Padilla Law Group, LLP

Workers' compensation paying for fewer hospitalizations

Many Californians who are injured in a workplace accident wind up needing extensive medical care. They may need immediate hospitalization as well as long-term rehabilitation. Some of these individuals even suffer a disability that never fully heals. However, as time rolls on and federal, state, and local laws and regulations seek to reinforce workplace safety, workers may see less need for such extensive care.

At least that's what one recent study showed. The California Workers' Compensation Institute, based out of Oakland, found that between 2008 and 2016 inpatient hospitalization for injured workers decreased by more than 31 percent. The study looks at more than 32 million hospitalizations from that time period to determine which benefits system paid for the stay. Workers' compensation hospitalizations made up less than one percent of all stays in 2016, with a two-tenths of a percent decrease since 2008.

So why the decline? The study found a number of reasons. The number of workers' compensation claims decreased during that period, and use of other medical care options, such as ambulatory surgery centers increased. Also, advances in medical technologies have allowed many injured workers to receive care on an outpatient basis. However, workers' compensation claim adjudicators and benefits reviewers have also taken a harder line on ensuring that injured workers receive care that is specialized for their medical condition prior to awarding a claim. This may lead to fewer claims being granted, meaning that workers' compensation is paying for fewer hospitalizations.

What does this mean for injured California workers? First, it means that they need to make sure their claims are meeting the requirements for medical evidence before moving forward. Second, it means that, even though hospitalizations paid for by workers' compensation has decreased over the years, extensive medical care is still often needed. Instead of hospital stays, though, these workers are typically seeking alternative forms of treatment. Therefore, even if a workers doesn't require hospitalization, he or she should think about pursuing workers' compensation benefits and how best to do so.

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