Evidence-based reform can strengthen public confidence in workers’ compensation by connecting policy decisions to measurable problems, reliable research, and documented outcomes. Workers’ compensation systems must balance multiple objectives, including timely medical treatment, appropriate benefits, administrative efficiency, employer responsibilities, dispute resolution, and long-term financial sustainability. When reforms are developed around credible evidence rather than assumptions, policymakers have a stronger foundation for determining which changes are necessary and whether those changes actually improve the system.
California provides several current examples of this research-driven approach. During 2026, the Division of Workers’ Compensation released major research examining access to medical care, the impact of Senate Bill 1160 on utilization review, and the sustainability of the Qualified Medical Evaluator system. These studies address different parts of workers’ compensation, but collectively they demonstrate the value of gathering data before determining where additional policy intervention may be appropriate.
Public confidence depends partly on whether participants believe the system is capable of identifying weaknesses and responding to them responsibly. Evidence-based reform can support that confidence by establishing measurable baselines, evaluating previous policy decisions, and distinguishing systemic problems from isolated experiences. Research cannot resolve every disagreement, but it can create a more disciplined foundation for workers’ compensation policy.
Evidence-Based Reform Begins With Understanding the System
Effective evidence-based reform should begin with a clear understanding of existing conditions. Before changing medical networks, utilization review procedures, fee schedules, evaluator requirements, claims processes, or other components of workers’ compensation, policymakers need reliable information about how those systems are currently performing.
California’s Commission on Health and Safety and Workers’ Compensation plays an important role in this research environment. CHSWC is charged with continuously examining California’s workplace health and safety and workers’ compensation systems and recommending administrative or legislative modifications intended to improve their operation. Its annual reporting incorporates data, legislative and regulatory developments, research, and recommendations concerning system performance.
This research infrastructure matters because evidence-based reform requires more than collecting statistics. Data must be interpreted in relation to specific policy questions. If policymakers are concerned about medical access, for example, they need information about provider availability, geographic differences, treatment timeliness, travel distance, and specialty participation. The objective of evidence-based reform is to identify the evidence that directly addresses the problem policymakers are attempting to solve.
Medical Access Demonstrates the Value of Reliable Data
Access to medical treatment is an area where evidence-based reform can be particularly important. Broad statements that workers either have adequate access or face widespread access problems can obscure substantial differences among specialties, geographic regions, and types of treatment.
In August 2026, DIR and DWC released the first in a planned series of four annual RAND studies examining injured workers’ access to medical care in California. The research used medical billing and injury-report data from 2017 through 2024 and evaluated treatment timeliness, travel distances, provider supply, specialty and geographic differences, and telehealth. The study found that access remained largely stable for most injured workers in recent years while identifying increased travel distances in rural and suburban areas and lower-than-expected provider participation in regions including Los Angeles and the Inland Empire.
These findings illustrate why evidence-based reform is more useful than policy built around generalizations. A statewide conclusion may fail to identify regional or specialty-specific difficulties. Research can help policymakers determine whether a problem requires broad structural intervention or a more targeted response. That distinction can make reform more precise and reduce the risk of disrupting portions of the system that are functioning adequately.
Evidence-Based Reform Can Test Whether Earlier Policies Worked
Research is also important after legislation has been enacted. Workers’ compensation reforms are frequently adopted with specific objectives, but the existence of a policy does not prove that those objectives were achieved. Evidence-based reform therefore requires policymakers to return to previous changes and measure their actual effects.
The 2026 RAND analysis of Senate Bill 1160 provides a useful example. SB 1160 reduced prospective utilization review requirements for certain treatments provided during the first 30 days following a work-related injury. DWC described the 2026 research as the first empirical examination of whether those provisions reduced administrative burdens while improving the timeliness and quality of medical care. Researchers used information from two large claims administrators together with Independent Medical Review and Workers’ Compensation Information System data.
This type of retrospective analysis is central to evidence-based reform. Policymakers should be able to ask whether an earlier intervention achieved its intended objectives, whether unexpected effects occurred, and whether additional adjustments are justified. Without that evaluation, workers’ compensation can accumulate reforms without developing a clear understanding of which changes actually produced meaningful improvements.
Research Can Support Sustainable Medical-Legal Reform
The Qualified Medical Evaluator system presents another area where evidence-based reform can support long-term sustainability. Medical-legal evaluations are important when medical disputes arise, and the effectiveness of the QME system depends on factors including evaluator availability, specialty coverage, report quality, geographic distribution, reimbursement, and timely access to medical records.
In May 2026, DWC released a RAND study evaluating the effectiveness and long-term sustainability of California’s medical-legal process. The research examined whether QME supply meets demand across specialties and regions, the effects of reimbursement changes on costs and recruitment, methods for improving report quality, telehealth evaluations, and strategies for improving the delivery of medical records to evaluators. DWC stated that the findings are expected to inform future rulemaking.
Evidence-based reform is particularly valuable in complex areas like the QME system because changing one component can influence several others. Increasing reimbursement, modifying evaluator requirements, expanding telehealth, or changing reporting procedures may affect access, quality, participation, and cost differently. Research allows policymakers to consider these relationships before adopting changes intended to solve one problem that could unintentionally create another.
Evidence-Based Reform Can Improve Regulatory Precision
Workers’ compensation regulation frequently involves technical subjects that benefit from specialized research. Medical treatment guidelines are a clear example. Treatment standards should evolve as medical evidence develops, but changes should be connected to credible clinical information rather than administrative preference alone.
California’s Medical Treatment Utilization Schedule incorporates evidence-based treatment guidelines, and DWC continued updating those standards during 2026. Evidence-based MTUS updates that became effective during the year included guidelines addressing chronic pain, eye disorders, initial approaches to treatment, ankle and foot disorders, and hip and groin disorders.
This approach demonstrates how evidence-based reform can operate at a detailed regulatory level. Workers’ compensation modernization does not always require comprehensive legislation. Sometimes meaningful improvement occurs through targeted updates to medical standards, administrative procedures, reporting systems, or other components where research indicates that change is appropriate.
Transparency Helps Evidence Build Public Confidence
Research alone does not automatically create public confidence. Evidence must also be accessible enough for stakeholders to understand how policymakers reached their conclusions. Workers, employers, medical professionals, claims administrators, attorneys, researchers, and other participants may disagree about policy priorities, but transparent evidence can provide a common factual starting point.
California’s public research process offers several mechanisms for this transparency. CHSWC posts research reports and studies, presents draft studies for feedback and public comment, and makes approved research available through its reports archive. Its 2026 meeting materials also included updates concerning studies on medical access, utilization review, and the medical-legal process.
Evidence-based reform becomes more credible when participants can examine the underlying research rather than simply being told that a change is supported by evidence. Transparency also creates opportunities to identify limitations, challenge assumptions, and provide additional information. A research-driven system should not treat evidence as a way to end discussion. It should use evidence to make discussion more precise.
Evidence-Based Reform Should Measure Outcomes That Matter
Workers’ compensation generates substantial amounts of administrative data, but evidence-based reform requires policymakers to determine which outcomes actually matter. Processing speed is important, but speed alone does not establish whether injured workers received appropriate medical care. Lower administrative costs may be beneficial, but cost reductions should be evaluated alongside access, quality, and benefit delivery.
Useful measures can include treatment timeliness, provider participation, travel distances, dispute frequency, evaluator availability, report quality, administrative burden, return-to-work outcomes, and the consistency of claims processes. Different policy questions will require different measures. The purpose of evidence-based reform is not to maximize a single metric but to understand how changes affect the system as a whole.
This is particularly important because workers’ compensation serves multiple constituencies. A reform that reduces administrative burden for one participant may increase responsibilities for another. Evidence-based reform can help identify those tradeoffs and provide policymakers with a more complete picture before they decide whether a particular change represents genuine system improvement.
Research Can Help Prevent Reactive Policymaking
Workers’ compensation policy can attract strong reactions because individual cases may involve serious injuries, delayed treatment, financial pressure, medical disputes, or substantial costs. Those experiences deserve attention, but policy designed around individual examples alone may not accurately represent the broader system.
Evidence-based reform provides a method for testing whether an observed problem is widespread, concentrated in particular regions or specialties, associated with a specific administrative process, or limited to unusual circumstances. This distinction matters because different problems require different solutions.
Research can therefore reduce the risk of reactive policymaking. Rather than immediately adopting broad reforms following a highly visible problem, policymakers can examine systemwide information and determine the scale, causes, and distribution of the issue. Evidence-based reform does not require delaying necessary action indefinitely. It requires matching the intervention to the available evidence whenever circumstances permit.
Evidence-Based Reform Requires Continued Evaluation
A sustainable workers’ compensation system cannot treat reform as a one-time event. Economic conditions change, healthcare delivery evolves, provider participation shifts, technologies develop, and administrative practices respond to new regulations. Evidence that supported a policy several years ago may eventually need to be reconsidered.
The medical-access study released in August 2026 illustrates this continuing approach. DWC described it as the first of four annual RAND reports intended to track access to medical care and the factors affecting it. By establishing a baseline and continuing measurement over subsequent years, California can determine whether conditions improve, deteriorate, or remain stable.
That longitudinal approach strengthens evidence-based reform because trends are often more informative than isolated measurements. A single year can be affected by temporary circumstances. Repeated research can reveal whether an apparent problem is persistent and whether policies adopted in response are producing measurable results.
Conclusion: Evidence-Based Reform Can Strengthen Trust
Evidence-based reform offers a practical foundation for improving workers’ compensation while strengthening public confidence in how the system evolves. Research can identify problems, establish baselines, test previous reforms, measure outcomes, and help policymakers distinguish between broad structural weaknesses and targeted issues.
California’s recent studies of medical access, utilization review, and the QME system demonstrate how research can inform workers’ compensation policy. These projects examine different aspects of the system but share an important principle: meaningful reform should begin with an accurate understanding of how the system is actually functioning.
Public confidence is strengthened when reform is transparent, measurable, and capable of being evaluated over time. Evidence-based reform cannot eliminate disagreement among stakeholders, nor can research answer every policy question. It can, however, create a more disciplined process in which decisions are connected to measurable conditions and reforms can be assessed against their stated objectives. That approach can help create a workers’ compensation system that is more responsive to changing conditions while remaining focused on fairness, access, administrative effectiveness, and long-term sustainability.
For further reading on current workers’ compensation research, studies, and system evaluation, review the California Commission on Health and Safety and Workers’ Compensation research resources. CHSWC maintains research addressing California’s workers’ compensation system and uses studies to inform potential administrative and legislative improvements.
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