July 11, 2019
2018-128
The Governor of California
President pro Tempore of the Senate
Speaker of the Assembly
State Capitol
Sacramento, California 95814
Dear Governor and Legislative Leaders:
As directed by the Joint Legislative Audit Committee, the California State Auditor conducted an audit of the timeliness of the provision of medical care to the California Department of Corrections and Rehabilitation (CDCR) employees and inmates who sustained work-related injuries (injured workers). The State Compensation Insurance Fund (SCIF) administers the workers’ compensation claims process for many state agencies and departments, including CDCR, and this report concludes that both CDCR and SCIF largely complied with applicable state laws and policies for promptly facilitating necessary medical treatment.
Our audit focused on determining the timeliness of claims approvals and the provision of medical treatment for a selection of workers’ compensation claims for both CDCR employees and inmates following a work-related injury. We also reviewed how long it took injured workers to be released from medical care and to return to work. State law requires SCIF to make a decision within certain time frames about whether an employer, such as CDCR, is financially responsible for the medical treatment resulting from a work-injury claim. In the selection of 30 employee and 36 inmate claims we reviewed from three correctional facilities, CDCR and SCIF took the necessary steps to comply with time requirements in most cases. Any late claims or liability decisions did not affect injured workers’ access to medical care.
We also found that medical care providers treated all injured workers promptly, and CDCR and SCIF authorized requested treatments within required time frames. Injured employees generally recovered from injuries more slowly than inmates, but the time it takes for injured workers to recover can vary greatly, even among comparable injuries, and depends on variables such as the severity of the injury and the worker’s health history. How quickly a worker returns to work can depend on the injured worker’s ability to perform job duties and the employer’s ability to accommodate work restrictions because of the injury.
Overall, the employees and inmates whose cases we reviewed received the necessary care through established and medical industry-approved processes within reasonable time frames. We did not identify any notable, systemic negative effects or areas for the processes to become more efficient. Therefore, we do not make any recommendations in this report.
Respectfully submitted,
ELAINE M. HOWLE, CPA
California State Auditor