improving our measures for dispute resolution - erd.dli.mt.gov
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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