Improving Our Measures for

Dispute ResolutionBRI LAKE, ERD RESEARCH ANALYST

GOVERNOR’S CONFERENCE ON WORKERS’ COMPENSATION

09/30/2021

Why do we care about dispute

resolution metrics?“Montana's workers' compensation and occupational disease insurance systems are intended to be primarily self-administering. Claimants should be able to speedily obtain benefits, and employers should be able to provide coverage at reasonably constant rates. To meet these objectives, the system must be designed to minimize reliance upon lawyers and the courts to obtain benefits and interpret liabilities.” (§39-71-105(4) MCA)

Metrics historically found in the MT Annual Report:• Mediation Counts

• by Plan Type• by Benefit Issue• by Resolution Status

• Work Comp Court Statistics as reported by the WCC

• Dollar amounts for attorney fees, settlements, and insurer legal expenses

0%

20%

40%

60%

80%

100%

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Claimant Attorney Involvement –

Distribution of Claims, IY 2005-2017

All Claims

Filed

Wage-Loss

Claims

Attorney

Claims

Wage-Loss-

Attorney

Claims

360,800 53,400 8,400 5,800

2%

Source: Workers’ Compensation Administrative Network (WCAN), MT DLI ERD

Percent of Claims with Attorney

Percent of Wage-Loss Claims with Attorney

0%

20%

40%

60%

80%

100%

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Claimant Attorney Involvement –

Distribution of Claims, IY 2005-2017

All Claims

Filed

Wage-Loss

Claims

Attorney

Claims

Wage-Loss-

Attorney

Claims

360,800 53,400 8,400 5,800

11%

Source: Workers’ Compensation Administrative Network (WCAN), MT DLI ERD

Claimant Attorney Involvement –

Distribution of Claims, IY 2005-2017

All Claims

Filed

Wage-Loss

Claims

Attorney

Claims

Wage-Loss-

Attorney

Claims

360,800 53,400 8,400 5,800

69%

0%

20%

40%

60%

80%

100%

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Source: Workers’ Compensation Administrative Network (WCAN), MT DLI ERD

Percent of Attorney Claims with Wage-Loss

Claimant Attorney Involvement –

Distribution of Claims (IY 2005-2017)

0%

20%

40%

60%

80%

100%

Percent of Claims with Attorney

Percent of Wage-Loss Claims with Attorney

Percent of Attorney Claims with Wage-Loss

0%

3%

6%

9%

12%

15%

Percent of Claims with Attorney

Percent of Wage-Loss Claims with Attorney

Percent of Attorney Claims with Wage-Loss

0%

1%

2%

3%

4%

Percent of Claims with Attorney

Percent of Wage-Loss Claims with Attorney

Percent of Attorney Claims with Wage-Loss

Source: Workers’ Compensation Administrative Network (WCAN), MT DLI ERD

Worker Attorney Involvement: A New

Measure (WCRI, 2017)

Source: https://www.wcrinet.org/reports/wcri-flashreport-worker-attorney-involvement-a-new-measure

Average Temporary Benefits Increase by $11,900 when a Claimant Attorney is Involved

Pre-Injury Wage

Injury Type Injury

Year

Source: Workers’ Compensation Administrative Network (WCAN), MT DLI ERD

Attorney Involve-ment

0%

10%

20%

30%

40%

50%

Wage Distribution Percent with Attorney

<$25,001

$25,001-$50,000

$50,001-$75,000

$75,001-$100,000

>$100,000

Injured Worker Wage vs. Attorney InvolvementClaim Cost vs. Attorney Involvement

Injury Type vs. Attorney Involvement

Claimant Attorney Cost & Correlates –

Wage-Loss Claims, IY 2005-2017

Injury

Distribution

Percent with

Attorney

Asbestosis, Respiratory

Disorder, Dust Disease <1% 20%

Fracture, Laceration 15% 7%

Sprain or Strain of the

Back or Neck23% 15%

Mediation – Petition Year vs. Injury Year

Source: Workers’ Compensation Administrative Network (WCAN), MT DLI ERD

0

200

400

600

800

1,000

1,200

1,400

1,600

19

80

19

81

19

82

19

83

19

84

19

85

19

86

19

87

19

88

19

89

19

90

19

91

19

92

19

93

19

94

19

95

19

96

19

97

19

98

19

99

20

00

20

01

20

02

20

03

20

04

20

05

20

06

20

07

20

08

20

09

20

10

20

11

20

12

20

13

20

14

20

15

20

16

20

17

20

18

20

19

20

20

20

21

Mediation Petitions by Petition Year Mediation Petitions by Injury Year

Mediation – Distribution of Claims,

(IY 2005-2017)

All Claims Filed Wage-Loss Claims Mediation ClaimsWage-Loss-

Mediation Claims

360,800 53,400 10,700 6,500

Mediations Claims

with Attorneys

5,100

Source: Workers’ Compensation Administrative Network (WCAN), MT DLI ERD

0%

20%

40%

60%

80%

100%

20

05

20

06

20

07

20

08

20

09

20

10

20

11

20

12

20

13

20

14

20

15

20

16

20

17

Percent of Claims with Mediation

Petition

Percent of Wage-Loss Claims with

Mediation Petition

Percent of Mediation Claims with

Wage-Loss

Percent of Mediation Claims with

Attorney

Percent of Mediation Petitions with

Attorney by Petition Year

0

100

200

300

400

500

19

99

20

00

20

01

20

02

20

03

20

04

20

05

20

06

20

07

20

08

20

09

20

10

20

11

20

12

20

13

20

14

20

15

20

16

20

17

20

18

20

19

20

20

Co

un

t o

f P

eti

tion

s

Petition Year

Time from Date of Injury to Petition for Mediation by Injury Year

Mediation – Timeframes

77

41

28

75th Percentile

Median

25th Percentile

Number of Days from Petition for

Mediation to Mediation Closure

1%

3%

2%

5%

12%

78%

Pending

Greater than 1 Year

271-365 Days

181-270 Days

90-180 Days

Less than 90 Days

Distribution of Time from Petition for Mediation to Mediation Closed

Source: Workers’ Compensation Administrative Network (WCAN), MT DLI ERD

Mediation – Issues

0%

10%

20%

30%

40%

19

98

19

99

20

00

20

01

20

02

20

03

20

04

20

05

20

06

20

07

20

08

20

09

20

10

20

11

20

12

20

13

20

14

20

15

20

16

20

17

20

18

20

19

20

20

Mediation Benefit Issues by Injury Year

Access to Records

Calculation of Wages

Course and Scope

Employment/Insurance Coverage

Medical Benefits

Notice/Filing Time

Other

Rehab Benefits

Relatedness

Wage Loss Benefits

Injury/Occupational Requirement

Source: Workers’ Compensation Administrative Network (WCAN), MT DLI ERD

Mediation – Resolution

Resolved,

80%

Unresolved,

19%

Resolved

Due to

Mediation,

36%

Resolved During

Mediation, 17%

Resolved Prior

to Mediation,

25%

Unresolved, 5%

WCC, 15%

0%

10%

20%

30%

40%

50%

19

99

20

00

20

01

20

02

20

03

20

04

20

05

20

06

20

07

20

08

20

09

20

10

20

11

20

12

20

13

20

14

20

15

20

16

20

17

20

18

Dismissed Resolved Due to Mediation

Resolved During Mediation Resolved Prior to Mediation

Unresolved WCC

Resolution Status by Injury Year

Source: Workers’ Compensation Administrative Network (WCAN), MT DLI ERD

Source: Workers’ Compensation Administrative Network (WCAN), MT DLI ERD

0% 20% 40% 60% 80% 100%

Dismissed

Resolved During Mediation

Resolved Prior to Mediation

Resolved Due to Mediation

Unresolved

WCC

Overall Access to Records

Calculation of Wages

Course and Scope

Employment/Insurance Coverage

Injury/Occupational Requirement

Medical Benefits

Notice/Filing Time

Other

Rehab Benefits

Relatedness

Wage Loss Benefits

Benefit Issue by Resolution

Resolution by Benefit Issue

0% 20% 40% 60% 80% 100%

Access to Records

Calculation of Wages

Course and Scope

Employment/Insurance Coverage

Injury/Occupational Requirement

Medical Benefits

Notice/Filing Time

Other

Rehab Benefits

Relatedness

Wage Loss Benefits

Overall

Dismissed

Open Petition

Recommendation Issued

Resolved During Mediation

Resolved Prior to Mediation

Resolved Due to Mediation

Unresolved

WCC

Mediation – Issues & Resolution

Workers’ Compensation Court

• Workers’ Compensation

Court Statistics

• Includes counts of

petitions, trials,

decisions, appeals,

settlement

conferences, and

more (1993-Current)

• ERD Dashboard for

WCC Statistics

ERD Database

WCC Database

Settlements – Distribution of Claims,

IY 2005-2017

All Claims Filed Wage-Loss Claims Settlement ClaimsWage-Loss-

Settlement Claims

360,800 53,400 20,900 12,700

Settlement Claims

with Attorneys

13,100

Source: Workers’ Compensation Administrative Network (WCAN), MT DLI ERD

0%

20%

40%

60%

80%

20

05

20

06

20

07

20

08

20

09

20

10

20

11

20

12

20

13

20

14

20

15

20

16

20

17

Percent of Claims with Settlement

Percent of Wage-Loss Claims with

Settlement

Percent of Settlement Claims with

Wage-Loss

Percent of Settlement Claims with

Attorneys

Source: Workers’ Compensation Administrative Network (WCAN), MT DLI ERD

Settlement Types & Times, IY 2005-2017Settlement Type Distribution

Settlement Type Count by Decision Date

0

500

1,000

1,500

2,000

Settlement for Best Interest

Settlement - Medical Reserved

Disputed Initial Compensability

WCC Settlement

All Other

16%

7%

19%

25%

33%

All Other

WCC Settlement

Disputed Initial Compensability

Settlement for Best Interest

Settlement - Medical Reserved

Median Settlement Amount

$23,500

$25,000

$5,000

$50,000

Settlement for Best Interest

Settlement - Medical Reserved

Disputed Initial Compensability

WCC Settlement

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

WCC Settlement

Disputed Initial Compensability

Settlement for Best Interest

Settlement - Medical Reserved

Overall Less than 1 Year

1-2 Years

2-3 Years

3-4 Years

4-5 Years

Greater than 5 Years

Settlement Type by Time from Injury Date to Decision Date

Time from Injury Date to Decision Date

28%

29%

16%

9%

6%

12%

Less than 1 Year

1-2 Years

2-3 Years

3-4 Years

4-5 Years

Greater than 5 Years

Settlement Types & Times, IY 2005-2017

Source: Workers’ Compensation Administrative Network (WCAN), MT DLI ERD

Source: Workers’ Compensation Administrative Network (WCAN), MT DLI ERD

0% 20% 40% 60% 80% 100%

>$100,000

$75,001-$100,000

$50,001-$75,000

$25,001-$50,000

<$25,001

Overall

Less than 1 Year

1-2 Years

2-3 Years

3-4 Years

4-5 Years

Greater than 5 Years

Time to Settlement vs. Injured Worker Wage

Wage-Loss Settlement Claims,

IY 2005-2017

Thank you!BRI.LAKE@MT.GOV