Post on 06-Oct-2020
Workers’ Compensation Overview and Updates
DOL’s Office of Workers’ Compensation Programs Division of Longshore & Harbor Workers’
Compensation Douglas Fitzgerald, Director Division of Longshore and Harbor Workers’ Compensation fitzgerald.douglas@dol.gov 202-343-5844
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Overview of Division of Longshore and Harbor Workers Compensation Program
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• In-take of Reports of Injury (LS 202) from E\C. • Creation of Cases. • Conduct Informal Dispute Resolution Conferences. • Evaluate and issue decisions on Special fund 8 (f) and 18 (b) applications,
stipulations , attorney fees, and 8(i) settlement applications. • Monitor Medical and Compensation Payments • Assess penalties for non-timely filing of notices of injury and final
compensation payments. • Manage Vocational Rehabilitation Services and Return to Work. • Engage in stakeholder outreach to improve first report of injury and first
payment performance.
Claims Management
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Insurance Authorization, Compliance Oversight and Special Fund Management • Authorize carriers to write insurance coverage under the LHWCA and its
extensions. • Authorize employers to become self-insured under the LHWCA and its
extensions. • Monitor compensation and medical expenditures through annual LS513
and LS274 reporting. • Annually conduct risk assessment and require E\Cs to securitize risk
through bonds, LOC, cash and other securities. • Monitor\Manage\Report Special Fund activity. • Make payment and collect penalties under the Special Fund. • Annually assess needs of the Special Fund. • Issues and collects annual industry assessments on each E\C based on 8(f)
utilization and SF needs. • Conducts E/C audits to ensure proper reporting of claims expenditures. • Collects assessments on identified under-reported claims expenditures.
Outline
• Claims Trends & Program Performance
• Operational Efficiencies through IT Modernization
• Areas of Focus in the Near Term
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Carrier/Self-Insured Payments by Company Year
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Claims Trends New Claims Reported
FY 2010 – FY 2017
12,742 13,242 12,367 11,858
15,176 13,760 13,547 14,162
01,0002,0003,0004,0005,0006,0007,0008,0009,000
10,00011,00012,00013,00014,00015,00016,00017,00018,00019,00020,000
2010 2011 2012 2013 2014 2015 2016 2017
Longshore Injuries Reported
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Claims Trends New Claims Reported
FY 2010 – FY 2017
14,844
11,604 12,168 11,610
7,892
5,864 6,089 6,622
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
9,000
10,000
11,000
12,000
13,000
14,000
15,000
2010 2011 2012 2013 2014 2015 2016 2017
DBA Injuries Reported
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Claims Trends New Claims Reported
FY 2010 – FY 2017 All Acts
4,085 4,097 3,650 3,787 3,512 3,504 3,650 3,888 4,369 4,357 4,075 4,146 4,541 6,299
2,200 4,961 5,075
15,141
11,367 12,255 14,844
11,604 12,168 11,610
7,892 5,864 6,089
6,622
15,809
15,472 14,460
13,998
13,890 12,733
12,742
13,242 12,367 11,858
15,176
13,760 13,547
14,162
22,646
24,980
23,537
33,395
29,170 28,952
31,628
29,169 29,287 28,189
27,349
23,963 24,276
27,122
-
5,000
10,000
15,000
20,000
25,000
30,000
35,000
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Longshore InjuriesReportedDBA Injuries Reported
NAFIA Injuries Reported
OCSLA Injuries Reported
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Claims Trends New Claims Reported
FY 2017 Claim Types
1,310
1,724 23,968
131
Occupational - Hearing
Occupational - All Other
Traumatic
Traumatic Fatal
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759
440 445
141
227 194
78
23
93
110
112
144
94
74
115
134
0
20
40
60
80
100
120
140
160
0
100
200
300
400
500
600
700
800
MedicalTreatment
TemporaryDisability
PermanentDisability
Injury AOE /COE
AverageWeekly Wage
Attorney Fees LastResponsible
Employer
Jurisdiction(Coverage)
Number of Disputes
Average Days
Claims Trends
Focus on Improving Quality and Timeliness of Reports of Injury and Initial Payments of Compensation
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First Reports of Injury – Percentage of First Reports of Injuries filed within 30 days of date of knowledge First Payments – Percentage of First Payments of Compensation made within 30 days of date disability began
FY 2017
Act Target ResultLongshore 89% 94%DBA 88% 94%
Act Target ResultLongshore 86% 88%DBA 67% 71%
Efficiencies through IT Modernization
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• Create ALL new claims in paperless format using OWCP’s Imaging System (OIS)
• Centralized Mail Room Activities and Case-Create Functions (FY 2014) • Piloted Electronically Transfer of Medical Records (FY 2014) • Deployed the Secure Electronic Access Portal (SEAPortal) (FY 2015) • New Regulations Finalized (801-802) for waiving rights to certified mail
in lieu of electronic service (FY 2015) • Piloted Electronic Transferring LS-202, Report of Injury, for case create
(FY 2016)
Efficiencies through IT Modernization
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Until FY 2014, 100% of Incoming Correspondence Arrived Via the USPS. In FY 2015 34% of Incoming Correspondence Was Received Electronically.
Efficiencies through IT Modernization
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In FY 2016 58% of Incoming Correspondence Was Received Electronically.
Efficiencies through IT Modernization
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In FY 2017 70% of Incoming Correspondence Was Received Electronically.
Efficiencies through IT Modernization
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DLHWC is Now Receiving Nearly 40% of All New Claims Electronically • May 2016 – Signal • December 2016 - CCSI • May 2017 - ALMA
Area of Focus in the Near Term?
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• Deploy new case management system in 2019. • New\consolidated forms to achieve efficiencies in
document submission and customer service – Ex. Combine 206 and 208 into one “notice of payment” form to report initial, interim or final payments, 8(f) applications, etc
• Institute process for monitoring opioid prescription usage for claims paid by the Special Fund
• Create digital fax capability for LS202 submission • Institute the concept of the “Intervention” to support more
effective dispute resolution outcomes. • Expand program integrity efforts and reporting compliance
audits to protect the Special Fund • Position the program to meet the challenges of proposed
major infrastructure investment and shipbuilding expansion