report to the san francisco workers’ compensation council...46 46% 42 42% airport 97 32 33% 26 27%...

Peggy Sugarman Workers’ Compensation Director

Report to the San Francisco Workers’ Compensation Council

March 4, 2019

Agenda

• Accomplishments & Initiatives • Performance Quick Facts • Claim Analytics • Financials

Workers' Compensation Council Meeting March 4, 2019 2

Accomplishments & Initiatives


Carve Out / “Alternative Dispute Resolution”

• Tentative agreements with SF Police Officers Association and SF Firefighters Local 798 signed 12/17/2018

• Agreements approved by the Division of Workers’ Compensation Administrative Director on 1/31/2019

• Board of Supervisors approved resolutions on 2/26/2019 • Implementation Plan in place • Joint Labor Management Committees (“Joint Committee”)

established, 2 meetings have occurred • ADR Director & Ombudsperson approved by Joint Committee • Mediators & Arbitrators selected and approved • Lists of physicians for independent medical evaluations approved

and ongoing


Presenter

Presentation Notes

Accomplishments & Initiatives

• PUC OSHA Pilot Successfully launched on 2/7/2019 • Electronic Deposit/Banking Project moving forward • Electronic Learning Management Ergonomic

Awareness Training Program completed and ready for roll-out

• Medicare Reporting Audit completed – Development of clear workflows established – Staff Training scheduled – Examining potential for external organizations to partner

with us to improve compliance by integrating with iVOS claims system


Updates

• Nurse Triage Injury Reporting roll out continuing • MPN Committee actively reviewing physician

performance and identifying new physicians for inclusion

• Administrative Filing with City Attorney for exposure based on working in or around Building 606


Performance Quick Facts


Presenter

Presentation Notes

Add a high-level one page slide: Worker’s Compensation: Fast Facts Performance against budget: Projected YE Actuals vs. Budget (surplus/deficit overall). No community college included. Claim volume: % Increase/Decrease for new claims added in the period vs. historical average. No community college included. Use FTE-weighted claim counts. Cost severity: Average cost of a claim closed within the last quarter (sum of total payments) / (sum of total claims closed) vs. a running 3-yr baseline (use same calc for longer period). Medical/Indemnity online. No community college included. Anecdote: Important program milestone/implementation

FY19 Q2 Performance Quick Facts

FY19 Q2: 109.3% FY19 Q1: 92.3%

Benchmark: 95%

403 Indemnity Claims 273 Medical Claims

Benchmark: 401 Indemnity Claims/Quarter 275 Medical Claims/Quarter

Indemnity: $13,887 Medical: $782

Benchmark: Indemnity: $15,637 Medical: $611

249 Days Benchmark: 324 Days

Fiscal Health

Ratio of Actuals to Budget

Claim Volume

Count of New Claims in Period

Duration

Average Days Open of Claims Closed in Period

Claim Cost

Average Cost of Claims Closed in Period

Notes: All benchmarks based on rolling four-year averages (FY15-18.) Fiscal health metric includes overhead and claim expenditures and is based on revised budget, excluding any carryforward. Duration excludes disability retirement and future medical claims.


Claim Analytics


Presenter

Presentation Notes

Possibly delete these slides if other slides are added. If kept, make more interesting by: Consolidation of some “like” claim causes Do stacked bars for severity charts to indicate newer claims (added within the last year) and older claims (added more than one year ago)

Claim Filing Frequency

FY15-18 FY19 Q2 FY19 Q2 Increase / Decrease

Department

Average Indemnity Claims Per

Quarter

Average Medical

Claims Per Quarter

Average Indemnity +

Medical Claims Per

Quarter

Total Indemnity

Claims

Total Medical Claims

Total Indemnity +

Medical Claims

Indemnity Medical Indemnity + Medical

Public Health 88 106 194 70 130 200 -18 or -20% 24 or 22% 6 or 3%

Police 79 44 123 84 40 124 5 or 6% -4 or -8% 1 or 1%

Fire 61 17 78 69 19 88 8 or 13% 2 or 13% 10 or 13%

Sheriff 36 8 44 38 11 49 2 or 7% 3 or 31% 5 or 11%

Public Works 15 15 30 24 16 40 9 or 59% 1 or 7% 10 or 33%

Human Services 22 14 35 24 7 31 2 or 11% -7 or -48% -4 or -12%

Airport 19 14 33 22 9 31 3 or 16% -5 or -35% -2 or -6%

Recreation & Parks 18 21 39 18 9 27 0 or 2% -12 or -58% -12 or -31%

Public Library 6 4 10 9 4 13 3 or 57% 0 or 3% 3 or 35%

Water Pollution Control 7 4 11 9 4 13 2 or 30% 0 or 8% 2 or 22%

Citywide 401 275 676 403 273 676 2 or 0% -2 or -1% 0 or 0%

10 Workers' Compensation Council Meeting March 4, 2019 10

Department 2015 2016 2017 2018 2019 Est.

Fire 21 19 19 23 23

Sheriff 21 23 20 20 20

Police 20 23 23 21 20

Public Health 12 12 11 13 12

Citywide 11 11 11 12 11

Public Works 10 11 9 10 11

Recreation & Parks 9 9 9 9 8

Airport 10 10 10 10 8

Human Services 7 6 6 8 7

Water Pollution Control 2 2 2 3 3

PUC-Water 3 3 3 4 3

Claims Incurred Per 100 FTE

Notes: 1. 2019 Est. reflects a straight line of Q1 and Q2 claim volume for the whole fiscal year


Presenter

Presentation Notes

Note: FTE is department specific.

Claims Incurred Per 100 FTE

Notes: 1. 2019 Est. reflects a straight line of Q1 and Q2 claim volume for the whole fiscal year

0

5

10

15

20

25

2015 2016 2017 2018 2019 Est.

Top 10 Departments

Fire

Sheriff

Police

Public Health

Citywide

Public Works

Recreation & Parks

Airport

Human Services

Water Pollution Control

PUC-Water


Claim Cause Distribution

Notes: 1. Claim cause group definitions are listed in Appendix 1

0

50

100

150

200

BodilyMotion

Exposure CumulativeTrauma

Fall, Slip orTrip

PhyscialAssault

Abrasion StruckBy/Against

Misc Caught In,Under,

Between

Stress

Top 10 Claim Cause Groups by Frequency - New Claims in FY2019 Q2

Public Works

Fire

Sheriff

Police

All Other Departments

Public Health


Notes: 1. $100K+ Total Incurred = $308.8 Million 2. All policy years for which incurred costs >=$100k/claim

Open Claim Stratification

100K-150K

150K-200K

200K-250K

250K-300K

300K-350K

350K-400K

400K-450K

450K-500K

500K-550K

550K-600K

600K-650K

650K-700K

700K-750K

750K-800K

800K-850K

850K-900K

900K-950K

950K-1M

Over1M

Recreation & Parks 11 13 4 5 1 2 3 1 1 2Sheriff 61 52 20 10 6 3 3 1 1 1 2Public Health 66 43 14 11 6 7 4 1 2 4 2 2 1 1 1 1Fire 83 81 45 11 13 8 4 1 1 2 1 3All Other Departments 113 59 39 19 12 7 6 5 3 2 2 1 2 0 1 4 0 0 4Police 133 94 74 36 16 15 11 6 2 1 1 1 1 2 3 1 1 2 7

0

50

100

150

200

250

300

350

400

450

500


Open Claim Stratification

1,308 Claims >=$100k $308.8 Million Data as of 2/25/2019

Note: Dollar figures in millions

$101.0, 33%

$56.7, 18% $39.0, 13%

$32.7, 10%

$11.2, 4%

$68.1, 22%

Police

Fire

Public Health

Sheriff

Recreation & Parks

All Other Departments


Litigation Statistics

16

Department Open Indemnity

Claims Added from FY15-FY19Q2

Represented Claims Represented % Litigated Claims Litigated %

Police 375 209 56% 186 50%

Fire 291 126 43% 121 42%

Public Health 260 101 39% 104 40%

Sheriff 202 96 48% 87 43%

Human Services 99 46 46% 42 42%

Airport 97 32 33% 26 27%

Public Works 89 41 46% 39 44%

Recreation & Parks 60 35 58% 31 52%

PUC-Water 40 12 30% 10 25%

Water Pollution Control 34 22 65% 22 65%

Citywide 1763 826 47% 764 43%


Presenter

Presentation Notes

Financials


Department Expenditure Trends

Department

FY18 Budget FY18 Actuals FY19 Orig. Budget

FY19 Rev. Budget

FY19 Estimated YE Actuals

FY19 Surplus/ (Deficit)

Police 15,691,689 20,898,127 17,270,551 18,238,494 22,120,096 -3,881,602

Public Health 12,026,726 10,831,216 12,001,726 12,545,259 11,996,259 549,001

Fire 9,354,940 8,817,237 9,154,940 9,623,463 10,990,286 -1,366,824

Sheriff 5,630,186 5,387,756 5,630,186 5,630,186 5,600,338 29,848

Public Works 3,598,881 2,362,963 3,709,007 4,259,007 3,883,670 375,337

Recreation & Parks 3,569,246 2,637,724 3,569,246 4,920,001 3,545,808 1,374,193

Human Services 2,901,364 2,629,920 2,876,364 2,876,364 3,262,581 -386,217

PUC-Water 2,504,098 2,138,127 2,580,723 2,580,723 2,436,107 144,616

SF Airport 2,494,467 2,344,896 2,570,798 2,720,369 2,896,450 -176,081

Juvenile Probation 1,079,467 929,729 1,029,467 1,029,467 496,997 532,470

Total Top Ten Departments 58,851,064 58,977,692 60,393,008 64,423,333 67,228,594 -2,805,261

Total of All City Departments 69,378,135 67,615,222 71,991,903 77,571,049 77,862,793 -291,745

Notes: 1. Expenditures exclude LC4850 salary continuation benefits, and include program admin/overhead 2. All budget figures are Original Budget and do not include carry forwards


Costs by Expenditure Category

FY17-18 Actuals FY18-19 Actuals YTD FY19 Est. YE Actuals YOY Change (%)

INDEMNITY

Temporary Disability 8,220,280 4,081,508 8,163,016 -0.7%

Permanent Disability 15,776,104 8,842,701 17,685,401 10.8%

INDEMNITY SUBTOTAL 23,996,384 12,924,209 25,848,417 7.2%

VOCATIONAL REHABILITATION 226,139 81,259 162,517 -39.1%

MEDICAL 26,044,350 14,922,583 29,845,165 12.7%

EXPENSE 3,040,483 1,611,799 3,223,598 5.7%

RECOVERY (692,535) (268,122) (536,244) -29.1%

GRAND TOTAL 52,614,822 29,271,727 58,543,454 10.1%

Notes: 1. Expenditures reflect benefit payments maintained in the iVOS Financial System, and do not include overhead or LC 4850 salary continuation benefits.

19 Workers' Compensation Council Meeting March 4, 2019 19

Presenter

Presentation Notes

*650k of copy service expenditures are listed under Medical in FY18, not in in Expense, due to fee schedule review and bill review coding

Medical Costs In Focus

HospitalInpatient

HospitalOutpatient

SpecialFacility (incl

ASC)

SkilledNursing Home Health Hospital

Other

2017 1H 63 1,786 211 1 58 12017 2H 91 1,689 155 2 152018 1H 92 2,497 183 6 35 9

0

500

1,000

1,500

2,000

2,500

3,000Bi

ll Co

unt

• The vast majority of hospital procedures are done on an outpatient basis, however the quantity of hospitalizations has increased. Data Source: EK Health Services, Inc.



HospitalInpatient

HospitalOutpatient

Special Facility(incl ASC) Skilled Nursing Home Health Hospital Other

2017 1H $35,157 $492 $2,997 $175 $500 $592017 2H $44,470 $799 $3,105 $5,466 $4942018 1H $36,549 $724 $2,895 $12,268 $442 $690

$0

$5,000

$10,000

$15,000

$20,000

$25,000

$30,000

$35,000

$40,000

$45,000

$50,000

Ave

rage

Allo

wan

ce p

er B

ill

• Positively, average cost per bill has stabilized to 2017 1H levels (January to June, 2017). Data Source: EK Health Services, Inc.


HospitalInpatient

HospitalOutpatient

SpecialFacility (incl

ASC)

SkilledNursing

HomeHealth

HospitalOther

2017 1H $2,214,913 $878,066 $632,384 $175 $28,978 $592017 2H $4,046,796 $1,350,250 $481,343 $10,932 $7,4152018 1H $3,362,514 $1,808,405 $529,722 $73,609 $15,485 $6,213

$0

$500,000

$1,000,000

$1,500,000

$2,000,000

$2,500,000

$3,000,000

$3,500,000

$4,000,000

$4,500,000Al

low

ance

• Despite price stabilization, the increase in bill quantity has resulted in expenditure growth. Data Source: EK Health Services, Inc.



Actuarial Analyses

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200

250

300

350

400

450

500

FY08-09 FY09-10 FY10-11 FY11-12 FY12-13 FY13-14 FY14-15 FY15-16 FY16-17

Mill

ions

CCSF Workers' Compensation Future Liability

• The current and long-term liability, as presented in the CAFR, has grown an average 3.3% year-over-year, over the last five years. Efforts to reduce tail exposure include an increase in Compromise & Releases.


Ultimate Severity & Frequency

• Ultimate Severity, as defined by the average cost per claim is increasing, whereas Ultimate Frequency, defined by claim incidence per $1M of payroll has declined. Source: Willis Towers Watson


Financial Pressures

Upward Cost Pressures • Growing employee population

increases incidence of claims and aggregate costs; 6.8% growth from 7/1/13 to 7/1/17

• Above average incidence of high exposure and catastrophic claims within public safety departments

• Increased activity to settle and close medium to high exposure claims, increasing near-term expenditures but providing long-term cost savings

• Growth in state annual assessment has increased by 10% annually in recent years

Downward Cost Pressures • Alternative Dispute Resolution

("Carveout") will lower claim and litigation costs based on reported savings by other programs

• Expanded fast-track, formulary and other pre-authorization programs deliver benefits faster with less administrative review/expense

• Negotiated savings in document retrieval service contracts took effect in October 2018

• Banking Modernization will lower banking and printing fees in transformation of existing check-issuance framework


Appendix


Appendix 1: Claim Cause Group Definitions

Claim Cause Group Definition Type(s) of Injury Abrasion Injuries sustained as a result of rubbing against a rough

surface/wall Skin

Bodily Motion Injuries sustained due to physical motion, such as bending, lifting, reaching, pulling/pulling, twisting/turning, etc.

Primarily orthopedic injuries.

Caught In, Under, Between Injuries that have occurred due to being pinned by, under or between objects, furniture, or equipment. This includes injuries occurring as a result of a cave-in.

Orthopedic injuries, lacerations, crush injuries.

Cumulative Trauma Use for repetitive stress injuries due to repeated exposure over time.

Single or multiple body parts used in repeated exposure over a period of time – e.g. Carpal Tunnel, prolonged standing, psyche stress.

Explosion Used for injuries sustained as a result of an explosion. Orthopedic, burns, internal, catastrophic injuries, etc.

Exposure

Used for various internal injuries, such as repeated exposure to carcinogens, stressful work situation, or hard physical work leading to a negative bodily reaction. This can also include reactions to poisonous or toxic substances.

Cancer, heart trouble, internal injuries or exposure to poison oak, MRSA, or heat stroke. Also may include foreign substance into eyes or body, or blood borne pathogen exposure.

Fall, Slip or Trip Injuries sustained from a slip and fall, or trips and slips. This includes falls from elevation, from stairs, ladders, onto walkways, etc.

Single or multiple body parts, resulting in sprains, strains, contusions, lacerations, fractures, etc.

Ingestion Injury sustained due to ingesting harmful substance. Internal/exposure.


Appendix 1: Claim Cause Group Definitions, Cont.

Claim Cause Group Definition Type(s) of Injury Misc Miscellaneous injury not covered in other areas or

rarely filed Misc

Personal Injury/Illness Injury that is non-occupational in nature, but aggravated or exacerbated by work.

Personal injury of a orthopedic or internal nature.

Physical Assault Injuries sustained due to physical altercations (being struck or striking person or people).

Single or multiple body parts involved. Results in lacerations, sprains, strains, fractures, abrasions, even internal injuries.

Stress Injuries sustained due to work related stress. Primarily psychological/psychiatric injuries, including any resulting physical symptoms.

Struck By/Against

Injuries when objects are thrown at employees, when an employee is hit by a random moving machine part or object; or collides with an object such as a door or piece of furniture.

Orthopedic or head injuries

Suffocated Injuries sustained due to suffocation, such as during a fire.

Respiratory injuries, smoke inhalation. May overlap with Exposure.

Vehicle Accident Injuries sustained due to a vehicle, including vehicle/pedestrian accident or incident. This may be car or truck, motorcycle, bicycle, scooter, etc.

Orthopedic, single or multiple body parts, head, internal

Vibration Injuries sustained due to vibration or seismic event, such as an earthquake. Orthopedic, internal, head, etc.


Appendix 2: Claim Cause Definitions

Claim Cause Group Claim Cause When Used Abrasion ABRASION/RUBBED Injuries sustained as a result of rubbing against a rough surface/wall

Bodily Motion BENDING/STOOPING Bending down to tie shoes, etc.

Bodily Motion LIFTING Injuries from lifting weights, desks, tables, equipment, etc.

Bodily Motion PUSHING/PULLING Pushing or pulling of furniture, equipment or patients.

Bodily Motion REACHING Reaching for equipment resulting in hyperextension of extremities, etc.

Bodily Motion RUNNING/WALKING Injuries while running (during exercise or running after suspects), stepping off a curb the wrong way, injuries while walking.

Bodily Motion THROWING/WIELDING Injury sustained during baton-use exercise or other use of equipment in a throwing or maneuvering type motion.

Bodily Motion TWISTING/TURNING Injuries resulting from exiting vehicle, maneuvering in small spaces, etc.

Caught In, Under, Between CAUGHT IN, UNDER, BETWEEN Injuries as a result of being pinned under, or between objects, furniture, or equipment.

Caught In, Under, Between CAVE IN Injuries sustained due to being crushed by collapsing debris, such as in a tunnel or collapsing building in a fire.

Cumulative Trauma CONTINUOUS TRAUMA For repetitive stress injury due to repeated exposure over time.

Cumulative Trauma REPEATED MOTION Repetitive stress injury due to continued motion (typing, etc.). May be used interchangeably with CONTINUOUS TRAUMA

Cumulative Trauma REPEATED TRAUMA same as CONTINUOUS TRAUMA

Explosion EXPLOSION Injuries when bombs are set off during demonstrations and protest or fireworks during celebrations. Also may be a gas/fire explosion.


Appendix 2: Claim Cause Definitions, Cont.

Claim Cause Group Claim Cause When Used

Exposure ADVERSE REACTION Dizziness/Fatigue/Headaches due to heat exposure, intense exercise, dehydration, etc. Also could be an allergic reaction or exposure to poisonous substance.

Exposure BODILY REACTION The body's reaction to repeated exposures to carcinogens, stressful work situations, hard physical work. This could also be an allergic reaction to a poisonous substance or toxic substance.

Exposure CONTACT INFECTIOUS AGENT Needle Sticks, Exposure to blood borne pathogens (blood, saliva, urine, etc.)

Exposure CONTACT WITH CHEMICALS Exposure to Toxin, chemicals

Exposure CONTACT WITH ELECTRICITY Electrocution

Exposure CONTACT WITH EXTREME TEMPERATURE Injuries sustained during firefighting or working in extreme heat.

Exposure Contact with Radiation

Exposure DERMAL Dermatitis due to contact with poison oak, poison ivy, etc.

Exposure FOREIGN SUBSTANCE Object/s getting into the eyes

Exposure INHALATION Injuries from smoke inhalation during firefighting, or inhaling chemical vapors.

Exposure SPLASHED Refers to when liquid splashes onto eyes or body. Overlaps with CONTACT INFECTIOUS AGENT.

Fall, Slip or Trip FALL FROM CHAIR Sitting and falling off chair. Chair might have slid from underneath claimant.

Fall, Slip or Trip FALL FROM ELEVATION Fall from a height, such as from a roof.

Fall, Slip or Trip FALL FROM LADDER Injuries while falling off ladder.



Claim Cause Group Claim Cause When Used Fall, Slip or Trip FALL FROM STAIRS Injuries resulting from falling down stairs or steps.

Fall, Slip or Trip FALL FROM VEHICLE Injuries due to an officer falling off a police motorcycle or bicycle.

Fall, Slip or Trip FALL ONTO AGAINST OBJECTS Filed if someone fell onto a certain object or machine, or against an object or machine such as gurneys and side tables

Fall, Slip or Trip FALL SAME LEVEL Slip and Fall due to wet floor,slippery floo. Also used for an employee falling onto the ground (similar to Slip/Trip)

Fall, Slip or Trip FALL SCAFFOLD/WALKWAY Fall from scaffolding/walkway

Fall, Slip or Trip SLIP / TRIP Slipping on wet surface or tripping over object on the floor.

Ingestion INGESTION Sustained due to drinking/eating harmful substance such as chemicals

Misc EVENT TYPE (NEC)

Misc FAULTY EQUIPMENT Injuries from defective chairs, tables and other equipment

Misc FAULTY ROADWAY MTA Injury sustained due to road/street defect such as sinkhole or large pothole. Track/Track issues

Misc UNASSIGNED

Personal Injury/Illness PERSONAL INJURY/ILLNESS Injury or illness of a nonindustrial nature but filed as EE was at work (or aggravated by work).

Physical Assault ASSAULT, PHYSICAL Used for physical assaults by the public, by patients/detainees, or between employees in a Workplace Violence setting

Stress ASSAULT, MENTAL/VERBAL Altercation between co-workers, with the public, patients, etc. Overlaps with STRESS, RELATIONAL CONFLICT



Claim Cause Group Claim Cause When Used Stress RELATIONAL CONFLICT Stress as a result of interpersonal conflicts at work (with Supervisor and/or co-workers)

Stress STRESS MTA MTA uses this for all stress claims

Struck By/Against COLLISION Running into another person at the office, striking a body part (e.g., nose) against another object, Hallway and door collisions

Struck By/Against STRUCK BY FALLING OBJECT Injuries resulting from fighting fires or being hit by an object.

Struck By/Against STRUCK BY MOVING OBJECT Injuries when objects are thrown at employees. May overlap with PHYSICAL ASSAULT. Also if EE is hit by a random moving machine part or object.

Suffocated SUFFOCATED Fighting fires

Vehicle Accident VEHICLE ACCIDENT Motor Vehicle Accidents (City Vehicles, motorcycles), rear-enders, collision with other vehicles

Vehicle Accident VEHICLE OVERTURNED Use VEHICLE ACCIDENT

Vehicle Accident VEHICLE RAN OFF ROADWAY Use VEHICLE ACCIDENT

Vehicle Accident VEHICLE SUDDEN START/STOP Use VEHICLE ACCIDENT

Vibration VIBRATION Earthquake


SFMTA Municipal

Transportation Agency

Worker’s Compensation 12 Month Loss Summary Workers’ Compensation Council

March 4th 2019

Claim Volumes NEW CLAIMS BY TYPE

CLAIM TYPE FY 18-19 July August September October November December January February March April May June FY Total Monthly Average INDEMNITY # 39 38 46 62 44 54 50 333 48 MEDICAL ONLY # 4 7 6 9 4 4 1 35 5 OTHER # 1 4 2 8 11 2 5 33 5 INDEMNITY % 88.64% 77.55% 85.19% 78.48% 74.58% 90.00% 89.29% 83.04% 84.21% MEDICAL ONLY % 9.09% 14.29% 11.11% 11.39% 6.78% 6.67% 1.79% 8.73% 8.77% OTHER % 2.27% 8.16% 3.70% 10.13% 18.64% 3.33% 8.93% 8.23% 7.02%

CLAIM TYPE FY 17-18 July August September October November December January February March April May June FY Total Monthly Average INDEMNITY # 51 54 40 45 57 32 44 52 40 44 45 41 545 45 MEDICAL ONLY # 3 6 5 11 13 7 12 10 6 13 9 2 97 8 OTHER # 2 1 3 3 3 3 2 1 5 3 7 2 35 3 INDEMNITY % 91.07% 88.52% 83.33% 76.27% 78.08% 76.19% 75.86% 82.53% 78.43% 73.33% 73.77% 91.11% 79.75% 80.70% MEDICAL ONLY % 5.35% 9.83% 10.41% 18.64% 17.80% 16.66% 20.68% 15.87% 11.76% 21.66% 14.75% 4.44% 15.03% 15.79% OTHER % 3.58% 1.65% 6.26% 5.09% 4.12% 7.15% 3.46% 1.60% 9.81% 5.01% 11.48% 4.45% 5.22% 3.51%

CLAIM TYPE FY 16-17 July August September October November December January February March April May June FY Total Monthly Average INDEMNITY # 46 41 38 46 36 41 40 36 47 53 60 63 547 46 MEDICAL ONLY # 6 9 8 4 5 4 4 8 13 9 5 6 81 7 OTHER # 0 5 5 1 1 0 0 1 0 1 5 3 22 2 INDEMNITY % 88.46% 74.54% 74.50% 90.19% 85.71% 91.11% 90.90% 80% 78% 84% 86% 87% 83% 85% MEDICAL ONLY % 11.54% 16.36% 15.68% 7.84% 11.90% 8.89% 9.10% 17.77% 22% 14% 7% 8% 14% 13% OTHER % 0.00% 9.10% 9.82% 1.97% 2.39% 0.00% 0.00% 2.33% 0% 2% 7% 5% 3% 2%

CLAIM TYPE FY 15-16 July August September October November December January February March April May June FY Total Monthly Average INDEMNITY # 40 51 44 56 32 58 45 52 59 50 39 39 565 47 MEDICAL ONLY # 6 9 3 7 8 7 2 12 6 9 7 8 84 7 OTHER # 3 0 0 2 0 1 2 1 2 1 2 3 17 1 INDEMNITY % 81.63% 85.00% 93.62% 86.15% 80% 87.87% 91.84% 80% 88% 83% 81% 78% 85% 84% MEDICAL ONLY % 12.24% 15.00% 6.38% 10.77% 20% 10.60% 4.08% 18.46% 9% 15% 15% 16% 13% 12% OTHER % 6.12% 0.00% 0.00% 3.08% 0.00% 1.53% 4.08% 1.54% 3% 2% 4% 6% 2% 4%

CLAIM TYPE FY 14-15 July August September October November December January February March April May June FY Total Monthly Average INDEMNITY # 31 32 43 42 35 42 40 34 31 36 32 45 443 36.92 MEDICAL ONLY # 3 4 5 9 4 6 7 5 9 7 8 7 74 6.17 OTHER # 0 1 1 3 0 1 3 1 1 2 2 1 16 1.33 INDEMNITY % 91.18% 86.49% 87.76% 77.78% 89.74% 85.71% 80.00% 85.00% 75.61% 80.00% 76.19% 84.91% n/a 83.36% MEDICAL ONLY % 8.82% 10.81% 10.20% 16.67% 10.26% 12.24% 14.00% 12.50% 21.95% 15.56% 19.05% 13.21% n/a 13.77% OTHER % 0.00% 2.70% 2.04% 5.56% 0.00% 2.04% 6.00% 2.50% 2.44% 4.44% 4.76% 1.89% n/a 2.86%

Data prior to March 2013 is drawn from Sedgwick data as reported in HR Monthly Reports Other # = First Aid, Future Medical, Reported


Claim Volumes CLAIMS REOPENED

FISCAL YEAR July August September October November December January February March April May June FY Total Monthly Average FY 2018-2019 2 12 6 11 6 3 5 45 6 FY 2017-2018 3 3 8 7 11 4 9 6 13 3 7 6 80 7 FY 2016-2017 11 12 8 3 6 7 2 8 4 9 13 9 92 8 FY 2015-2016 8 7 4 7 4 6 6 6 18 8 7 11 92 8 FY 2014-2015 8 14 5 15 5 3 10 12 7 6 5 7 97 8 FY 2013-2014 8 15 13 13 10 10 16 12 6 7 9 4 123 10

CLAIMS CLOSED

FISCAL YEAR July August September October November December January February March April May June FY Total Monthly Average

FY 2018-2019 45 60 56 71 34 68 74 408 58 FY 2017-2018 52 69 51 53 50 98 58 70 70 69 42 73 755 63 FY 2016-2017 48 67 59 61 68 75 47 60 67 70 62 73 757 63 FY 2015-2016 46 53 45 82 41 99 35 62 72 82 75 69 761 63 FY 2014-2015 41 57 54 69 67 81 54 47 46 54 57 44 671 56 FY 2013-2014 110 88 61 254 74 71 50 52 41 64 57 48 970 81

CLOSING RATIO

FISCAL YEAR July August September October November December January February March April May June FY Total Monthly Average FY 2018-2019 98% 98% 93% 79% 52% 108% 121% 94% 93% FY 2016-2017 76% 100% 100% 113% 136% 144% 102% 113% 105% 97% 75% 90% 102% 104% FY 2015-2016 80.70% 79.10% 88.24% 113.89% 93.18% 137.50% 63.63% 87.32% 84.70% 120.58% 136.36% 113.11% 100% 100% FY 2014-2015 97.62% 111.76% 100.00% 100.00% 152.27% 155.77% 90.00% 90.38% 95.83% 105.88% 121.28% 73.33% 107% 108% FY 2013-2014 183.33% 107.32% 107.02% 416.39% 129.82% 165.12% 98.04% 108.33% 89.13% 100.00% 114.00% 96.00% 145% 143%

CLAIMS PENDING EOM

FISCAL YEAR July August September October November December January February March April May June FY Total Monthly Average

FY 2018-2019 1,616 1,617 1,621 1,640 1,671 1,666 1,653 1,653 1,641 FY 2017-2018 1,620 1,615 1,620 1,633 1,667 1,615 1,624 1,623 1,617 1,611 1,637 1,615 1,615 1,625 FY 2016-2017 1,643 1,643 1,643 1,636 1,616 1,593 1,592 1,585 1,582 1,584 1,605 1,613 1,613 1,611 FY 2015-2016 1,642 1,656 1,662 1,652 1,655 1,628 1,648 1,657 1,670 1,656 1,636 1,628 n/a 1,649 FY 2014-2015 1,673 1,667 1,667 1,667 1,644 1,615 1,621 1,626 1,628 1,625 1,615 1,631 n/a 1,640 FY 2013-2014 1,923 1,917 1,913 1,720 1,703 1,675 1,676 1,672 1,677 1,677 1,670 1,672 n/a 1,741 Data prior to March 2013 is drawn from Sedgwick data as reported in HR Monthly Reports

Other # = First Aid, Future Medical, Reported


Lag Time Report ROLLING 12 REPORTING MONTHS - INJURIES BY DIVISION

DIVISION NAME CLAIM FREQUENCY

Days Between Employer Knowledge and Reported to TPA

Days Between DOI and

Received by TPA ADMIN., TAXIS & ACCESIBLE SERV. 4 -0.50 1.25 ADMINISTRATION 2 56.00 56.00 Administration & Finance 2 4.50 12.00 CABLE CAR & RAIL SYSTEMS 5 160.80 161.60 CHIEF MECHANICAL OFFICER (BUS SECTION) 2 0.00 0.00 CHIEF MECHANICAL OFFICER (RAIL SECTION) 3 4.33 11.67 CITATION DIVISION 0 0.00 0.00 COMMUNICATIONS MAINTENANCE SECTION 1 0.00 2.00 DIESEL MAINTENANCE 3 5.67 5.67 DIRECTOR OF TRANSIT OPS 1 6.00 6.00 DIVISION OF SUSTAINABLE STREETS 23 44.91 46.48 ELECTRICAL MAINTENANCE 19 19.63 29.68 ENFORCEMENT SERVICES 46 19.11 23.33 EXECUTIVE DIRECTOR/CEO 1 13.00 13.00 FINANCE, ADMIN., INFORMATION TECH. 5 0.40 5.00 Islais Creek 3 4.00 4.00 LEGISLATIVE AFFAIRS 0 0.00 0.00 MAINTENANCE / UNASSIGNED 5 7.80 18.00 MAINTENANCE DIVISION 20 3.55 6.25 Muni Metro East 3 9.33 9.33 OPERATIONS / UNASSIGNED 36 51.36 69.97 Parking Authority 8 108.50 154.75 SAFETY, SECURITY & ENFORCEMENT 23 4.30 19.61 STRUCTURE & WAYS 4 10.25 10.75 TAXI COMMISSION 2 15.00 37.50 TECHNICAL SERVICES 0 0.00 0.00 TRANSPORTATION DIVISION (TRAN) 406 20.93 24.94 Not yet assigned 54 6.78 14.41 Grand Total 681 22.26 26.54


Financials

FY 2017/2018 Seven Month Expenditures

FY 2018/2019 Seven Month Expenditures Increase/Decrease % of Change

INDEMNITY Temporary Disability $5,168,363 $5,573,277 $404,914 7.83% Permanent Disability $3,592,388 $2,620,020 ($972,368) -27.07%Total Indemnity $8,760,751 $8,193,298 ($567,453) -6.48%

Total Vocational Rehabilitation $60,359 $52,544 ($7,815) -12.95%

Total Medical $4,016,190 $5,408,454 $1,392,264 34.67%

Total Expense $646,629 $919,857 $273,227 42.25%

RECOVERYTotal Recovery Processed ($92,066) ($518,642) ($426,575) 463.33%

GRAND TOTAL $13,391,864 $14,055,511 $663,648 4.96%

MEDICAL

EXPENSE

Vocational Rehabilitation


Financials Open Claims Stratification: $100K+ Total Incurred = 666

0

50

100

150

200

250

100k-150K

150k-200K

200k-250K

250k-300K

300K-350K

350K-400K

400k-450K

450k-500K

500k-550K

550k-600K

600k-650K

650k-700K

700k-750K

750k-800K

800k-850K

850k-900K

900k-950K

950K-1M

1M+

Total 229 136 115 50 33 17 14 14 8 2 3 5 9 3 3 1 4 3 17

229

136

115

50

33 17 14 14 8 2 3 5 9 3 3 1 4 3

17

Open Claims Stratification by Severity All Policy Years $100K+ Incurred Claims


Litigation Statistics LITIGATION RATIO

FISCAL YEAR 2018-2019

July August September October November December January February March April May June Open Litigated Claims* 412 418 411 410 417 415 421

Open Indemnity Claims* 1,075 1,076 1,076 1,098 1,120 1,119 1,128 Litigated Ratio 38.33% 38.85% 38.20% 37.34% 37.23% 37.09% 37.32% #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!


July August September October November December January February March April May June Open Litigated Claims* 399 409 429 429 428 418 423 423 429 428 433 417

Open Indemnity Claims* 1,077 1,085 1,081 1,094 1,117 1,082 1,079 1,084 1,073 1,079 1,098 1,075 Litigated Ratio 37.05% 37.70% 39.69% 39.21% 38.32% 38.63% 39.20% 39.02% 39.98% 39.67% 39.44% 38.79%



Open Indemnity Claims* 1080 1129 1106 1096 1076 1058 1045 1042 1037 1038 1,052 1,065 Litigated Ratio 33.15% 34.81% 34.63% 35.31% 36.06% 36.48% 36.84% 37.33% 37.70% 36.32% 36.98% 36.71%



Open Indemnity Claims* 1113 1121 1128 1129 1046 1098 1127 1130 1135 1114 1105 1076 Litigated Ratio 37.02% 36.22% 35.73% 35.16% 36.71% 35.06% 34.07% 33.45% 32.69% 32.85% 34.12% 33.83%







*Does not include Future Medical Claims Data prior to March 2013 is unreliable and is excluded


Cause Analysis

CLAIM CAUSE ANALYSISBY FREQUENCY

0

10

20

30

40

50

60

70

80

RepeatedMotion

Assault/Physical

VehicleAccident

Twisting/Turning

Collision Pulling/Pushing

Fall SameLevel (NEC)

Stress-MTA

Continuous Trauma

Struck ByMovingObject

Total 54 72 49 33 18 58 19 20 35 25

54

72

49

33

18

58

19 20

35

25

Top 10 Claim Causes by Frequency Rolling 12 Reporting Months


Cause Analysis

CLAIM CAUSE ANALYSISBY SEVERITY

$0

$200,000

$400,000

$600,000

$800,000

$1,000,000

$1,200,000

$1,400,000

$1,600,000

$1,800,000

RepeatedMotion

Assault/Physical

VehicleAccident

Twisting/Turning

Collision Pulling/Pushing

Fall SameLevel(NEC)

Stress-MTA

Continuous Trauma

Struck ByMovingObject

Total $1,035,932 $1,761,841 $1,184,103 $449,451 $313,927 $966,683 $316,062 $387,586 $657,057 $1,264,429

$1,035,932

$1,761,841

$1,184,103

$449,451

$313,927

$966,683

$316,062 $387,586

$657,057

$1,264,429

Top 10 Claim Causes by Severity Rolling 12 Reporting Months


Cost Analysis CLAIMS CLOSED - ROLLING 12 REPORTING MONTHS ENDING 1/31/2019

CLAIM CAUSE DESCRIPTION CLOSED CLAIMS

TOTAL COST OF CLOSED

CLAIMS

AVERAGE TOTAL COST PER CLAIM

AVERAGE DURATION OF

CLAIM (MONTHS)

AVERAGE COST PER

CLAIM PER MONTH

CLAIM CAUSE DESCRIPTION

CLOSED CLAIMS

TOTAL COST OF CLOSED

CLAIMS

AVERAGE TOTAL COST PER CLAIM

AVERAGE DURATION OF CLAIM (MONTHS)

AVERAGE COST PER CLAIM PER

MONTH

ABRASION/RUBBED 8 $11,220 $1,403 2.21 $116.88 FAULTY ROADWAY-MTA 0 $0 $0 0 $0.00

ADVERSE REACTION 7 $784,827 $112,118 100.20 $9,343.18 Foreign Substance 18 $35,448 $1,969 5.19 $164.11

ASSAULT, MENTAL/VERBAL 23 $287,447 $12,498 9.29 $1,041.47 INGESTION 0 $0 #DIV/0! 0 #DIV/0! ASSAULT, PHYSICAL 72 $2,456,206 $34,114 26.11 $2,842.83 INHALATION 15 $49,323 $3,288 27.69 $274.02

BENDING, STOOPING 5 $16,113 $3,223 5.88 $268.55 LIFTING 17 $470,391 $27,670 21.56 $2,305.84

BODILY REACTION 20 $1,731,344 $86,567 55.32 $7,213.93 Personal Injury/Illness 10 $1,083 $108 1.90 $9.03

CAUGHT IN, UNDER, BETWEEN 21 $167,038 $7,954 8.18 $662.85 PULLING/PUSHING 75 $3,734,280 $49,790 40.18 $4,149.20 COLLISION 15 $830,303 $55,354 8.91 $4,612.79 REACHING 9 $735,311 $81,701 35.90 $6,808.44

CONTACT INFECTIOUS AGENT 2 $10,815 $5,408 2.49 $450.63 REPEATED MOTION 48 $2,331,214 $48,567 28.58 $4,047.25

Contact W/temp Extremes 2 $16,483 $8,242 5.44 $686.79 RUNNING/WALKING 15 $105,147 $7,010 8.06 $584.15

CONTACT WITH CHEMICALS 1 $8,398 $8,398 5.95 $699.83 SLIP/TRIP 26 $2,151,281 $82,742 107.72 $6,895.13

Contact With Electricity 2 $1,430 $715 3.48 $59.58 Splashed 1 $0 $0 1.68 $0.00

CONTINUOUS TRAUMA 58 $3,456,272 $59,591 80.17 $4,965.91 STRESS - MTA 15 $179,201 $11,947 14.17 $995.56

Dermal 3 $4,728 $1,576 4.27 $131.33 STRUCK BY FALLING OBJECT 12 $193,144 $16,095 8.86 $1,341.28

EVENT TYPE (NEC) 8 $8,136 $1,017 3.47 $84.75 STRUCK BY MOVING OBJECT 31 $1,151,581 $37,148 32.30 $3,095.65

Explosion 2 $16,771 $8,386 7.98 $698.79 Throwing/Wielding 2 $3,844 $1,922 7.00 $160.17 FALL FROM CHAIR 4 $11,749 $2,937 13.90 $244.77 TWISTING/TURNING 30 $411,950 $13,732 9.28 $1,144.31

FALL FROM ELEVATION (NEC) 4 $9,523 $2,381 9.51 $198.40 Unassigned 22 $430,205 $19,555 22.04 $1,629.56 Fall From Ladder 1 $34,800 $34,800 43.19 $2,900.00 Vehicle Accident 52 $2,236,757 $43,015 52.81 $3,584.55 FALL FROM STAIRS 5 $1,491 $298 3.25 $24.85 Vehicle Off Roadway 1 $1,607 $1,607 3.75 $0.00 FALL ONTO AGAINST OBJECTS 1 $165,051 $165,051 41.88 $13,754.25 Vehicle Overturned 1 $134,921 $134,921 29.25 $11,243.42

FALL SAME LEVEL (NEC) 26 $330,950 $12,729 14.06 $1,060.74 VEHICLE SUDDEN STOP/START 17 $153,300 $9,018 13.67 $751.47

Fall/Scaffold,Walkway 1 $155 $155 3.15 $12.92 VIBRATION 0 $0 #DIV/0! 0.00 #DIV/0!

Fall From Vehicle 4 $63,731 $15,933 4.76 $1,327.73

TOTAL CLAIMS, TOTAL COST, AVERAGE COST 713 $25,012,524 $35,081 32.73 $2,923.39

FAULTY EQUIPMENT - MTA 1 $77,553 $77,553 129.25 $6,462.75


4790 4856

5,729 5,723

5,885 5,919 5,962

5,749

5,918 5,917 5,898

562 539

654 657 693

707 716 679

655 670

667

11.73 9.55 10.64 9.71 10.51

4400

4600

4800

5000

5200

5400

5600

5800

6000

0

100

200

300

400

500

600

700

800

Nov

-13

Jan-

14

Mar

-14

May

-14

Jul-1

4

Sep-

14

Nov

-14

Jan-

15

Mar

-15

May

-15

Jul-1

5

Sep-

15

Nov

-15

Jan-

16

Mar

-16

May

-16

Jul-1

6

Sep-

16

Nov

-16

Jan-

17

Mar

-17

May

-17

Jul-1

7

Sep-

17

Nov

-17

Jan-

18

Mar

-18

May

-18

Jul-1

8

Sep-

18

Nov

-18

Jan-

19

Agency Injury Rate Claims Incurred During Prior 12 Months

per 100 Employees

Active Employees

Rolling 12 Month Aggregate

Injury Rate per 100 Employees

11.32


Claims Denied

9

26

8

17

12 12

17

9

15

9

11

18

9

17

12

17

8 8

6

18

10

17

6

14

20

12

10

15

10

14

6

12

20

31

13

15

17

25

14 14 15

16

12

14

21

17

10 9

12

18

14

19

15

0

5

10

15

20

25

30

35


Division Statistics ROLLING 12 REPORTING MONTHS - INJURIES BY DIVISION

DIVISION NAME CLAIM FREQUENCY PERCENT OF ALL

CLAIMS IN PERIOD CLAIM SEVERITY PERCENT OF TOTAL

INCURRED FOR PERIOD ADMIN., TAXIS & ACCESIBLE SERV. 4 0.59% $34,000 0.26% ADMINISTRATION 2 0.29% $63,000 0.47% ADMINISTRATION & FINANCE 2 3.77% $3,120 0.47% CABLE CAR & RAIL SYSTEMS 7 1.03% $100,362 0.75% CHIEF MECHANICAL OFFICER (BUS SECTION) 2 0.29% $925 0.01% CHIEF MECHANICAL OFFICER (RAIL SECTION) 3 0.44% $1,363 0.01% CITATION DIVISION 0 0.00% $0 0.00% COMMUNICATIONS MAINTENANCE SECTION 1 0.15% $17,000 0.13% DIESEL MAINTENANCE 3 0.44% $35,849 0.27% Director of Transit 1 1.89% $17,000 2.54% DIVISION OF SUSTAINABLE STREETS 23 3.38% $452,368 3.39% ELECTRICAL MAINTENANCE 19 2.79% $352,531 2.65% ENFORCEMENT SERVICES 46 6.75% $871,274 6.54% EXECUTIVE DIRECTOR/CEO 1 0.15% $0 0.00% FINANCE, ADMIN., INFORMATION TECH. 5 0.73% $4,424 0.03% Islais Creek 3 0.44% $54,872 0.41% LEGISLATIVE AFFAIRS 0 0.00% $0 0.00% MAINTENANCE / UNASSIGNED 5 0.73% $35,487 0.27% MAINTENANCE DIVISION 20 2.94% $695,130 5.22% Muni Metro East 3 0.44% $17,000 0.13% OPERATIONS / UNASSIGNED 36 5.29% $381,485 2.86% Parking Authority 8 1.17% $22,537 0.17% SAFETY, SECURITY & ENFORCEMENT 23 3.38% $506,981 3.80% STRUCTURE & WAYS 4 0.59% $44,804 0.34% TAXI COMMISSION 2 0.29% $27,679 0.21% TECHNICAL SERVICES 0 0.00% $0 0.00% TRANSPORTATION DIVISION (TRAN) 405 59.47% $8,916,248 66.91% Not yet assigned 53 7.78% $669,771 5.03% Grand Total 681 100.00% $13,325,208 100.00%


Division Statistics ROLLING 12 REPORTING MONTHS - INJURIES BY LOCATION FOR TRANSPORTATION DIVISION

TRANSPORTATION DIVISION - LOCATION NAME

CLAIM FREQUENCY

PERCENT OF ALL CLAIMS IN PERIOD

CLAIM SEVERITY

PERCENT OF TOTAL INCURRED FOR PERIOD

BUS TRANSPORATION SECTION 29 7.16% $1,498,508 16.81% CABLE CAR CABLE TRANSPORTATION UNIT 39 9.63% $1,081,230 12.13% CENTRAL CONTROL 0 0.00% $0 0.00% DATA COLLECTION UNIT 1 0.25% $17,000 0.19% DISPATCH UNIT RAIL & BUS 0 0.00% $0 0.00% DIVISION OPERATIONS 0 0.00% $0 0.00% FLYNN MOTOR COACH TRANSPORTATION UNIT 42 10.37% $848,757 9.52% GREEN METRO RAIL TRANSPORTATION UNIT 34 8.40% $609,028 6.83% KIRKLAND MOTOR COACH TRANSPORTATION UNIT 40 9.88% $749,499 8.41% METRO RAIL TRANSPORTATION UNIT 4 0.99% $181,088 2.03% POTRERO ELECTRIC TROLLEY TRANSPORTATION 65 16.05% $1,024,015 11.48% PRESIDIO 0 0.00% $0 0.00% PRESIDIO ELECTRIC TROLLEY TRANSPORTATION 10 2.47% $197,602 2.22% PRESIDIO TROLLEY COACH 19 4.69% $580,022 6.51%

RAIL TRANSPORTATION SECTION 1 0.25% $101 0.00% SAFETY/TRAINING 0 0.00% $0 0.00% SCHEDULES SECTION 1 0.25% $83,462 0.94% STATION OPERATIONS 6 1.48% $123,676 1.39% STREET SUPERVISION 2 0.49% $39,600 0.44% TRANSPORTATION DIVISION II (TRAN) 40 9.88% $618,245 6.93% WOODS MOTOR COACH TRANSPORTATION UNIT 68 16.79% $1,167,945 13.10% Null 4 0.99% $96,470 1.08% Grand Total 405 100.00% $8,916,248 100.00%


Report Definitions CLAIM VOLUMES

Category Method Notes

Claims Opened iVOS - Claim_Log (Main) Add Date (claim) = each month; Format = PDF; data prior to March 2013 is unreliable in iVOS, and is drawn from Sedgwick data as reported in HR Monthly Report New Claims by Type iVOS - Claim_Log (Main) Add Date (claim) = each month; Format = PDF

Claims Re-Opened iVOS - SFMTAClaimStatusMain (Main) Reporting History Period by each month; Format = PDF; data prior to March 2013 is unreliable in iVOS, and is drawn from Sedgwick data as reported in HR Monthly Report

Claims Closed iVOS - SFMTAClaimStatusMain (Main) Reporting History Period by each month; Format = PDF; data prior to March 2013 is unreliable in iVOS, and is drawn from Sedgwick data as reported in HR Monthly Report

Closing Ratio Calculation % "Claims Closed"/("Claims Opened" + "Claims Reopened")

Claims Pending EOM iVOS - SFMTAClaimStatusMain (Main) Reporting History Period by month; Format = PDF; data prior to March 2013 is based on formula calculated backwards from March 2013 FINANCIALS


Payments Issued iVOS - LossRunMTA (Main) Reporting History Period by each month; Format = PDF; Reporting History Period = FY2013-2014; Reporting History Period = FY2012-2013

Open Claims Financials iVOS - LossRunMTA (Main) Reporting History Period = Last Month; Period Claimant Status = Open; Format = PDF; Data from Paid, Outstanding and Incurred columns Open Claims Stratification iVOS - LossRunMTA (Main) Reporting History Period = Last Month; Format = Excel Data Only; Pivot table filtered for "Open" and grouped by $50K

LITIGATION STATISTICS Category Method Notes

Open Litigated iVOS - SFMTAClaimStatusMain (Main) Reporting History Period by each month; Litigated (claimant) = checked; Format = PDF; Data from Ending Open column (Indemnity row); data prior to March 2013 is unreliable in iVOS and is excluded

Open Indemnity iVOS - SFMTAClaimStatusMain (Main) Reporting History Period by each month; Format = PDF; Data from Ending Open column (Indemnity row); data prior to March 2013 is unreliable in iVOS and is excluded

CAUSE ANALYSIS Category Method Notes

Cause by Frequency iVOS - LossRunMTA (Main) Reporting History Period = Last Month; Add Date (Claim) = last 12-month period; Format = Excel Data Only; Pivot Table filtered for top-10 Causes by count of Claim Numbers

Cause by Severity iVOS - LossRunMTA (Main) Reporting History Period = Last Month; Add Date (Claim) = last 12-month period; Format = Excel Data Only; Pivot Table filtered for top-10 Causes by sum Payment Amounts

Closed Claims iVOS - LossRunMTA (Main)

Reporting History Period = Last Month; Closed Date (claimant) = last 12-month period; Period Claimant Type (claimant_reporting_history) = First Aid, Medical, Indemnity, Future Medical, Disability Retirement (excludes Reported, Pending); Format = Excel Data Only, calculate Duration (Months), calculate Average Monthly Cost; Pivot Table with Totals and Averages, calculate Average Cost per Claim per Month

Cause Determination Department and Adjuster Verification Cause codes are provided utilizing the NCCI mandated codes for State reporting purposes. The cause is determined by the department reporting the claim within SFMTA, our new set-up staff importing the claim to the system and the final review by the claims adjuster when managing the claim.

DIVISION STATISTICS Category Method Notes

Injuries by Division iVOS - LossRunMTA (Main) Reporting History Period = Last Month; Incident Date = last 12-month period; Format = Excel Data Only; Pivot Table filtered for top-10 Divisions by count of Claim Numbers and sum of Payment Amounts

INJURY RATE


Injury Rate Per Month iVOS - LossRunMTA (Main) Reporting History Period = Last Month; Incident Date = last 12-month period; Format = PDF No Detail/ FTE # from SFMTA

LAG TIME REPORT


Lag Time Information iVOS- LagTime Report Reporting History Period = Last Month; Add Date =last 12-month period; Sort by Division, Format = PDF No Detail


Claim Cause Definitions I. Burn or Scald — Heat or Cold Exposures — Contact With 01. Chemicals: Includes Hydrochloric Acid, Sulfuric Acid, Battery Acid, Methanol, Antifreeze 02. Hot Objects or Substances: 11. Cold Objects or Substances: 03. Temperature Extremes: Non-Impact Injuries Resulting in a Burn Due to Hot or Cold Temperature Extremes, includes Freezing or Frostbite 04. Fire or Flame: 05. Steam or Hot Fluids: 06. Dusts, Gases, Fumes or Vapors: Includes Inhalation of Carbon Dioxide, Carbon Monoxide, Propane, Methane, Silica (Quartz), Asbestos Dust and Smoke 07. Welding Operations: Includes Welder’s Flash (Burns to Skin or Eyes as a Result of Exposure to Intense Light from Welding 08. Radiation: Includes Effects of Ionizing Radiation Found in X-Rays, Microwaves, Nuclear Reactor Waste, and Radiating Substances and Equipment. Includes Non-Ionizing Radiation Such as Sunburn 14. Abnormal Air Pressure: 84. Electrical Current: Includes Electric Shock, Electrocution and Lightning 09. Contact With, NOC: Not Otherwise Classified in Any Other Code. Includes Cleaning Agents and Fertilizers II. Caught In, Under or Between 10. Machine or Machinery: Running or Meshing Objects, a Moving and a Stationary Object, Two or More Moving Objects 12. Object Handled: Includes Medical Hospital Bed and Parts, Wheelchair, Clothespin Vise 20. Collapsing Materials: Slides of Earth 13. Caught In, Under or Between, NOC: Either Man-Made or Natural, Not Otherwise Classified in Any Other Code III. Cut, Puncture, Scrape Injured by 15. Broken Glass: 16. Hand Tool, Utensils; Not Powered: Includes Needle, Pencil, Knife, Hammer, Saw, Axe, Screwdriver 17. Object Being Lifted or Handled: Includes Being Cut, Punctured or Scraped by a Person or Object Being Lifted or Handled 18. Powered Hand Tool, Appliance: Includes Drill, Grinder, Sander, Iron, Blender, Welding Tools, Nail Gun 19. Cut, Puncture, Scrape, NOC: Not Otherwise Classified in Any Other Code. Includes Power Actuated Tools IV. Fall, Slip or Trip Injury 25. From Different Level (Elevation): Includes Collapsing Chairs, Falling from Piled Materials, Off Wall, Catwalk, Bridge 26. From Ladder or Scaffolding: 27. From Liquid or Grease Spills: 28. Into Openings: Includes Mining Shafts, Excavations, Floor Openings, Elevator Shafts 29. On Same Level: 30. Slip, or Trip, Did Not Fall: Slip or Trip and Did Not Come in Contact with the Floor or Ground 32. On Ice or Snow: 33. On Stairs: 31. Fall, Slip or Trip, NOC: Not Otherwise Classified in Any Other Code. Includes Tripping Over Object, Slipping or Organic Materials V. Motor Vehicle 40. Crash of Water Vehicle: 41. Crash of Rail Vehicle: 45. Collision or Sideswipe with Another Vehicle,: Vehicle Collision, Both Vehicles in Motion 46. Collision with a Fixed Object:: Collision Occurring with Standing Vehicle or Stationary Object 47. Crash of Airplane: 48. Vehicle Upset: Includes Overturned or Jackknifed 50. Motor Vehicle, NOC: Not Otherwise Classified in Any Other Code. Includes Injuries Due to Sudden Stop or Start, Being Thrown against Interior Parts of the Vehicle and Vehicle Contents Being Thrown against


Claim Cause Definitions, Con’t VI. Strain or Injury by 52. Continual Noise: Injury to Ears or Hearing Due to the Cumulative Effects of Constant or Repetitive Noise 53. Noise: 53. Twisting : Free Bodily Motion That Imposes Stress or Strain on Some Part of Body. Includes Assumption of Unnatural Position, Involuntary Motions Induced by Sudden Noise, Fright , loss of balance 54. Jumping or Leaping: 55. Holding or Carrying: Applies to Objects or People. Includes Restraining a Person 56. Lifting: Includes Objects or People 57. Pushing or Pulling: Includes Objects or People 58. Reaching: 59. Using Tool or Machinery: 61. Wielding or Throwing: Physical Effort or Overexertion from Attempts to Resist a Force Applied by an Object Being Handled 97. Repetitive Motion: Cumulative Injury or Condition Caused by Continual, Repeated Motions; Strain by Excessive Use, Carpel Tunnel 60. Strain or Injury by, NOC: Not Otherwise Classified in Any Other Code VII. Striking Against or Stepping on NOTE: Applies to Cases in Which the Injury Was Produced by the Impact Created by the Person, Rather than by the Source 65. Moving Part of Machine: 66. Object Being Lifted or Handled: 67. Sanding, Scraping, Cleaning Operation: 68. Stationary Object: 69. Stepping on Sharp Object: 70. Striking Against or Stepping on, NOC: Includes Scratches or Abrasions Caused by Sanding, Scraping, Cleaning Operations, Not Otherwise Classified in Any Other Code VIII. Struck or Injured by NOTE: Applies to Cases in Which the Injury Was Produced by the Impact Created by the Source of Injury, Rather than by the Injured Person 74. Fellow Workers, Patient or Other Person: 75. Falling or Flying Object: 76. Hand Tool or Machine in Use: Struck by Co-Worker, Either on Purpose or Accidentally. Includes Being Struck by a Patient While Lifting or Moving Them Not in Act of a Crime 77. Motor Vehicle: Applies When a Person is Struck by a Motor Vehicle, Including Rail Vehicles, Water Vehicles, Airplanes 78. Moving Parts of Machine: 79. Object Being Lifted or Handled: Includes Dropping Object on Body Part 80. Object Handled by Others: Includes Another Person Dropping Object on Injured Person’s Body Part 85. Animal or Insect: Includes Bite, Sting or Allergic Reaction 86. Explosion or Flare Back: Rapid Expansion, Outbreak, Bursting, or Upheaval. Includes Explosion of Cars, Bottles, Aerosol Cans, or Buildings. “Flare back” Involves Superheated Air and Combustible Gases 81. Struck or Injured, NOC: Not Otherwise Classified in Any Other Code. Includes Kicked, Stabbed, Bitten IX. Rubbed or Abraded by 94. Repetitive Motion: Caused by Repeated Rubbing or Abrading; Applies to Non-Impact Cases in Which the Injury Was Produced by Pressure, Vibration or Friction between the Person and the Source of Injury. 95. Rubbed or Abraded, NOC: Not Otherwise Classified in Any Other Code. Includes Foreign Body in Ears X. Miscellaneous Causes 82. Absorption, Ingestion or Inhalation, NOC: Not Otherwise Classified in Any Other Code. Applies Only to Non- Impact Cases in Which the Injury Resulted from Inhalation, Absorption (Skin Contact), or Ingestion of Harmful Substance 87. Foreign Matter (Body) in Eye(s): Injury to Eyes Resulting from Foreign Matter That is Not Otherwise Classified in Any Other Code 88. Natural Disasters: Injury Resulting from Natural Disaster. Includes Hurricane, Earthquake, Tornado, Flood, Forest Fire


report to the san francisco workers’ compensation council...46 46% 42 42% airport 97 32 33% 26 27%...

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