October 9, 2026 | Sacramento, CA — MedLegalNews.com — Workers compensation medical access varies substantially across California, with new research showing that an injured worker’s geographic location can influence provider availability, travel distance and the time required to reach certain types of care. An August 2026 RAND study commissioned by the California Department of Industrial Relations examined medical billing and injury-report data from 2017 through 2024, creating a new baseline for evaluating whether injured workers throughout the state can obtain appropriate medical treatment.
The statewide findings indicate that workers compensation medical access remained relatively stable for the typical injured worker in recent years, but the statewide averages do not tell the complete story. Regional analysis identified meaningful differences between urban, suburban and rural areas and among California’s Division of Workers’ Compensation regions. Provider participation was comparatively low in areas including the Inland Empire, while injured workers in several rural regions faced longer travel distances or delays for certain services. These geographic differences demonstrate why medical access must be evaluated at both the statewide and regional levels.
Geographic Differences Shape Workers Compensation Medical Access
California’s size and population distribution create significant challenges when evaluating workers compensation medical access. A statewide provider count can suggest that the system has substantial medical capacity while concealing areas where injured workers have fewer participating physicians or must travel farther for treatment. RAND therefore examined provider participation and patient access geographically rather than relying exclusively on statewide averages.
The study divided California into DWC regions and examined the supply of participating providers relative to the number of workers’ compensation patients. Among the larger regions, the Bay Area had approximately 580 participating physicians per 10,000 workers’ compensation patients in 2024. The Inland Empire was substantially lower, with approximately 268 physicians per 10,000 patients. The Central Valley and Inland Empire also ranked toward the lower end across multiple provider categories.
Those differences matter because workers compensation medical access depends on more than whether a physician exists somewhere within the state. A provider must be reasonably accessible to the injured worker and willing to participate in the workers’ compensation system. The number and distribution of physicians, physical therapists, psychologists and other practitioners can therefore influence whether injured workers can obtain timely treatment near their homes or workplaces.
The RAND findings also suggest that regional problems can have different underlying causes. In the Central Valley, relatively low workers’ compensation provider supply appears connected in part to broader healthcare workforce limitations. In contrast, RAND identified the Inland Empire and Los Angeles as regions where workers’ compensation provider participation was lower than would be predicted based on the underlying general healthcare provider supply. That distinction could become important when policymakers consider strategies for improving workers compensation medical access.
Travel Distance Creates Different Challenges Across California
Travel distance is another important measure of workers compensation medical access because treatment may technically be available while still requiring an injured worker to travel a considerable distance. RAND calculated driving distances between workers’ residential areas and provider locations for first in-person visits involving several categories of care, including evaluation and management, physical medicine, orthopedic services and behavioral health.
For the typical injured worker, changes in median travel distance were relatively modest. However, the study found that average distances increased more noticeably, suggesting that a smaller group of injured workers was experiencing substantially longer travel. RAND also found that travel distances increased in rural and suburban areas, highlighting a geographic access issue that may not be apparent from statewide median figures.
Regional differences were particularly visible in areas such as the North Sacramento Valley, North State-Shasta, Eastern Sierra/Foothills, Central Valley and Central Coast. Several of these regions showed relatively high travel distances for evaluation and management or physical medicine. The findings demonstrate how workers compensation medical access can be experienced very differently depending on where an injured employee lives.
Longer travel may also create practical complications for workers recovering from occupational injuries. An employee with a significant orthopedic condition, mobility restriction or pain may experience greater difficulty traveling long distances than an uninjured patient. Transportation availability, work restrictions and the frequency of treatment can further affect the practical burden associated with obtaining medical care.
Treatment Timeliness Also Varies by Region
Workers compensation medical access can also be measured by how quickly an injured worker receives treatment after a claim is reported. RAND examined the number of days between claim reporting and the first visit for evaluation and management services and physical medicine. The analysis focused primarily on initially accepted specific injury claims so that delays associated with claim investigations or denials would not distort the measurement of the medical delivery system itself.
Statewide, the median time to the first evaluation and management visit was one day, and the study found that this measure had remained relatively stable since 2019. For physical medicine, the statewide median time to the first visit was 16 days in 2024, slightly lower than the 17-day median reported for 2022–2023. These statewide figures generally support RAND’s conclusion that workers compensation medical access had not broadly deteriorated for the typical injured worker.
Regional results, however, reveal a more complicated picture. Median time to the first physical medicine visit reached 26 days in the Central Valley and 31 days in the Central Coast, compared with the statewide median of 16 days. RAND also found that the median time to the first evaluation and management visit exceeded the statewide one-day median in some of the most rural regions, including the North Sacramento Valley, Eastern Sierra/Foothills and North State-Shasta.
These differences show why treatment timeliness should not be evaluated only through statewide averages. Workers compensation medical access may appear stable at the statewide level while injured workers in specific regions encounter longer waits for certain services. Future annual RAND reports will be important for determining whether these regional differences persist, narrow or become more pronounced.
Provider Supply Is Uneven Across California
Provider availability is one of the most important components of workers compensation medical access because the system depends on healthcare professionals willing to treat occupational injuries. RAND reported that just under 75,000 individual providers participated in California workers’ compensation in 2024, but participation differed substantially by provider type, specialty and geographic region.
Among large regions, the Central Valley and Inland Empire had relatively low provider-to-patient ratios across many categories. The Bay Area had the largest physician supply relative to workers’ compensation patients among the large regions studied, while the Inland Empire had the lowest. San Diego showed comparatively strong participation among physical therapists and acupuncturists, demonstrating that the geographic distribution also changes according to provider type.
RAND’s comparison with the general healthcare system provides additional context. The Inland Empire stood out because workers’ compensation physician participation declined even as physician supply in the broader healthcare market increased. RAND calculated that participating workers’ compensation physicians in the Inland Empire declined from approximately 329 per 10,000 patients in 2020 to approximately 274 in 2024 in the comparison used for its trend analysis.
That difference suggests that workers compensation medical access can be affected by more than a general shortage of healthcare professionals. A region may have physicians serving the general population while still experiencing limited participation in workers’ compensation. Understanding why providers choose whether to participate could therefore become an important issue as California continues its annual access studies.
Rural and Suburban Workers May Face Different Access Barriers
Population density also affects workers compensation medical access. RAND separated ZIP codes into urban, suburban and rural categories to examine whether injured workers experienced different travel patterns. The analysis found that travel distances had increased in rural and suburban areas, even though statewide measures for the typical injured worker remained relatively stable.
Rural communities present an obvious geographic challenge because healthcare facilities and specialists may be separated by substantial distances. An injured worker may have access to a primary care provider nearby but need to travel considerably farther for orthopedic care, physical therapy or behavioral health treatment. Workers compensation medical access can therefore vary not only between regions but also according to the type of treatment required.
Suburban access presents a different challenge. A region may contain a substantial healthcare workforce while still having uneven distribution of participating workers’ compensation providers. Traffic patterns, provider concentration and limited participation by particular specialties can increase the practical burden of reaching care even when the straight-line geographic distance appears manageable.
These differences reinforce the importance of evaluating workers compensation medical access using multiple measures. Provider counts alone cannot establish whether treatment is realistically accessible, while travel distance alone does not show whether an injured worker received treatment promptly. Examining provider supply, distance and timeliness together provides a more complete picture of regional access.
Telehealth May Reduce Some Geographic Barriers
Telehealth represents one potential mechanism for addressing certain workers compensation medical access problems, although its usefulness depends heavily on the type of medical service involved. RAND found particularly notable telehealth use in behavioral health, where remote care can sometimes eliminate the need for injured workers to travel to an in-person provider.
The Central Valley and Central Coast provide useful examples. Both regions had relatively low supplies of psychologists and comparatively high travel distances for behavioral health services, but they also showed higher telehealth adoption. RAND’s analysis suggested that when at-home telehealth visits were treated as requiring no driving, the average travel burden for behavioral healthcare was meaningfully reduced in those regions.
Telehealth cannot solve every regional problem. Physical examinations, diagnostic procedures, rehabilitation services and many forms of treatment still require in-person care. Workers compensation medical access therefore continues to depend on maintaining adequate networks of participating healthcare providers throughout California.
Nevertheless, the behavioral health findings show how technology can affect the geographic dimension of workers compensation medical access. Future annual studies may provide additional information about whether telehealth continues reducing travel requirements and whether similar strategies can improve access to other appropriate services.
Regional Data Establish a Baseline for Future Annual Studies
One of the most important aspects of the 2026 RAND report is that it is the first of four annual studies required to evaluate injured workers’ access to medical care. The current report therefore establishes a baseline rather than providing a final assessment of workers compensation medical access in California. Future studies can compare new data against the geographic patterns identified through 2024.
That longitudinal approach is particularly important for regional provider supply. A single year with relatively low provider participation does not necessarily establish a long-term deterioration in workers compensation medical access. Repeated measurements can reveal whether participation continues to decline, stabilizes or improves after changes in medical payment, administrative requirements, telehealth use or other system conditions.
Future reports may also help determine whether areas such as the Inland Empire, Central Valley and rural Northern California continue to experience disproportionate access challenges. Comparing provider participation with general healthcare workforce trends can help distinguish problems unique to workers’ compensation from broader regional healthcare shortages.
For claims administrators, physicians, attorneys and policymakers, the geographic baseline creates an opportunity to evaluate workers compensation medical access with greater precision. Rather than discussing provider shortages as a single statewide issue, stakeholders can examine where specific shortages exist, what types of providers are affected and whether injured workers are experiencing measurable consequences in travel or treatment timeliness.
Geographic Access Will Remain an Important Medical-Legal Issue
The RAND findings do not indicate that California’s entire workers’ compensation medical delivery system is experiencing a uniform access crisis. For the typical injured worker with an accepted specific injury claim, several statewide measures remained relatively stable. The more significant finding is that workers compensation medical access is uneven, with geographic differences that can become obscured when statewide averages are considered alone.
For injured workers, those differences can have practical consequences. Longer travel, limited specialty availability and delays in reaching physical medicine or other services can affect the treatment experience. For treating physicians and claims professionals, geographic limitations may also affect referrals, scheduling and the availability of appropriate specialists.
The medical-legal significance becomes particularly important when questions arise concerning treatment delays. A delay may result from provider availability rather than patient noncompliance or a lack of medical necessity. Understanding regional workers compensation medical access can therefore provide useful context when evaluating treatment histories and medical records.
California now has a detailed 2017–2024 baseline against which future changes can be measured. As the remaining annual RAND studies are completed, workers compensation medical access can be evaluated not only as a statewide measure but as a regional issue involving provider participation, travel distance, treatment timeliness and changing methods of delivering care.
Read the official California Department of Industrial Relations and Division of Workers’ Compensation announcement for more information about the RAND study examining regional workers compensation medical access, provider participation, travel distance and treatment timeliness.
Subscribe to MedLegalNews.com for continuing coverage of California workers’ compensation medical care, DWC research, provider access, treatment trends and medical-legal developments affecting injured workers.
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FAQs: Workers Compensation Medical Access
Does workers compensation medical access vary across California?
Yes. The RAND study identified substantial regional differences in provider availability, travel distance and treatment timeliness. The Central Valley and Inland Empire were among the larger regions with relatively low provider supply, while several rural regions showed greater travel or timeliness challenges.
Which California region had the lowest physician participation among large regions?
The Inland Empire had approximately 268 participating physicians per 10,000 workers’ compensation patients in 2024, the lowest ratio among the large regions examined. The Bay Area had approximately 580 physicians per 10,000 patients.
How long do injured workers wait for physical medicine care?
The statewide median was 16 days to the first physical medicine visit in 2024. Regional differences were substantial, with the Central Valley at 26 days and Central Coast at 31 days.
Can telehealth improve workers compensation medical access?
Telehealth may improve access for services that can appropriately be delivered remotely. RAND found evidence that behavioral health telehealth reduced the practical travel burden in areas including the Central Valley and Central Coast, where in-person travel distances were relatively high.