Cost growth of services not subject to fee schedule caps has accelerated in recent years, driven largely by higher utilization.
Cost growth of services not subject to fee schedule caps has accelerated in recent years, driven largely by higher utilization.
Ambiguity for the billing of DME has led to significant increases in workers’ comp spend.
Many states experienced higher medical payments, driven by higher prices for professional services and evolving trends in prescription drug utilization.
The report overviewed data from 2004 to the present, focused on claims, benefits, costs, vocational rehab, disputes, and dispute resolution.
Approximately 3,675 IBR applications were filed in the first half of 2026, much higher than the 2,541 during the same period in 2025.
CT claims nearly doubled from 9.1% of claims to 16.5% from 2018-2025, with these claims increasing across all regions, demographics, and tenures.
The study focused on DME and professional services billed by nonhospital providers from January 1, 2010 through June 30, 2025.
California's rate of permanent partial disability claims reached approximately three times the national median.
While most industries saw declines in claim frequency, healthcare, office, and private education defied larger trends.
Designated doctors are selected to evaluate medical issues in claims, such as MMI, impairment ratings, disability, and more.
Since 2020, total costs for CT claims have more than doubled, with CT claims more likely to involve medical-legal and interpreter services early on.
The report compares prices paid for medical services across 36 states from 2008 to 2025.
Pharmaceutical requests represented 30.6% of all treatment requests submitted for IMR, a modest decline from 32.7% in 2024.
While claim frequency is declining, severity is increasing, with injured workers receiving more care or more complex treatment.
Claim costs increased 6% per year from 2022-2025 in the median study state, with state-level variations.
