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Anyone interested in protecting and improving the reputation of workers' compensation systems needs to read it. The study addresses a fundamental mission of the workers' comp system, which is to promote the injured worker's return to economic productivity, and thereport fortunately includes some bellwether workers' comp states: California, Connecticut, Florida, Maryland, Massachusetts, Michigan, North Carolina, Pennsylvania, Texas, Tennessee and Wisconsin.

Over seven years the WRCI has been asking the same questions, in English or Spanish, to workers who had had been injured several years before the interview.

Wisconsin workers reported that 10 percent had not returned to work several years after injury. An additional 4 percent had returned to work but often at fewer hours and/or lower pay.The figures from California were about twice as bad: 21 percent and 7 percent respectively.

I initially thought that California's results might be due to demographic factors. California has the greatest penetration of immigrant labor of any state. Some of the data suggest that Spanish-speaking workers have lower return-to-work rates.

However the WCRI figures show the across the board California workers have worse results.

For instance, among injured workers with some high school education, 52 percent of Californians were out of work, compared to only 23 percent of Wisconsin workers. Among those who returned to work, the duration of disability in California was close to twice as high. And Californians were more likely to have a second disabling injury after returning to work.

If you take the word of these workers at face value, the medical system in California is deeply flawed. About three times more workers in California than in Wisconsin were unhappy with the time it took to settle with a primary physician, and with quality of care.

Why are Californians so bugged out? One reason may be choice of doctor. A total of 19 percent said they, the worker, chose their initial medical provider, compared with 53 percent of workers in Wisconsin.

At the time of the injuries in California, the state was entering a period of reform, which included the creation of restrictive provider networks. It is plausible to infer that workers chafed at these closed networks.

On the other hand, it is reasonable to ask if California suffers from a complex web of worker expectations that will be hard to shake.

Comparing states with respect to premium levels has attracted attention of late, as more people have learned how to use insurance cost rankings prepared by Oregon and the firm Actuarial and Technical Solutions.

Oregon and ATS tend to rank Vermont, Alaska, and California as most expensive; and Indiana, Virginia and Arizona as least expensive. The WRCI's insights need to be given at least equal weight.

PETER ROUSMANIERE is an expert on the workers' compensation industry.

September 15, 2009

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