FOR IMMEDIATE RELEASE
The Commission on Health and Safety and Workers’ Compensation
Approves for Final Posting the Report on QME Delays
OAKLAND -- The Commission on Health and Safety and Workers' Compensation (CHSWC) has approved for final posting, “A Review of Disability Evaluation Delays and Supplemental QME Reports.”
CHSWC set out to quantify the delay in obtaining DEU ratings. Frank Neuhauser, of UC Berkeley Survey Research Center, analyzed a database of all summary ratings and consultative ratings issued in a 16-month period from September 2008 through December 2009. Summary ratings are issued on QME reports in unrepresented cases. Consultative ratings are issued in represented cases.
Across the 16 months of ratings examined, the ratings were prepared an average of 104 days after the DEU received the medical-legal reports. Mean and median waiting times were calculated for each month.
The analysis demonstrates the difference in waiting time for attorney-represented cases (consultative ratings) and unrepresented cases (summary ratings). Across the 16-month period, the average was 129 days for cases without attorneys and 84 days for cases with attorneys. The median for cases without attorneys was 96 days. In other words, half of all unrepresented cases were rated within about three months of receipt of the report, and half took longer. Because the statistical mean (129 days) is more than a month later than the median (96 days), there must have been a number of cases which waited much longer than four months for their ratings. This is consistent with the anecdotal information and complaints of waiting over a year for some ratings.
Month-by-month figures were also calculated for the mean and the median, for both consultative ratings and summary ratings. The study refutes complaints that the delays have been growing longer. After growing longer in the first six months of 2009, the delays reduced in the second six months. By December 2009, all cases except the mean time to rating for unrepresented cases had improved over December 2008. The mean time to rating for unrepresented cases remained at 119 days in December 2009.
Labor Code Section 4061(e) requires that the summary rating be issued within 20 days of receipt of the QME report. Based on the data analysis, the DWC is not making the statutory timeline. DWC management appears to be working to reduce the delay.
The report can be found in the report sections of the CHSWC website at http://www.dir.ca.gov/chswc/CHSWC_Research.html
CHSWC is charged with examining the health and safety and workers’ compensation systems in California and recommending administrative or legislative modifications to improve their operation. The Commission was established to conduct a continuing examination of the workers’ compensation system and of the state’s activities to prevent industrial injuries and occupational illnesses and to examine those programs in other states.
Information about the reports is available at www.dir.ca.gov/chswc and by writing to the Commission on Health and Safety and Workers' Compensation, 1515 Clay Street, Room 901, Oakland, CA 94612, by calling (510) 622-3959, by faxing a request to (510) 622-3265, or by emailing email@example.com.