WORKERS COMPENSATION (WC)

Transcription

1 WORKERS COMPENSATION (WC) Overview Office of Finance Office of Human Resources Management Office of Law

2 Millions Problem Statement The County s Risk Management deficit is increasing Estimated accrued debt has increased 40.3%, from $62 million in FY 2008 to $87 million in FY 2011 $120 $100 $80 $60 $40 $62 $67 $80 $87 $20 $0 $25 $27 $24 $22 FY 2008 FY 2009 FY 2010 FY 2011 Estimated PAYGO Estimated Accrued Debt Why should the County focus its attention on workers compensation? Workers Compensation claims make up 64% of all Risk Management claims received and 84% of all Risk Management payments Wednesday, June 13,

3 Current Structure and Funding Issues The County s Risk Management structure: Includes County Government agencies, the Board of Education (BOE), the Community College, and the Memorial Library System Excludes Revenue Authority and Housing Authority Board of Education has its own Risk Manager and staff; however, the County s Safety Officer provides training to all of the funds entities as requested Approximate total number of employees (FY 2012): 23,479 County Government (6,219), BOE (16,173), Community College (815), Memorial Library (272) Third Party Administrator, CorVel, handles the processing, managing, and subrogation of all claims from inception to disposition The County must deal with two funding issues: Keeping pace with the annual cost pressures related to risk management funding, which are tied to fringe benefits (Current portion of estimated liability on pending claims) Additional funding needed to gradually close the accumulated deficit associated with risk management liability (Estimated liability on pending claims noncurrent) Wednesday, June 13,

4 Worker s Compensation Claim Process Injury occurs Injury reported to supervisor with in 24 hours Employee takes disability leave CorVel Investigates Claim/Claim filed with State Worker s Compensation Commission (WCC) DRC Files Claim with CorVel Supervisor notifies the Department Risk Coordinator (DRC) Issues payment of benefits made by County or claim is contested WCC hears case and issues ruling County can appeal WCC ruling in Circuit Court Wednesday, June 13,

5 CorVel Claim Review Process Claim received by CorVel Claim assigned to nurse and claims supervisor Nurse reaches out to claimant Claim specialist develops action plan and implements Claim specialist contacts claimant, the reporting supervisor and medical provider to confirm claim details Supervisor assigns claim to claims specialist Supervisor reviews claim progress every 30, 60 and 90 days Wednesday, June 13,

6 Worker s Compensation Benefits Process Healing Period Maximum Medical Improvement Benefits Permanency/Death Benefits can be paid Or paid following hearing at Worker s Compensation Commission & the issuance of an order Medical Care & Treatment Temporary Total Disability Temporary Partial Disability Paid Voluntarily or if entitlement is contested Permanent Partial Disability Permanent Total Disability Or Vocational Rehabilitation By Stipulation: Parties agree on amount of permanent disability (claim open for future benefits) By Settlement: Parties agree on a dollar sum to be paid & future life of the claim Wednesday, June 13,

7 Disability Leave Program An employee who is temporarily disabled, resulting from an injury or illness sustained directly in the performance of their work, is entitled to disability leave. Employees must report an injury within 24 hours of the occurrence. Disability leave is approved by the Office of Human Resources Management, except for requests stemming from the Fire Department. Disability leave is not deducted from an employee s annual or sick leave balances. The maximum amount of disability allowed is 180 days, although some labor groups have a different maximum amount. *Disability leave is documented in Personnel Law and Personnel Procedure 284 Wednesday, June 13,

8 Disability Leave Program Physician: -Treats employee -Completes Attending Physician's Statement (APS) Employee: -Suffers injury/illness -Reports injury with in 24 hours OHRM: -Reviews DL Request -Completes Form 2099 Personnel Liaison/Coordinator: -Verifies Information -Sends all forms Supervisor: -Collects APS from employee -Completes injury forms: 1 st Report of Injury, Form 1383, Form 1384 Employee Payroll Department OHRM DL file Wednesday, June 13,

9 Methodology Things to know as you review the data contained in this presentation Claim counts are for all claims received within the stated fiscal year (regardless of when the incident actually occurred) This is the normal reporting method used for submitting information to the State of Maryland Claim payments are for all payments made in the stated fiscal year regardless of when the claim was received This method results in less fluctuation in yearly data as a result of when a report is run Method is useful for determining the County s financial obligation for the fiscal year in question When the presentation refers to County Government it is excluding the Board of Education (BOE), the Community College, and the Memorial Library from the Risk Management Pool Wednesday, June 13,

10 Risk Management Fund Historical Trend Claims General Liability 13% FY07 FY12 Property Damage 1% Workers Compensation from FY 2007-FY 2012 (thru April 30 th ) makes up almost two-thirds of Risk Management claims Auto Liability 22% Workers' Comp 64% Category FY 2007 FY 2008 FY 2009 FY 2010 FY 2011 % Change FY07 to FY11 Wednesday, June 13, FY 2012* Total number of claims 4,691 4,789 4,160 4,290 4,119 12% 2,942 Number of WC claims 2,817 2,839 2,716 2,721 2,748 2% 2,171 BOE % of WC claims 52% 54% 55% 54% 57% 10% 56% *As of April 30, 2012

11 Risk Management Fund Historical Trend Payments Auto Liability 4% General Liability 11% FY07 FY12 Property Damage 1% Workers Compensation from FY 2007-FY 2012 (thru April 30 th ) makes up 64% of Risk Management claims, but more than 80% of Risk Management payments Workers' Comp 84% *As of April 30, 2012 Category FY 2007 FY 2008 FY 2009 FY 2010 FY 2011 Total payments (millions) % Change FY07 to FY11 Wednesday, June 13, FY 2012* $39.5 $40.1 $38.7 $46.2 $ % $43.2 WC claims (millions) $35.2 $34.0 $34.9 $38.4 $ % $35.8 BOE % of WC dollars 36% 35% 29% 24% 17% 53% 6%

12 Fringe Benefits Workers Compensation as a Percentage of Fringe Benefits Fringe benefits, which include items such as health benefits and workers compensation, have been steadily increasing over the last five fiscal years 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% FY 2007 FY 2008 FY 2009 FY 2010 FY 2011 Fringe Benefits as % of Compensation WC as % of Fringe Benefits Wednesday, June 13,

13 Historical Trend Workers Compensation Cases FY07 FY08 FY09 FY10 FY11 Trend FY12* New claims 2,817 2,839 2,716 2,721 2,748 2,171 Open cases as of 4/30/ ,047 Number of claims with lost time from work Cost 1, Average medical $ $3,459 $3,626 $3,434 $3,475 $3,611 $3,945 Average benefit $ $9,809 $10,639 $10,641 $11,700 $12,106 $11,533 Adopted from Montgomery County CountyStat *As of April 30, 2012 Several indicators have remained steady Average benefits costs (indemnity payments) have increased by 23% Open claims provide opportunity for additional review and strategies towards closure Wednesday, June 13,

14 Workers Compensation Breakdown Percentage of Payments By Cluster Public Works & Environmental Resources 4% General Government 4% Public Safety 92% CLUSTER NUMBER OF AGENCIES NUMBER OF EMPLOYEES Public Safety 5 4,436 Public Works & Environmental Resources General Government Wednesday, June 13,

15 Workers Compensation Public Safety Cluster includes: Police, Fire, Office of Homeland Security, Corrections, and Sheriff 95% Cluster s Percentage of County Government s Total 90% 85% 80% 75% 70% FY 2007 FY 2008 FY 2009 FY 2010 FY 2011 Claims Payments Points of Interest Police makes up 47.3% of all Public Safety claims while accounting for almost two-thirds of all Public Safety payments, followed by Fire at 32.4% of claims and one-fifth of payments Accounts for approximately 71% of County Government employees 44% of the Fire Department s claims between FY 2007 and FY 2012 are from employees with three or more claims (208 employees) Wednesday, June 13,

16 Workers Compensation Public Works and Environmental Resources Cluster includes: Public Works & Transportation (DPW&T), Soil Conservation, and Environmental Resources (DER) 15% Cluster s Percentage of County Government s Total 10% 5% 0% FY 2007 FY 2008 FY 2009 FY 2010 FY 2011 Claims Payments Points of Interest DPW&T makes up 65.6% of all Public Works & Environmental Resources claims while accounting for 58% of all the cluster s payments, followed by DER at 34.3% of claims and 41.7% of payments Accounts for approximately 16% of County Government employees Wednesday, June 13,

17 Workers Compensation General Government Cluster includes: All County Government agencies not included in the Public Safety and Public Works & Environmental Resources clusters 20% Cluster s Percentage of County Government s Total 15% 10% 5% 0% FY 2007 FY 2008 FY 2009 FY 2010 FY 2011 Claims Payments Points of Interest Central Services is responsible for 25.5% of all General Government claims while accounting for only 17.8% of all cluster payments Accounts for approximately 13% of County Government employees Wednesday, June 13,

18 Workers Compensation Breakdown Top 10 Agencies - County Government Only Agency FY 2007 FY 2012 (as of April 30 th ) Percent of Claims Percent of Payments 1. Police Department 39.60% 53.31% 2. Fire Department 27.11% 23.68% 3. Office of the Sheriff 5.99% 8.56% 4. Corrections 9.21% 6.65% 5. Public Works 5.74% 1.99% 6. Environmental Resources 3.00% 1.43% 7. Central Services 1.92% 1.20% 8. Circuit Court 1.02%.77% 9. Housing & Community Development.49%.66% 10. Health Department.96%.43% Ranking is according to the percentage of Workers Compensation dollars attributed to each agency Wednesday, June 13,

19 Workers Compensation Claims Benchmark Jurisdiction % change 2009 to 2011 Baltimore County 3,734 3,966 4, % Baltimore City 3,745 3,655 3, % Prince George s County 2,998 3,035 3, % Montgomery County 1,987 1,990 2, % Anne Arundel County 1,873 1,964 1, % Harford County 1, , % Source: MD State Commission Website Wednesday, June 13,

20 Session Findings and Recommendations Finding #1: Risk management is not accounted for in annual employee performance evaluations, with the exception of the Fire Department. o o Recommendation A: Safety evaluations and accidents should be incorporated into an annual employee performance evaluations. Recommendation B: Repeat claim filers should be put through additional safety training. Finding #2: Internal policies requiring agencies to investigate work s compensation injury claims should be reviewed and strengthened. o o Recommendation A: Supervisors and DRCs should investigate injury claims as soon as they are notified. Recommendation B: Clear documentation procedures should be drafted by OHRM and OOL and given to supervisor and DRCs. This will help protect the County if the claim award is appealed to the WCC. Wednesday, June 13,

21 Session Findings and Recommendations (cont.) Finding #3: The availability of light-duty assignments across all government agencies is unknown and not coordinated. o Recommendation A: OHRM should create and manage a government wide light-duty assignment roster all departments can access. Wednesday, June 13,