The Rise in California Cumulative Trauma Workers’ Compensation Claims

California employers are seeing a sharp increase in workers’ compensation claims involving cumulative trauma, and many of these claims aren’t filed until after employment has been terminated. These claims are often disputed and frequently litigated, and they can have a significant impact on workers’ compensation costs.

Here’s what California employers need to know about this growing trend, the steps they can take to help manage their risks and how they can get involved in broader efforts to address the issue.

What Are Cumulative Trauma Workers’ Compensation Claims?

Some work-related injuries can be traced to a specific event. A construction worker falls and breaks his leg. A driver gets into a car crash and injures his back. A janitorial worker suffers chemical burns when a container holding an industrial-strength cleaning solution cracks open.

Cumulative trauma happens over time. Daily typing can lead to carpal tunnel syndrome. Serving drinks in a concert hall can contribute to hearing loss. Sitting at a desk for hours every day can result in back pain. There’s no single incident to point to, but after months or years of repeated exposure, the injuries become severe.

The Unique Challenges of Cumulative Trauma Claims

For employers trying to manage workers’ compensation costs, cumulative trauma claims can be especially challenging.

Some cumulative trauma claims are legitimate, but the nature of these claims can also make causation difficult to determine. When an injury has a clear cause, it’s fairly straightforward to determine whether or not the injury is work-related. Cumulative trauma is more complicated. If an office administrator develops carpal tunnel syndrome, is it because they type for work, or is it tied to their personal smartphone usage? If a worker loses their hearing, is it because of loud equipment at work, or is it because they practice target shooting on the weekends?

This uncertainty means that claims can be contentious. Disagreements over causation are common, and workers may seek the help of an attorney if the initial claim is denied. When this happens, attorney fees and other legal costs can add to the total size of the claim.

Further complicating matters is the fact that claims can, and often do, emerge after employment has ended. This is in contrast to claims that are tied to a single event, which are typically filed soon after the event occurs. Employers may be caught off-guard by claims from former employees, resulting in higher-than-expected losses. When a claim is filed after termination, questions may arise about the circumstances surrounding the claim, making careful documentation especially important.

Why California Is Seeing More Cumulative Trauma Claims

The vast majority of states permit cumulative injury workers’ compensation claims. According to Business Insurance, Virginia is the sole exception, and lawmakers in that state have been reconsidering coverage.

However, even though most states permit cumulative trauma workers’ compensation claims, the requirements for a successful claim can vary from state to state. As a result, costs and prevalence can also vary.

In California, an injury or illness can be considered work-related “if an event or exposure in the work environment either caused or contributed to the resulting condition or significantly aggravated a pre-existing injury or illness.” This means that a person’s job does not need to be the sole cause of an injury, as long as work is a contributing factor.

According to WCIRB California, cumulative trauma claims have increased sharply in recent years. Moreover, post-termination claims have increased from 44% in 2013-15 to 58% in 2022-24. These trends have a significant impact on workers’ compensation indemnity costs because cumulative trauma claims are especially likely to be litigated. Litigation is particularly common when claims are filed after termination. In fact, 99% of post-termination cumulative trauma claims are litigated.

IRMI says California is one of the costliest states for workers’ compensation, and cumulative trauma claims are the primary driver.

Insights from Cumulative Trauma Claims Data

WCIRB California says that cumulative trauma claims now account for approximately one-quarter of total pure premium costs.

• All industries are affected. The share of indemnity claims associated with cumulative trauma has increased across all industry groups, with the highest rates observed in office clerical, manufacturing and accommodation & food service.
• More recent hires are more likely to file claims. The majority of workers who file cumulative trauma claims have been with the company for less than five years at the time of the claim. Just over 25% were with the company for less than a year.

How Can Employers Manage Cumulative Trauma Costs?

As cumulative trauma claims surge, employers can take steps to help prevent injuries associated with repetitive tasks and exposures.

• Create ergonomic workspaces. For office workers, the chair, keyboard, mouse and other equipment used can play a role in reducing strain over time. Ergonomic designs are also important for factory workers and other employees engaged in repetitive motion. Something as simple as the height of a workstation or chair can make a difference.
• Train workers. Workers may need training on proper lifting techniques to help avoid back strain. They may also benefit from training on posture and techniques for performing repetitive tasks to help minimize musculoskeletal injuries and wrist strain. For example, UMass Memorial Health explains that keeping the wrist in a neutral position and using the whole hand, rather than just the thumb and index finger, to grip an object may help prevent carpal tunnel syndrome.
• Ensure that workers take adequate breaks. Appropriate rest periods can help reduce strain associated with repetitive tasks.
• Provide personal protective equipment when appropriate. Depending on the job and the hazards involved, appropriate protective equipment may help reduce workers’ exposure to injury risks.
• Use pre-employment integrity assessments. This type of employment selection procedure is recognized and sanctioned by the EEOC and can help employers make better hiring decisions. Testing can help identify applicants who are more likely to follow safety procedures, comply with workplace rules and remain reliable employees, which may help reduce injury frequency and workers’ compensation costs over time.

If a cumulative trauma claim emerges, and especially if it occurs after termination, employers should be prepared for a complex claim that may involve litigation. Notify your insurer and make sure all relevant documentation is in order.

If you are concerned about workers’ compensation abuses, you can also get involved in reform efforts, such as those being proposed by Fix CA Workers’ Comp Now. This development is also raising concerns across the insurance industry, with stakeholders supporting reforms aimed at addressing rising costs and potential abuse. Even sophisticated claims investigations, data analytics, litigation management and underwriting controls may have limited impact when broader systemic factors drive claim trends.

Heffernan Insurance Brokers can help your organization evaluate your workplace risks and secure workers’ compensation solutions that fit your organization’s needs. Learn more about our workers’ compensation options.