionally, Arcadia and St. Mariam submitted more than $5.5 million in claims to Medi-Cal, which paid the companies a total of just over $1.35 million.

If convicted of the charges in the indictment, Contreras would face a statutory maximum sentence of 50 years in prison, while Black would face up to 40 years. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

The United States Department of Health and Human Services, Office of the Inspector General; the FBI; and California Department of Justice investigated this matter. Assistant United States Attorney Kristen A. Williams of the Major Frauds Section is prosecuting this case.

RAND COVID-19 Presumptions Study Shows Challenges & Confusion

A new 253 page report describes work undertaken by the RAND Corporation for the California Commission on Health and Safety and Workers’ Compensation (CHSWC) in the Department of Industrial Relations (DIR).  The goal of this study is three-fold:

(1) evaluate the overall impacts of COVID- 19 claims on California’s workers’ compensation system,
(2) evaluate the overall impacts of COVID-19 claims on California’s workers’ compensation indemnity benefits, medical benefits, and death benefits, including differences in the impacts across differing occupational groups, and
(3) assess the overall and cost impacts of the frontline worker and outbreak presumptions created by Senate Bill (SB) 1159 on California workers’ compensation system.

Senate Bill 1159, which was signed into law on September 17, codified this temporary presumption and introduced distinct presumptions for two groups of workers who fell ill with COVID-19 on July 6, 2020 or later:

– – Labor Code section 3212.87 covers specified health-care workers and workers in specified health care facilities, active firefighters, and peace officers primarily engaged in active law enforcement. We refer to this presumption as the frontline presumption.
– – Labor Code section 3212.88 covers workers not covered by the frontline presumption who tested positive for COVID-19 while working outside the home during an outbreak period at their job site. We refer to this presumption as the outbreak presumption.

These presumptions, which remain in effect until January 1, 2023, apply to workers meeting these criteria who test positive for COVID-19 using a polymerase chain reaction (PCR) test.

RAND conducted a mixed-methods study analyzing claims outcomes overall and by industry and occupation from the Workers’ Compensation Information System (WCIS) between January 2020 and June 2021.COVID-19 accounted for over 20 percent of claims in June and July of 2020 and peaked at 55 percent of claims in December 2020. Applicants filed a total of 82,000 claims filed for December 2020 injury dates. In comparison, in the decade before the pandemic (2010 to 2019), there had never been more than 68,000 claims filed in a single month.

During the first wave of the pandemic, the volume of non-COVID-19 claims dropped sharply following the statewide stay-at-home order, and so total claim volumes dropped early in the pandemic and were 25 percent lower than the volume typical before the pandemic during the temporary presumption period. Total claim volumes in most months since July 202 have remained below pre-pandemic levels.

COVID-19 claims are denied much more often than non-COVID-19 claims. Depending on the time period, denial rates on COVID-19 claims across all occupations have ranged from 44 percent for claims filed before any presumptions were in effect, 26 percent during the temporary presumption, and 34 percent after the outbreak and frontline presumptions took effect. Denial rates on non-COVID-19 claims filed at these times were 13 percent, 14 percent, and 10 percent, respectively. Denial rates varied widely across workers covered by different presumptions and, within groups of workers covered by the same presumption, across industries and occupations.

The main factor influencing whether a worker filed a claim was having access to federal and state COVID-19 paid leave. Workers then decided to file a workers’ compensation claim when their need for time off exceeded the time available from these other federal and state paid leave programs. Workers were able to access medical care for COVID-19 without using workers’ compensation, suggesting that workers’ compensation medical care benefits for COVID-19 were not critical to helping most workers receive needed care.

Overall, its study uncovered several challenges with the functioning of the workers’ compensation system during the pandemic. For employers, these challenges primarily related to handling a large, fluctuating volume of claims within shortened claim administration timeframes for making an initial claim decision.

For workers, confusion around filing a COVID-19 claim presented challenges, including questions about what occupations were covered and qualified for workers’ compensation under the presumption and whether a positive COVID-19 test was needed. In the face of these challenges, we consider how the specific aspects of the presumptions identified by SB 1159 impacted workers and employers within the workers’ compensation system.

Judge Allows Insurers San Francisco Antitrust Suit Against Drugmakers

Courthouse News reports that a federal judge in San Francisco ruled that he nation’s largest health insurer can sue two pharmaceutical giants over claims that they colluded to drive up the price of life-saving HIV drugs in violation of multiple state laws.

United HealthCare Services, which insures 70 million people in the U.S. through its affiliates and subsidiaries, sued Gilead Sciences and Teva Pharmaceuticals in federal court last year. The insurer, owned by parent company UnitedHealth Group, claims the drug makers entered into a series of unfair patent settlements that delayed generic versions of HIV drugs from hitting the market and shot up prices for consumers.

UnitedHealth’s complaint against the pharma firms is part of a flurry of federal antitrust suits filed last year against the makers of HIV antiretroviral drugs. Major retailers and insurers, including Humana and Blue Cross Blue Shield, have also sued the pharmaceutical giants.

The lawsuits claim Teva struck deals to settle patent suits with Gilead that delayed the introduction of a generic form of Viread until December 2017 and generic forms of Truvada and Atripla until September 2020. They say those deals enabled the drugmakers to charge hundreds of millions of dollars in higher prices for necessary medications that would have otherwise been cheaper in a truly competitive market.

A separate suit filed against Gilead by Humana last year claims that most of the company’s HIV medications cost $10 to produce, but for nearly 20 years Gilead charged health plans thousands of dollars for a 30-day supply. HIV drugs earned Gilead nearly $17 billion in sales in 2020.

Gilead makes three of the four top-selling HIV medications in addition to other drugs used in HIV combination antiretroviral therapy, or “cART.” More than 80% of U.S. patients starting HIV treatment take one or more of Gilead’s products each day, according to lawsuits filed by retailers.

Teva and Gilead had asked U.S. District Judge Edward Chen to dismiss claims that the companies violated antitrust and consumer protection laws in Indiana, Louisiana, Mississippi, Pennsylvania and Utah.

The two drugmakers argued laws in those states only allow a consumer who buys drugs for their own personal use to file suit. Chen rejected that argument in a 16-page ruling, but he dismissed some claims for other reasons.

Judge Chen resolved a similar dispute back in March 2020 when he ruled that labor union insurers could sue drug makers for antitrust under the same state laws, even though those insurers were third-party payors.

Gilead and Teva argued that situation was different because the plaintiffs were union health and welfare funds, not for-profit corporations like UnitedHealth. Chen found the argument unavailing. “Even though a union health and welfare fund is a nonprofit entity by nature, it functions like an insurer,” Chen wrote.

The judge denied Teva and Gilead’s motions to dismiss claims under Indiana, Louisiana and Pennsylvania consumer laws. He dismissed a claim under Mississippi law without prejudice because UnitedHealth did not try to resolve the dispute through required settlement process first.

The judge refused to advance Utah state law claims on behalf of UnitedHealth’s insureds because only state residents can sue, but he allowed UnitedHealth to sue on behalf of its Utah-based subsidiary, finding the parent company would be “standing in the shoes” of its affiliate.

Chen also dismissed Massachusetts, Kansas and Vermont state law claims based on his prior analysis of those laws in a separate March 2020 ruling.

Additionally, Chen eliminated claims against Teva based on purchases made before Oct. 19, 2017, finding those claims are barred by a four-year statute of limitations.

WCAB to Reopen for Trials on Monday March 21

Remote appearances have saved lawyers and witnesses travel time, relieved court congestion, while offering clients the ability to watch the proceedings from home. With mask mandates in place, remote appearances allow an opportunity for many to evaluate facial expressions and hear clearly words that may otherwise be muffled.

However attorneys who practice worker’s compensation law in California received notification that the WCAB will be reopening for Trials, Lien Trials and Expedited Hearings beginning Monday, March 21. Conferences and walk throughs will continue to be remote only. The DWC Newsline will be released within the next few days.

And state courts have started to move in the same direction. After Gov. Gavin Newsom lifted most of the state’s indoor masking requirements Feb. 15, Chief Justice Tani Cantil-Sakauye issued an order last week withdrawing effective April 30, several court emergency orders she imposed in March 2020.

One order allows judges in felony criminal cases to hold a preliminary hearing 30 days after a defendant is charged, instead of the previous 10-day deadline. At a preliminary hearing, the judge decides whether prosecutors have presented enough evidence to proceed with their case.  Another order extended by 60 days the previous deadlines for starting trials in civil cases.

Cantil-Sakauye also revoked orders that gave local courts broad authority to conduct proceedings remotely, and that allowed courts to adopt pandemic-related rules without 45 days of public comment, as previously required.

Citing Newsom’s orders, the chief justice said, “these events mark an important and hopeful change as the residents and government of our state transition to a semblance of pre-COVID-19 California”

In a follow-up action, the state Judicial Council, chaired by Cantil-Sakauye, said it would meet Friday to consider repealing the remaining emergency court rules as of June 30.

A few weeks into the COVID-19 pandemic, the Judicial Council adopted emergency rule 3, which became effective on April 6, 2020. This emergency rule authorized courts to hold proceedings remotely via videoconference or by phone. The council has now said it would consider sponsoring legislation that would preserve, by state law rather than regulations, the current system authorizing remote appearances.

Cantil-Sakauye’s order on Thursday does not mean the end of remote hearings in state courts other than the WCAB. The state’s legislature in September passed a law that will allow courts to hold civil proceedings remotely until at least July 2023.

Senate Bill 241 enacted the new Code of Civil Procedure section 367.75, which will be effective from January 1, 2022 through July 1, 2023, authorizes at least some litigants, witnesses, judges, lawyers and even jurors to voluntarily appear in a case by video.

The judiciary recently upgraded 500 courtrooms to allow for video appearances. Los Angeles County Superior Court alone conducts about 5,000 remote proceedings a day, according to the Judicial Council.

At a May legislative hearing, Alameda County Superior Court Presiding Judge Tara Desautels raved about remote appearances and trials, saying “our jurors love it.”

But interpreters and court reporters told a different story, one of video participants being accidentally shut out of hearings, sketchy technology dropping participants and one litigant’s image going dark after his cellphone minutes ran out.

Employee groups thus negotiated a July 2023 sunset clause added to C.C.P. 367.75, meaning that remote civil proceedings will end 18 months after the bill takes effect unless lawmakers agree to extend its provisions.

Luxury Resort Fined $3.3M for Pandemic Re-Hire Rule Violations

The Labor Commissioner’s Office has cited Terranea Resort in Rancho Palos Verdes $3.3 million for failing to offer job positions to 53 employees laid off during the COVID-19 pandemic once the resort re-opened, as required by law.

The employees included housepersons, banquet servers and bartenders, junior sous chefs and massage therapists.

The Labor Commissioner’s Office started its investigation in July 2021 after receiving Reports of Labor Law Violation from Unite Here Local 11 on behalf of 14 laid-off workers.

The workers claimed they were not offered an opportunity to return to their jobs based on seniority when the hotel increased business operations in 2021. The investigation included interviews with former and current workers, depositions from Terranea’s Human Resources managers and an audit of payroll records from April 16 to December 31, 2021.

The investigation determined that DH Long Point Management, LLC dba Terranea Resort had violated the Right to Recall law and cited the hotel $3,080,000 in liquidated damages, $5,300 in civil penalties, and $208,582 in assessed interest for a total of $3,293,882.

The law entitles each worker whose rights are violated liquidated damages of $500 per day until the violation is cured and civil penalties against the employer of $100 for each employee whose rights are violated. Any employee suffering unlawful retaliation for asserting recall rights may also be awarded back pay, front pay benefits and reinstatement.

In addition to issuance of the citation for liquidated damages payable to the employees and civil penalties payable to the State, a Notice to Discontinue Labor Violations was issued that directs Terranea to offer positions to employees who should have been returned to work, but still have not had that opportunity.

The Right to Recall law went into effect on April 16, 2021 and runs through December 31, 2024. Covered workers include employees at hotels or private clubs with 50 or more guest rooms, airports, airport service providers, and event centers. Also included are laid-off employees engaged in building services such as janitorial, maintenance and security services at retail and commercial buildings.

White House Announces Help for EDD Fraud Prosecution

According to a report in the Modesto Bee, the battle against unemployment insurance scams – fraud that’s meant an estimated $20 billion in suspect payments in California – got powerful new tools from President Joe Biden in his State of the Union address.

We’re going after the criminals who stole billions in relief money meant for small business and millions of Americans. And tonight, I’m announcing that the Justice Department will soon name a chief prosecutor for pandemic fraud.,” the president said. Members of Congress applauded the idea.

Nancy Farias, director of California’s Employment Development Department, enthusiastically welcomed the news. EDD manages the state’s unemployment program.

“California took aggressive and unprecedented action to block fraudsters who scammed the emergency federal benefit programs,” she told The Sacramento Bee. “The president’s move to boost fraud fighting will help states continue to hold criminals accountable.”

A White House fact sheet explained how the already-existing Justice Fraud Enforcement Task Force would name the chief prosecutor. The prosecutor would focus on “the most egregious forms of pandemic fraud.”

The new appointee would “lead teams of specialized prosecutors and agents focusing on major targets of pandemic fraud, such as those committing large-scale identity theft, including foreign-based actors.”

These strike force teams, it said, would use analytics to “to connect the dots on identity theft and other complex fraud schemes committed across state lines or transnationally, as well as investigate major cases of criminal fraud in programs like the Paycheck Protection Program and Unemployment Insurance.”

The White House plan will need Congress to approve more funds and increase penalties for criminals who commit pandemic-related fraud. Biden also pledged an executive order to help prevent identity theft in public benefit programs.

The White House offered no details, saying the order would aim to “prevent and detect identity theft involving public benefits, while protecting privacy and civil liberties and preventing bias that results in disparate outcomes.”

In California, a team of state and local prosecutors has been working with the Justice Department and others to investigate unemployment insurance fraud. They’ve been eyeing suspected organized crime efforts in addition to individuals who are simply trying to deceive the government.

CWCI Study Shows Consistent Acceptable Access to Medical Care

A new California Workers’ Compensation Institute study finds that overall, injured workers’ access to medical care for their initial treatment remained relatively consistent between 2010 and 2020, though average and median wait times for the first doctor visit varied by type of care, and as in group health and other systems, rural residents have the farthest to travel and access to fewer providers, especially specialists.  

For its access study, CWCI used data from more than 1.5 million job injury claims from accident year (AY) 2010 -AY 2020 to measure changes in the amount of time that elapsed between an employer’s notice of injury and the first treatment, and the average distance that injured workers traveled to receive their initial care.

The average wait time from employer notice to the initial treatment showed some variation across the 11-year span, ranging from a low of 3.3 days for AY 2011 claims to 4.4 days for claims from AY 2020 – the first year of the pandemic, but the median number of days to first treatment showed no change, as the median values across all 11 years indicated initial care rendered on the same day that the employer was notified of the injury.  The average time from the employer’s notice to the first E&M visit also rose slightly over the 11-year span, ranging from 4.1 days for AY 2011 claims to 5.2 days for AY 2020 claims, but again the median values for all years indicated that the initial E&M visit occurred on the same day that the employer was notified of the injury.

On the other hand, the average wait time for some specialty services showed greater variation over time.  For example, the average wait time to a first PM visit increased from 31.8 days for AY 2010 claims to 37.5 days for AY 2015 claims, but then trended back down to 31.2 days by AY 2020.  

The median number of days to first PM visit showed a similar pattern, climbing from 15 days to 20 days between AY 2010 and AY 2015, then falling back to 15 days by AY 2020.  Notably, most of the increase in the number of days to the first PM visit began in 2013, coinciding with legislative reforms and emergency regulations impacting workers’ comp Medical Provider Networks (MPNs) and the Utilization Review (UR) process – including a mandate that treating physicians use a new Request for Authorization form effective January 1, 2013, and a requirement that disputes over medical necessity of a requested treatment be resolved through a new Independent Medical Review (IMR) process.  

CWCI notes that the subsequent declines in the average and median days to the first PM visit may have resulted from improved processes by physicians and payers as they became familiar with these new requirements.

In addition to measuring changes in the wait times for various treatment services, the Institute also calculated the average distance from each injured worker’s residence to the location of their initial treatment, with results broken out by year.  

This analysis found that the average distance traveled by California injured workers to their initial treatment was remarkably stable across the 11-year study period, ranging between 5.3 and 5.7 miles.  

Segmenting the results into geographic subcategories (urban, suburban, and rural) the study found that the average distances that injured workers living in the more densely populated urban and suburban regions traveled to receive their initial care was about one-third to one-half of the average for those living in less densely populated rural parts of the state.  

But even among rural residents, who in AY 2020 accounted for 8.8 percent of all California injured workers, the average distance traveled showed only minor variations during the study period, ranging from 11.0 miles in 2010 to 13.1 miles in 2017.  

Notably, in all cases, the average distances injured workers had to travel were well within the medical access standards set by the state for MPNs, which provide nearly 92 percent of all workers’ compensation treatment in the state.  Those standards require that injured workers have a choice of 3 primary care providers within 30 minutes or 15 miles of their home or workplace; a choice of 3 medical specialty providers within 60 minutes or 30 miles; and a hospital emergency room or non-hospital provider of all emergency healthcare services within 30 minutes or 15 miles.  

The latest proximity to care findings also track with results of CWCI’s April 2021 research which found that 99 percent of claims in which treatment was rendered by an MPN provider, and 98 percent of non-MPN claims met the state’s access standards.