SC Workers’ Compensation Commission SC Workers’ Compensation Educational Association Medical Seminar Commission Update March 1, 2011

COMMISSION UPDATE South Carolina Workers’ Compensation Commission

Claims Activity FY FY FY (YTD) Hearings Set (Docketed) 9,86610,912 6,107 Hearings Held (Single Commissioner) 2,345 2,211 1,242 Settlements10,50610,715 6,117 South Carolina Workers’ Compensation Commission

Informal Conferences AssignedConducted FY ,264 3,549 FY (YTD) 3,410 2,518

South Carolina Workers’ Compensation Commission Informal Conferences Adjusters please bring ……… 14B’s Medical Narrative

South Carolina Workers’ Compensation Commission Single Commissioner Hearings FY FY FY (YTD) Docketed 9,866 10,912 6,107 Hearings 2,345 2,211 1,242

South Carolina Workers’ Compensation Commission Don’t Request a Hearing Unless You Are Ready…… Hearing Requests Processed29 days Hearings Scheduled 102 days Appellate Appeals117 Days

South Carolina Workers’ Compensation Commission Appeals to Full Commission FY FY FY (YTD) Docketed Hearings

Legislative Audit Council Report September 2010 Issues Depositing of Checks Vocational Rehabilitation Referrals Informal Conference Mediators Increased Compliance Enforcement South Carolina Workers’ Compensation Commission

Focus Groups Attorney Add Additional Case Status Information Register at South Carolina Workers’ Compensation Commission eCase

Website: Commissioners Preferences Case Status Information eCase Business Meetings Agendas South Carolina Workers’ Compensation Commission

Medical Fee Schedule Surgical Implant Fee Repackaged Pharmaceuticals Claims Administrations Workshops South Carolina Workers’ Compensation Commission

Electronic Service Hearing Notices Orders Coming Soon Consent Orders Clinchers Fee Petitions

South Carolina Workers’ Compensation Commission Legislation H 3653 Annual Review MSPM Appeals to ALJ S 407 Transfer 10% Earmarked Funds FY FY

South Carolina Workers’ Compensation Commission Legislation FY Budget 10% Reduction General Fund $193,675

South Carolina Workers’ Compensation Commission Comp System Cost Hospital Fee Schedule Reductions Actual FY FY Savings Medical Expense$422.4 $296.0 $126.4

South Carolina Workers’ Compensation Commission Premiums Paid ( millions ) % of total Commercial Market CY 2009 $ % Self Insurance FY 2010 $ % State Accident Fund FY 10 $ % Total $ %

South Carolina Workers’ Compensation Commission Premium Tax Paid To General Fund Commercial Market (CY 2009) $ 14,673,877 Self Insurance Tax (FY 2010) $ 4,909,000 ___________ Total$ 19,582,877 Commission Budget General Fund FY10-11$ 1,919,955 Proposed FY11-12$ 1,743,070

South Carolina Workers’ Compensation Commission System Cost Total ( millions )% of Total Medical $ % Indemnity (Comp.)$ % Total$ %

South Carolina Workers’ Compensation Commission Indemnity Total % of Total (millions)Indemnity System* Agreements $ % 60.54% Awards $ % 3.55% Total $ % *System Cost = Medical and Indemnity

South Carolina Workers’ Compensation Commission Indemnity – Temporary Awards % of Total (millions) Awards System* Partial$.7 2% Total $ % Total $ % 1.82% *Total System Cost = Medical and Indemnity

South Carolina Workers’ Compensation Commission Indemnity – Permanent Awards % of Total (millions) Awards System* Partial$ % Total $ % Disfigurement $.068 <1% Total $ % 1.74% *Total System Cost = Medical and Indemnity

South Carolina Workers’ Compensation Commission Indemnity – Permanent Agreements % of Total (millions) Agmts System* Partial$ % Total $ % Disfigurement$.4 <1% Clinchers$ % Total $ % 43.15% *System Cost = Medical and Indemnity

South Carolina Workers’ Compensation Commission Average Cost Per Case Closed FY 2009 FY 2010 $12,821 $13,181 Medical ($ 5,869) ($ 4,734) Indemnity ($ 6,951) ($ 8,448)

South Carolina Workers’ Compensation Commission Questions? Comments? Suggestions? Thank you!

South Carolina Workers’ Compensation Commission Compliance Activities Increased enforcement SC DEW Wage Information Fines/Assessments Show Cause Hearings

South Carolina Workers’ Compensation Commission Compliance FY09 FY10 FY11 (YTD) Investigations Initiated 1,092 1,375 1,204 Show Cause Hearings Set Compliance Agreements Total Investigations Closed 443 1,

Claims Activity FY FY FY (YTD) Accidents Reported71,97358,783 N/R Ind. Reported Accidents 26,31323,686 15,278 Reopened ( 1,575) (1,738) (1,669) South Carolina Workers’ Compensation Commission

FY FY FY (YTD) Cases Closed 71,973 62,536 N/R Ind. reported (26,313) (29,044) 18,026 Minor Medical (45,660) (33,492) N/R

South Carolina Workers’ Compensation Commission Indemnity – Temporary Agreements % of Total (millions) Agmts System* Partial$ 3.0 2% Total $ % Total $ % 17.38% *Total System Cost = Medical and Indemnity

Claims Administrations Workshops May 5, 2011 September 29, 2011 South Carolina Workers’ Compensation Commission

Hospital Fee Schedule Approved 2006 Inpatient Outpatient Ambulatory Surgery Centers Medicare + 40%