September 9, 2026 | Sacramento, CA — MedLegalNews.com — California is taking a closer look at whether injured workers can obtain necessary treatment when they need it. A new RAND study released by the California Department of Industrial Relations (DIR) and its Division of Workers’ Compensation (DWC) examines workers compensation medical care access across the state, focusing on the timeliness of treatment, travel distances, provider participation, geographic differences and the expanding role of telehealth.
The August 27 report is the first in a planned series of four annual studies designed to establish a continuing picture of workers compensation medical care access. RAND analyzed medical billing and injury-report information covering 2017 through 2024. While the study does not conclude that access has broadly deteriorated for the typical injured worker, it identifies meaningful differences between urban, suburban and rural communities and highlights areas where provider participation may not be keeping pace with system needs.
RAND Study Establishes a New Baseline for Medical Access
The new research gives California regulators a more detailed framework for evaluating workers compensation medical care access than a simple statewide average. RAND examined how quickly injured workers received initial treatment, how far they traveled for care and whether enough providers were participating in the workers’ compensation system. The study also considered provider specialty, geographic region and telehealth adoption, particularly in behavioral health.
The importance of the baseline is that statewide averages can conceal substantial differences among communities. RAND found that access for the typical injured worker remained relatively stable in recent years, but the experience was not uniform throughout California. The report therefore creates a foundation for future comparisons as additional annual studies are completed and regulators evaluate whether changes in provider participation or geographic availability are becoming more significant.
Timeliness of Treatment Remains Relatively Stable
One of the more significant findings concerns the timing of medical treatment. RAND reported that the median time to a first evaluation and management visit remained at approximately one day after an injury was reported to the employer beginning in 2019. For injured workers receiving physical medicine treatment, the median time to the first visit was 16 days in 2024, compared with 17 days in 2022 and 2023. These results suggest that the statewide median does not show a broad deterioration in workers compensation medical care access for accepted specific injury claims.
That finding is important because a stable statewide median does not mean every injured worker experiences the system in the same way. RAND cautioned that the analysis focused on initially accepted specific injury claims and that certain categories, including cumulative trauma, occupational disease, mental health claims and denied claims, were treated differently because of their more complicated timelines. Consequently, the study provides a useful access measurement without suggesting that every workers’ compensation claim follows the same path to treatment.
Rural and Suburban Workers Face Greater Travel Burdens
Travel distance is one of the clearest areas where the study identifies emerging concerns. RAND found that driving distances to certain types of medical care increased for workers living in suburban and, particularly, rural areas. Urban workers generally experienced more stable travel distances, while rural and suburban workers increasingly faced longer trips for in-person services. This geographic divide could become an important component of future workers compensation medical care access evaluations.
The implications extend beyond convenience. Longer travel can create additional practical burdens for injured employees who must attend repeated physical therapy, orthopedic, behavioral health or other medical appointments. Travel can also affect scheduling, transportation arrangements and the ability to maintain employment while complying with treatment plans. RAND’s findings do not establish that longer distances necessarily prevent treatment, but they indicate that geography is an increasingly relevant factor when assessing whether care is genuinely accessible.
Regional Differences Complicate the Statewide Picture
California’s workers’ compensation system does not operate against a uniform provider landscape. RAND found meaningful regional variation in both the timing of care and the number of providers available relative to workers’ compensation patients. For example, the study identified longer median waits for physical medicine services in the Central Valley and Central Coast compared with the statewide median. These differences demonstrate why workers compensation medical care access cannot be evaluated solely through a single statewide statistic.
Provider availability also differed considerably between major regions. RAND reported that the Central Valley and Inland Empire had among the lowest provider-to-patient ratios, while the Bay Area and San Diego had substantially higher ratios. The Inland Empire had approximately 507 providers per 10,000 workers’ compensation patients, compared with approximately 907 in the Bay Area and 817 in San Diego. Such differences may affect how easily injured workers can locate participating providers, particularly when treatment requires a specific specialty.
Provider Participation Raises a Separate Concern
The study also examined whether the supply of medical professionals participating in workers’ compensation is keeping pace with broader healthcare provider availability. In 2024, just under 75,000 individual providers delivered some care to injured workers through the system. Although the overall number remained relatively flat, the composition of participating providers changed, with participation shifting away from some physicians, chiropractors, physical therapists and psychologists and toward nurse practitioners and physician assistants.
RAND found that the broader California healthcare system experienced stronger physician-supply growth than workers’ compensation. The report compared providers participating in workers’ compensation with general healthcare provider supply and found a decline in workers’ compensation physicians per 10,000 patients from 2020 through 2024, even as general-system physician availability increased. This creates a potentially important long-term issue for workers compensation medical care access because growth in California’s overall healthcare workforce does not automatically translate into greater participation in workers’ compensation.
Physician Participation May Affect Specialty Care
The provider findings become more significant when examined by specialty. RAND reported recent declines among participating physicians in several areas, including primary care, orthopedic surgery, other surgery, anesthesiology, physical medicine and rehabilitation, and neurology. Those specialties can be particularly important in managing musculoskeletal injuries, complex physical impairments, pain conditions and other work-related medical issues.
A decline in specialty participation does not automatically establish that an injured worker will be unable to obtain treatment. However, it may increase the importance of provider networks, geographic availability and appointment scheduling. For claims involving specialized treatment, workers compensation medical care access may depend not only on whether a provider exists in a community but also on whether that provider accepts workers’ compensation patients and can accommodate the injured worker within a clinically appropriate timeframe.
Telehealth Could Change the Access Equation
Telehealth is another major component of the RAND analysis. The study examined the adoption of telehealth and its relationship to access, with particular attention to behavioral health. Virtual treatment can potentially reduce the significance of geographic barriers for some services, especially for workers who live far from participating providers.
At the same time, telehealth cannot replace every form of workers’ compensation medical care. Physical examinations, diagnostic procedures, surgery, rehabilitation and many forms of hands-on treatment require in-person services. The future of workers compensation medical care access may therefore depend on how effectively California combines virtual and physical care rather than treating telehealth as a universal substitute for local providers.
Inland Empire and Los Angeles Draw Attention
The RAND study specifically identified the Inland Empire and Los Angeles as regions where workers’ compensation provider participation was lower than expected. That finding is significant because both areas contain large populations of injured workers and substantial healthcare markets. A lower-than-expected level of workers’ compensation participation can create challenges even when the overall healthcare system contains a large number of medical professionals.
The issue is particularly relevant when considering workers compensation medical care access from the perspective of an injured worker rather than the healthcare market as a whole. A physician who does not participate in workers’ compensation may be available to privately insured or other patients but does not necessarily increase the practical supply of providers available to an injured worker whose treatment must be delivered within the workers’ compensation framework.
What the Findings Could Mean for Claims Administration
Claims administrators may increasingly need to consider geographic access when coordinating medical treatment. A provider directory may technically contain a participating physician, but the practical availability of that provider can depend on appointment timing, specialty, location and willingness to accept new workers’ compensation patients. The RAND study gives policymakers additional data for examining these system-level questions.
For injured workers, the report reinforces the importance of documenting difficulties obtaining treatment. If a worker encounters repeated delays, long-distance appointments or limited specialty options, records of those problems may provide useful context when evaluating workers compensation medical care access. Documentation does not by itself establish a legal entitlement to a particular provider, but it can help demonstrate the practical circumstances surrounding treatment.
Medical Access Could Influence Future Policy Decisions
California regulators now have a baseline against which future reports can be compared. DIR and DWC plan additional annual studies, allowing policymakers to determine whether the patterns identified in the 2017–2024 data are temporary, stable or part of a longer-term shift. That ongoing monitoring could become particularly important if provider participation continues to diverge from broader healthcare workforce growth.
The statutory framework also gives the access study a practical policy purpose. Labor Code section 5307.2 requires an independent study of access to medical treatment and allows the DWC administrative director to consider adjustments to medical fee schedules if inadequate access is identified. The RAND report therefore connects workers compensation medical care access with broader questions about reimbursement, provider participation and the sustainability of the medical delivery system.
Why the 2026 RAND Report Matters
The most important takeaway is not that California’s workers’ compensation medical system is experiencing a statewide collapse in access. The evidence points instead to a more complicated picture: relatively stable statewide timeliness for the typical accepted specific injury claim alongside increasing travel burdens in rural and suburban communities, substantial regional differences in provider supply and concerns about participation among certain physician specialties.
That distinction matters for policymakers, providers, claims professionals and injured workers. Workers compensation medical care access is ultimately about whether a worker can obtain appropriate treatment within a reasonable timeframe and without unreasonable geographic barriers. The first RAND report gives California a stronger data foundation for asking that question, while future reports should show whether the disparities identified in 2026 become more pronounced.
Conclusion
California’s new RAND study places workers compensation medical care access under closer scrutiny at a time when provider participation, regional healthcare shortages and treatment logistics remain important issues. The research provides evidence that the typical injured worker continues to receive care within relatively stable timeframes, but it also identifies geographic and provider-supply differences that deserve continued attention.
The findings should not be viewed as a final assessment of California’s workers’ compensation medical system. They are the starting point for a four-report monitoring effort. As additional data become available, regulators will have a better opportunity to determine whether changes in provider participation, travel distance, telehealth use and regional supply are improving or limiting workers compensation medical care access across California.
Read more at the California Department of Industrial Relations — RAND Medical Access Report.
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FAQs: Workers Compensation Medical Care Access
What did the 2026 RAND study examine?
The RAND study examined workers compensation medical care access using California medical billing and injury-report data from 2017 through 2024. It evaluated treatment timeliness, travel distance, provider participation, geographic differences and telehealth adoption.
Did RAND find that California workers are generally unable to access medical care?
No. RAND found that access for the typical injured worker remained largely stable in recent years. However, the study identified increased travel distances in rural and suburban areas and meaningful regional differences in provider supply.
Which California regions showed provider-supply concerns?
The RAND study found relatively low provider-to-patient ratios in the Central Valley and Inland Empire compared with several other regions. It also identified the Inland Empire and Los Angeles as areas where workers’ compensation provider participation was lower than expected.
Why is provider participation important to workers’ compensation?
A large general healthcare workforce does not necessarily mean sufficient workers’ compensation capacity. Providers must participate in the workers’ compensation system for their services to be practically available within that system. Changes in specialty participation can therefore directly affect workers compensation medical care access.