Is Data The Answer?

By: Mark Webb

In the fall of 2021, RAND Corporation published a report, “Posttraumatic Stress in California’s Workers’ Compensation System”. The report was presented to the Commission on Health and Safety and Workers’ Compensation (CHSWC) and was in response to a request from Assembly Insurance Committee Chair Tom Daly. Specifically, the report was an analysis of the issues framed by Senate Bill 542 (Stern), legislation creating a presumption of compensability for posttraumatic stress disorder (PTSD) for specified public safety officers and first responders. The presumption applies to injuries on and after January 1, 2020, and sunsets on January 1, 2025.


The RAND report was not met with great enthusiasm by CHSWC. In fact, several Commissioners provided public comments expressing concern about the methodology of the study and the availability of data critical to the analysis. The report did not seem to advance any substantive dialogue in Sacramento and questions raised by the Commissioners, while answered by RAND, remain open for debate.


It is within that context that Senate Bill 284 (Stern) should be read. SB 284 would have expanded the PTSD presumption in SB 542. But it was vetoed on September 29th. Part of Governor Newsom’s veto message has a familiar ring to it:


“Expanding coverage of the PTSD injury presumption to significant classes of employees before any studies have been conducted on the existing class for whom the presumption is temporarily in place could set a dangerous precedent that has the potential to destabilize the workers’ compensation system going forward, as stakeholders push for similarly unsubstantiated presumptions.”


That pretty much consigns the RAND report to the archives, does it not? It also sends a signal to other groups who have perennially sponsored presumption bills for a wide range of public and private employment.


So, the question becomes where do we go from here?


That turns the focus on another bill related to presumptions, Senate Bill 1127 (Atkins) which Governor Newsom signed. While the primary expressions of concern over the bill concern the shortened timeframe to investigate presumptive claims (75 days), the expansion of temporary disability payments to firefighters who have presumptively compensable cancer, and new penalties from unreasonable denial of presumptive claims, there is another part of the bill relevant to this discussion.


SB 1127 requires the Division of Workers’ Compensation, upon an appropriation by the Legislature, to identify and amend its existing data collection processes to include collection of the date on which a claimant is notified of acceptance, denial, or conditional denial of liability.


This would seem to answer the question posed by then Commissioner Christy Bouma in her comments on the RAND report: “How is it that there could be a statutory requirement for a determination of compensability on or before 90 days, but no system of data captures the status of such a claim at 90 days?”


Christy Bouma who is now Governor Newsom’s Legislative Affairs Secretary.


It will take more than data to get California’s workers’ compensation system out of its multi-generational presumption quagmire. New, actionable, data will help. But we must not presume all issues – and all stakeholders – will be satisfied with where the data leads the discussion if it is still within the same box built in 1935 when the first presumption was enacted.


Note: The opinions expressed herein may or may not be those of Workers’ Comp Executive. Mark Webb is a former Arizona insurance regulator, insurance company chief compliance officer, and is an expert in corporate governance, risk and compliance. He is the owner of Prop 23 Advisors.