The Price of Getting Old: California Gets Under Our Skin (and Contents)

23 Jul, 2018 Bob Wilson


A week ago, I was in California, speaking at the annual conference of the California Coalition on Workers’ Compensation. A very big topic there was the proliferation of “Skin and Contents” cases that are overwhelming the system, particularly in the Los Angeles basin. “Skin and Contents” is another phrase for cumulative trauma injuries. The ailments produced under many of these claims are the result of what many of us outside California would call “getting old.” Within California, however, they are the basis of broad and largely compensable claims, as the laws of the state have enabled this phenomenon.

As coincidence would have it, the Los Angeles Times published an investigative piece on the subject just two days after the CCWC conference concluded. It focuses primarily on first responders leveraging the lax disability standards along with an overly generous retirement system, but the message is clear; there is an intentional effort underway to take advantage of overly broad standards in the state. 

The article quotes attorneys involved in some of these cases, some who spoke off the record on the matter. It is pretty clear that the nature of permissive cumulative trauma standards in California comp have allowed some law firms and their medical partners to circumvent Schwarzenegger era reforms that were designed to reduce fraud in the system. They make it clear that to recoup potential losses from that reform, they simply had to start “adding body parts” to cumulative injury claims in older workers. Prior to those reforms, in 2004, the WCAB reviewed 16,000 claims with five or more body parts. By 2016, that number had grown to 38,000. These cases are expensive, too, with CWCI reporting that the average cumulative trauma claim costs employers over $73,000, compared to just over $48,000 for specific injury cases.

One attorney, who now defends employers and spoke on the record, explained by saying, ““I’m 52, and if somebody asked me what hurts I could start from the top and work my way to the bottom.”

While the Los Angeles Times article focuses on first responders, this is a problem that all employers face in the state. It is just that the generous benefits negotiated for public employees are exacerbating the problem in that sector. Reading that article should be pretty disgusting for any taxpayer in the region, as it makes a pretty solid case that abuse is fairly rampant.

I’m not sure if a solution will be forthcoming in the state, or if one does come about what it will look like. Politically the state is just not situated to address the issue, and it seems to be moving leftward from its current positions. I do not see effective relief for employers anytime in the near future. Despite the growing concerns over cumulative trauma claims, the legislature only acted once, in 2013, when it specifically fixed an issue with professional athletes from out of state filing CT claims in California. In 2017, a bill designed to reduce medical fraud in the state, AB 1244, briefly contained language that would eliminate some cumulative trauma claim obligations of employers, but that language did not survive in the final edition.

Still, employers and concerned citizens need to keep trying. They should to be making their case to state representatives and publicizing the expense that the general population is paying. It is pretty clear that the “skin and contents” game will continue in California until constituents effectively get under the skin of those who can fix the problem.

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