November 15, 2004

Christine Baker

CHSWC Releases RAND Report on Medical Treatment Guidelines
and Submits Additional Implementation Recommendations
to the Administrative Director of the Division of Workers' Compensation

SAN FRANCISCO -- The California Commission on Health and Safety and Workers' Compensation (CHSWC) has released the CHSWC study by RAND entitled Evaluating Medical Treatment Guideline Sets for Injured Workers in California. In addition, it has submitted its recommendations to the Administrative Director (AD) of the Division of Workers' Compensation (DWC) based on this study.

New Labor Code Section 77.5, established by Senate Bill (SB) 228, requires CHSWC to conduct a survey and evaluation of evidence-based, peer-reviewed, nationally recognized standards of care, including existing medical treatment utilization standards, and including independent medical review, as used in other states, at the national level and in other medical benefit systems.

This Labor Code Section also requires CHSWC to issue a report of its findings and recommendations to the AD for purposes of adopting a medical treatment utilization schedule. This report shall be updated periodically.

The CHSWC study by RAND offers short-, intermediate-, and long-term recommendations. The main recommendation is that the AD should adopt the American College of Occupational and Environmental Medicine (ACOEM) Guidelines supplemented by the American Association of Orthopedic Surgeons (AAOS) Guidelines for lumbar spinal fusion surgeries. The study also recommends that the state develop a consistent set of utilization criteria to be used by all payors.

In response to the foregoing, CHSWC recommends the following course of action. (1) Present RAND report to the AD of the DWC for the AD's consideration; (2) Recommend consideration of RAND findings in the adoption of medical treatment utilization schedule; (3) Recommend establishing an ad hoc advisory group, and (4) Recommend further studies to be conducted jointly by DWC and CHSWC.

CHSWC is charged with overseeing 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 diseases and to examine those programs in other states.

Since its inception in 1994, CHSWC has held meetings, conducted fact-finding hearings, and directed several studies to determine how these crucial programs are serving California employees and employers. These studies, conducted by independent research organizations under contract with CHSWC, and other activities were aided by the involvement of state agency personnel and interested members of the workers' compensation community. This cooperative public-private partnership continues to work together to identify, describe, measure and propose solutions to problems and difficulties in the current health and safety and workers' compensation systems.

Information about CHSWC may be accessed on the internet at CHSWC's home page at Information may also be obtained by writing to CHSWC at 455 Golden Gate Avenue, 10th Floor, San Francisco, California 94102, by calling (415) 703-4220, or by faxing a request to (415) 703-4234. Effective December 1, 2004, CHSWC's address will be 1515 Clay Street, Room 901, Oakland, California 94612. CHSWC's new telephone number will be (510) 622-3959, and FAX number will be (510) 622-3265.