Risk Management Workers Comp Projects Christian DeVoll, Risk Management Specialist December 2012

Project Overview Conducted 3 separate projects ($10,000 per project) Looked at both State and Self Insured programs 7 properties participated: Ben Franklin, Clallam, Link, Pierce, Gray Harbor, Spokane, and Island Transit 3-4 months per project

Scope of Work State Programs Review open time loss claims Train personnel in investigating new claims Revise plans for time loss claims Work with transits to develop action plans for remediating claims

Scope of Work (cont.) Work with transits to develop benchmarks Provide continuing support for both open and potential future claims

Scope of Work Self Insured Reviewed systems used with TPA and agency’s request for improvement Reviewed 2-4 open claims to determine level of TPA participation in claims Review TPA contract for scope of work, deliverables, costs and extra fees

Scope of Work Self Insured Reviewed type of loss control and claims data supplied by TPA Reviewed documents to determine level of regular review of claims by TPA with agency

Program Benefits On average 50% reduction in active open claims Cost savings per open and future claims??? Increased effectiveness in claims processing Professional services post project

Program Benefits (Cont.) Dispelling of Myth information Better understanding of the workers comp process and employers role Better control of costs and ways to reduce them Light Duty program Periodic follow of claims

Satisfaction Survey (State) I believe that I have been taught the appropriate skills by the consultant so I can request actions an adjustor should take in resolving a claim After working with the consultant, I feel confident I can advocate for what should be done on a claim with regards to managing the medical outcomes for a claimant so they can reach maximum medical improvement (MMI) I believe after working with the consultant, we have been able to resolve/and or close claims in a more timely manner

Satisfaction Survey (State) After working with the consultant, I know how to go about investigating a new claim and relaying that information to the Department of Labor and Industries adjuster. I believe this type of consulting work should continue and I would use the service again, if offered.

Satisfaction Survey Self Insured The consultant gave us specific and helpful advice regarding our Request for Proposal for worker’s comp third party services The consultant worked with us to help identify specific information regarding losses, causes of injury, and how to document that information for managers within our organization. The consultant reviewed a sample of our current claims and provided feedback as to the quality of adjudication services we were obtaining form our TPA. I believe this type of consulting work was helpful an I would use the service again, if offered.

Conclusions Determining quantitative cost savings from Workers Comp project is difficult Qualitative benefits include access to professional expertise, networking, and training State costs of workers comp claims continues to escalate. Without some stop measure or quality control on workers comp, claims cost will become more burdensome for transit systems to absorb

Questions