According to an analysis reported by Safety + Health Magazine, there is substantial variation in the percentage of injured workers that go to the emergency room (ER) for their initial care from state to state. California is on the lower end of the spectrum—which is good news for employers, insurers, and claims administrators, as less ER utilization can lower the overall costs of the workers’ compensation system. In this blog post, our Sacramento workers’ compensation defense lawyer provides an overview of the state-by-state data on ER utilization and initial workers’ compensation treatment. 

Background: $10,000.00 of Care Pre-Authorized While Workers’ Compensation Claims Processed

The cost of initial medical care always matters. In California, state law mandates that employers are required to provide no-fault workers’ compensation insurance coverage. Among other things, this type of coverage applies to an injured employee’s job-related medical expenses. Notably, state law also mandates that employers must pre-authorize up to $10,000.00 of medical coverage while a claim is being investigated but has not yet been processed.

The Emergency Room is an Expensive Way to Get Initial Care

It is worth emphasizing the fact that the emergency room (ER) is often the first place people go when they need medical care for a sudden or unexpected injury or illness. However, using the ER for initial care can be expensive, especially if the injury or illness is not truly an emergency. ERs are equipped to handle serious, life-threatening conditions, so they have a higher level of staffing, equipment, and supplies than other types of medical facilities. This added cost is passed on to patients—or in the case of a workers’ compensation claim, employers, employees, insurers, and claim administrators—making ER visits more expensive than visits to other types of medical facilities.

California Performs Better than Other States on the ER Utilization Metric

The Workers’ Compensation Research Institute (WCRI) conducted a study of 28 different states. The organization found that there is wide variation in how often injured workers go to the emergency room for their initial case. For example, in Massachusetts, 37% of people hurt on the job got their initial care at the ER. However, in California, just 14% of people who were injured while in the workplace received their initial care at the ER. Massachusetts had the highest rate amongst the 28 states reviewed. California was tied with Arizona for the lowest. This represents some tangible cost savings for the workers’ compensation program in California.

Consult With a Sacramento Workers’ Compensation Defense Attorney Today

At Yrulegui & Roberts, we are a law firm that provides reliable, results-driven workers’ compensation defense services. Our firm works closely with employers, insurance carriers, and claims administrators to help them find the best solutions. Call us now or send us a direct message to arrange a fully private consultation with a top workers’ compensation lawyer. We serve clients in Sacramento, Sacramento County, and throughout all of North Central California.