兰德-Evaluation-of-the-Return

Summary of the Evaluation of the Return-to-Work Fund in California's Workers' Compensation System

Core Content

This report evaluates the performance of California's Return-to-Work Supplement Program (RTWSP), which is part of the Return-to-Work (RTW) Fund, in its third year of implementation. The RTWSP was established in 2015 under Senate Bill (SB) 863 to provide supplemental payments to workers with disproportionately low permanent disability (PD) benefits relative to their earnings loss. The program provides a one-time $5,000 payment to workers who are not offered a return-to-work opportunity by their employer and have received an SJDB (Supplemental Job Displacement Benefit) voucher.

The evaluation, conducted by the RAND Corporation for the Department of Industrial Relations (DIR), aims to assess the adequacy, equity, and efficiency of the RTWSP, as well as to identify policy improvements. It uses both qualitative and quantitative methods, including stakeholder interviews, administrative data analysis, and a review of program operations.

Main Findings

• Targeting: The RTWSP successfully targets workers with more severe disabilities, who are more vulnerable and likely to experience disproportionate earnings losses. These workers tend to have lower pre-injury wages, more severe injuries, and are less likely to return to work.

• Take-Up Rate: Despite the program's efficiency, just over half of eligible workers apply for the RTWSP. The take-up rate is significantly lower than previously estimated, especially when compared to the more limited pool of workers who used the SJDB voucher for vocational rehabilitation (VR) services.

• Eligibility and Growth: The eligible population is larger than initially expected, and the program may continue to grow if DIR increases take-up. The increase in SJDB voucher issuance suggests that the RTWSP's design may have unintentionally incentivized more workers to seek VR services, even though a stronger labor market should have led to improved return-to-work rates.

• Administrative Efficiency: The RTWSP is administered efficiently, with most applications processed within three weeks and a high acceptance rate (96%). There is little evidence of fraud or abuse, and stakeholders perceive the program as having good integrity.

• Barriers to Access: Legal representation is the strongest factor associated with RTWSP take-up. Workers without legal representation are significantly less likely to apply. Other factors like language, geography, and internet access are not strongly linked to application rates.

Key Policy Recommendations

1. Make the RTWSP Automatic: DIR should consider amending regulations to make the RTW Supplement automatically available to workers who receive an SJDB voucher. This would ensure full take-up without requiring workers to apply, though it could increase administrative burden and reduce verification processes.

2. Increase Outreach and Notification: If automatic payments are not implemented, DIR should improve outreach and notification efforts to inform eligible workers about the RTWSP. Enhancing the clarity and accessibility of the SJDB voucher notification and educating treating physicians and other advocates about their reporting responsibilities could help increase take-up.

3. Improve Monitoring of SJDB Voucher Issuance: DIR should collect routine data on SJDB voucher issuance to better track changes in the RTWSP-eligible population and anticipate program costs. This data would also support future evaluations of the VR system's effectiveness.

Additional Considerations

• SJDB Utilization: The increase in SJDB voucher usage is likely due to the RTWSP's design and other policy changes in SB 863. However, the effectiveness of the SJDB in promoting better employment outcomes remains unclear, and more research is needed.

• Cost Projections: The program's potential costs could exceed the $120 million funding level if take-up rates reach 100%. DIR should consider contingency planning for higher-than-expected expenses.

• Need for Better Evidence: To assess the impact of the RTWSP on employment outcomes, DIR should conduct an empirical evaluation of the SJDB's effectiveness, using data on voucher issuance and VR billing.

Conclusion

The RTWSP is a well-designed and efficiently administered program that targets vulnerable workers with more severe disabilities. However, its low take-up rate among eligible workers suggests that access and awareness issues remain significant challenges. The report recommends that DIR explore options to increase take-up, including automatic disbursement and improved outreach, while also strengthening monitoring of SJDB voucher issuance to better manage program costs and improve outcomes for disabled workers.