| Workers' Compensation changes |
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| Changes simplify processes |
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Workers' Compensation changes simplify claims, speed benefits.
In response to the Governor’s regulatory streamlining initiative, the state’s Workers’ Compensation Division (WCD) set a goal to more effectively and efficiently monitor and improve the health of the workers’ compensation system. A healthy workers’ compensation system means injured workers get the benefits they are entitled to and costs and burdens are low for employers. This goal supports the Department of Consumer and Business Services’ mission — protecting consumers and workers while supporting a positive business climate. To achieve this goal, WCD began a regulatory redesign project to, first, eliminate unnecessary processes, and then streamline, modify, and design new structures and processes, as needed, to achieve the system’s objectives.
To begin, WCD staff reviewed more than 71 functions and submitted 750 ideas to improve efficiencies such as reducing burdens on the industry and increasing the performance of industry claims processing. Some staff recommendations proposed to eliminate unnecessary regulations and functions, others required better use of electronic information systems. Currently, a management team is continuing to review recommendations and so far 232 recommendations have been approved for implementation, of which 96 directly affect stakeholders.
One of the recommendations improved the dispute resolution process. Dispute resolution occurs when an injured worker, medical provider, or insurer disagrees with the injured worker’s medical treatment. The division developed a streamlined alternative dispute resolution process to better assist with these disputes. By grouping three or more disputes from the same provider, WCD staff resolved disputes through negotiation, settlements, and means other than the formal dispute process. The division’s Medical Review Unit (MRU) has reduced the time it takes to resolve a dispute by 34 percent from 2002 to 2006. This is a significant time and cost savings because it eliminates the need for litigation in the majority of the cases and expensive expert opinion and witness costs. MRU also implemented a pilot project to fast-track simpler disputes, such as disputes over medical fees.
Another example of WCD streamlining is adding the capability to conduct hearings by telephone conferencing to resolve vocational services disputes. This has decreased paperwork for agency and stakeholders, and saves travel and time costs to attend hearings. Often cases can be resolved in a 20-minute call, rather than participants traveling to and from formal hearings.
Improvements to the Workers' Compensation Division's return-to-work programs are helping injured workers become self-sufficient. Injured workers seeking employment are able to more quickly resolve disputes with their insurer over vocational matters, such as eligibility for direct employment plans. The average time for resolution has dropped from 67 days to 30 days. And, emloyers can get their injured workers back to work earlier with increased return-to-work financial assistance through the Preferred Worker Program.
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