ILARS STATISTICS FOR 2015 PAUL GREGORY WIRO IMPLEMENTATION DIRECTOR 1.

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Presentation transcript:

ILARS STATISTICS FOR 2015 PAUL GREGORY WIRO IMPLEMENTATION DIRECTOR 1

ILARS INVOICING Calendar YearNo of invoicesAverage invoiceAmount Invoices processed $ 2,380 $ 16, ,991 $ 2,132 $ 6,376, ,417 $ 3,338 $ 38,105, ,251 $ 5,001 $ 51,261,721 Total 24,666 $ 3,882 $ 95,760,288 2

WHAT HAS THE MONEY BEEN SPENT ON IN 2015 ILARS Cost Item Total invoice amountsPercentage Professional fees (including GST)$38,785,88476% Disbursements (excluding GST)24% Medico-legal$9,441,47476% Barrister Fees$2,009,15716% NTD Report$315,8683% Clinical Notes$236,1512% Travel$160,5571% Barrister Country Loading$146,0511% Treating Specialist Report$60,0930% Interpreter$51,3270% Other$14,4090% Meal Allowance$2,6010% Total Disbursements$12,437,581 Grand Total$51,223,570 Note: The above figures are unaudited numbers from WIRO’s case management system. The ‘NTD Reports’ and ‘Treating Specialist Reports’ amounts may have been understated as they have been tagged as ‘Medico-legal’. 3

ILARS 4

ILARS OUTCOMES 2015 Desired Outcome not Achieved -38 % of matters; Average cost $3425 Achieved desired outcome 62% of Matters; Average cost $6117 ILARS Funding Withdrawn -1074; 10%; $3452 Cram Fluid -607 No Response to ILARS Follow-up -318 Other -131 Resolved prior to WCC – 2721; 25%; $3573 Insurer accepts claim By complying agreement after claim made Instructions withdrawn -1056; 10%; $2309Resolved after referral by WIRO Insurer - 68; 1%; $2130 Grant subsequently declined -132; 1%; $3631 Death Benefits - 3; 0%; $8483 Not proceeding after preliminary grant ; 12%; $2817 Worker does not reach WPI threshold -916 Medical evidence not supported -335 Commutation - 29; 0%; $3114 Grants Closed with outcomes -10,991 5

ILARS OUTCOMES 2015 OutcomeDesired Outcome not Achieved Achieved desired outcome WCC286; 3%; $ ; 34%; $7943 Resolved following MAC Resolved Teleconference0959 Resolved at Conciliation0961 Resolved at Arbitration59485 Resolved WIM dispute118 Appeals89; 1%; $ ; 1%; $8859 After Medical Appeal Panel75104 To the Deputy President /President 1214 To the Supreme Court21 6

LAW FIRMS During 2015 ILARS approved approximately $51 million – The top 5 law firms were 34% – The top 10 law firms were 47% – The top 20 law firms were 63% For the top 50 law firms the table below shows the percentage of matters which achieved the desired result for the injured worker. Covers 81% of matters closed % achieved desired result – amount invoiced % achieved desired result – number of matters Minimum %5629 Maximum %9488 Average8161 7

INSURERS Insurer Type% of Amount paid% of mattersAverage payment Scheme Agent76%77%$4991 TMF9% $5358 Specialized Insurer4% $5219 Self Insurer9% $4876 Total number of matters % achieved desired result – amount invoiced % achieved desired result – number of matters Scheme Agent TMF Specialized Insurer Self Insurer

ISSUES Primary issue of matter % of Amount paid% of mattersAverage payment Death claim1% $6930 Denial of Liability35%25%$6978 Medical treatment7%12%$2986 Weekly payments4%3%$5994 WPI53%59%$4511 Total number of matters % achieved desired result – amount invoiced % achieved desired result – number of matters Death claim Denial of Liability Medical treatment Weekly payments WPI

BODY LOCATION OF THE INJURY Nature of injury% of Amount paid% of mattersAverage payment Back16% 15% $4858 Ear12% 20% $2853 Psychological9% 7% $6341 Shoulder6% $4953 Knee5% $5142 Neck3% 15% $5009 Total number of matters % achieved desired result – $ % achieved desired result – number Back Ear Psychological Shoulder Knee Neck

DOCTORS During 2015 ILARS recorded the names of 190 doctors who were paid for an IME in 1442 matters – The top 5 doctors were 34% of all matters – The top 10 doctors were 51% of all matters – The top 20 doctors were 66% of all matters For the top 20 doctors the table below shows the percentage of matters which achieved the desired result for the injured worker. Doctor specialtyNumber of matters % achieved desired result – number of matters ENT Specialist53080 Orthopedic Specialist43756 Psychiatrist5358 Other specialties

BARRISTERS During 2015 ILARS recorded the names of 82 barristers who were paid for acting for injured workers in 757 matters – The top 5 barristers were 33% of all matters – The top 10 barristers were 49% of all matters – The top 20 barristers were 68% of all matters For all barristers the percentage of matters which achieved the desired result for the injured worker is 91% 12

WHICH REGIONS HAVE WHICH TYPE OF INJURIES Head Upper Body Upper Limb Lower Limb RegionEars Other HeadBack Other Upper BodyNeckShoulderElbow Hand and wrist Other Upper LimbKnee Angle and Feet Other Lower Limb Multiple areas Internal systemsPsychologicalUnspecifiedDeathTotal Hunter ,676 Liverpool/ Fairfield ,546 Western Sydney ,543 Central Coast ,378 South Coast ,363 North Coast ,175 Parramatta Macarthur/ Camden Canterbury/ Bankstown Inner West St George Central Tablelands Illawarra Sutherland Other areas ,477 Grand Total 3, , , , , ,468 13

DISBURSEMENTS Disbursements generally cover clinical notes, medical reports, interpreter fees, travel expenses and Counsel Fees Travel loading for instructing solicitors UHG arrangement Invoicing generally 14

UPLIFTS WIRO will consider a request for an uplift in professional fees where a matter has involved significant additional work due to complexity or where there are multiple respondents. Requests for an uplift should be made prior to the issue of your tax invoice. 15

ADMIN ISSUES Contact the Principal Lawyer handling your matter on his or her direct line and avoid using Urgent applications should be flagged Response times to applications and s follow up on old matters Death benefit claims 16

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