Functional Restoration Programs in California Workers' Compensation (Report to the Industry, September 2025)

A CWCI Report to the Industry provides detailed data on Functional Restoration Programs (FRPs) in California workers’ compensation.  The report examines the types of claims in which these programs are used, measures the time, intensity, and duration of FRP treatment relative to the MTUS guidelines, and compares the treatment costs and outcomes of FRP to claims that did not involve an FRP.   For its analysis, CWCI reviewed data from 635 indemnity claims that involved FRPs compiled from the utilization review systems of 6 California workers’ compensation insurers and using demographic, bill review, and medical management data, compared the FRP claim sample to 270,165 non-FRP indemnity claims to determine how they differ in terms of claim characteristics, geographic region, and clinical conditions. To gain a more precise assessment of FRP vs. non-FRP treatment costs, temporary disability (TD) duration, and claim durations, the FRP claims were also compared to a matched sample of 2,361 non-FRP indemnity claims which had similar clinical, demographic, and claim characteristics (i.e., claimant age at injury, attorney involvement, injury year, region, medical conditions, type of injury, and use of opioids or psychotropic drugs) to those of the FRP claims.