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

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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