general assembly on article 63 state employee workplace ... · gagement program. the swcp covers...
TRANSCRIPT
![Page 1: General Assembly on Article 63 State Employee Workplace ... · gagement program. The SWCP covers approximately 108,000 state employees as of June 30, 2017; thus, constant vigilance](https://reader033.vdocument.in/reader033/viewer/2022043004/5f85492f2994477a536299a2/html5/thumbnails/1.jpg)
R E P O R T T O
General Assembly on Article 63 State Employee Workplace Requirements Program
for Safety, Health & Workers’ Compensation
Report compiled by: North Carolina Office of State Human Resources - Safety, Health & Workers’ Compensation Division
![Page 2: General Assembly on Article 63 State Employee Workplace ... · gagement program. The SWCP covers approximately 108,000 state employees as of June 30, 2017; thus, constant vigilance](https://reader033.vdocument.in/reader033/viewer/2022043004/5f85492f2994477a536299a2/html5/thumbnails/2.jpg)
Members of the North Carolina General Assembly,
I am pleased to provide this report outlining the activitiesandaccomplishmentsoftheOfficeofState HumanResources’(OSHR)Safety,HealthandWorkers’ CompensationDivision(SHWC)forfiscalyear2017. ThisreportispursuanttoNCGS§143-583.Ourofficeis proudtohighlighttheprogressoftheStateWorkers’ CompensationProgram(SWCP)duringthefiscalyear. IntheAppropriationsActof2015,theGeneralAssembly designatedspecificunspentfunds—originally appropriatedforuseinFiscalYear2016—betransferred toOSHRforuseinsettlingworkers’compensationclaims forFY2017.Becauseofthisastutedecision,funds totaling$4,389,797wereavailableforOSHRtoallocate to state agencies and universities to assist in claims settlements.Thesefundshavegeneratedprojectedfuture costavoidanceofatleast$51.9milliondollars.
TheSHWC’seffectivework,outreach,andresourcefulnessisevidencedbythecontinueddeclineintotalclaimsinFY17.The4,379newclaimsfiledinFY17representsa19%percentdeclineoverthepastfourfiscalyears.ThissteadydecreaseindicatesanincreasedawarenessofworkplacehazardsbyStateagency/universityemployeesandemployers.Thedecreasealsosignifiestheimportanceofaddressingworkplacehazardsbeforeaninjuryoccursbyhavingacomprehensiveemployeeen-gagementprogram.TheSWCPcoversapproximately108,000stateemployeesasofJune30,2017;thus,constantvigilancetoreducesafetyhazards,ongoingsafetyandhazardawarenesstraining,andcontinuing management commitment to a strong safety culture are necessary to continue reducing the numberofinjuriesthatoccureachyear.
OSHRandtheSHWCDivisionwillcontinuetobeproactiveinreducingcostsandinjuriesbyprovidingbest practices, continuing to improve our robust employee engagement strategies, and collaborating withagenciesanduniversities.
If you have any questions or need further information, please do not hesitatetoletusknow.
Sincerely,
BarbaraGibsonDirectorOfficeofStateHumanResources
BarbaraGibson,DirectorOfficeofStateHumanResources
1
![Page 3: General Assembly on Article 63 State Employee Workplace ... · gagement program. The SWCP covers approximately 108,000 state employees as of June 30, 2017; thus, constant vigilance](https://reader033.vdocument.in/reader033/viewer/2022043004/5f85492f2994477a536299a2/html5/thumbnails/3.jpg)
Table of Contents
Introduction&ExecutiveSummary
DivisionStructure
SummaryofFY2017SafetyActivities
SummaryofFY2017Workers’CompensationActivities
Conclusion
2
3
19
7
5
4
![Page 4: General Assembly on Article 63 State Employee Workplace ... · gagement program. The SWCP covers approximately 108,000 state employees as of June 30, 2017; thus, constant vigilance](https://reader033.vdocument.in/reader033/viewer/2022043004/5f85492f2994477a536299a2/html5/thumbnails/4.jpg)
Introduction & Executive Summary
NCGS§143-583requirestheOfficeofStateHumanResources(OSHR)toannuallyfilethisreportnolaterthanSeptember1ofeachyearwiththeJointLegislativeCommission on Governmental Operations describing the safety,health,andworkers’compensation activities of Stateagencies,compliancewithChapter143,Article63andfinesleviedagainststateagencies pursuant to Chapter 95,Article16.
ThisreportincludesadescriptionoftheFY2017activitiesoftheOSHRSafetyHealthandWorkers’CompensationDivision.Statewideworkplacesafety,hazardidentification,andoutreachprogramsaredetailedherein.StateWorkers’Compensation Program performance metrics and a description of the Division’s effortstoimproveoverallclaimsmanagementthroughpartnershipswithcontracted vendors and ongoing education, communication, and resources providedtoStateagenciesanduniversitiesarealsodescribed.
3
![Page 5: General Assembly on Article 63 State Employee Workplace ... · gagement program. The SWCP covers approximately 108,000 state employees as of June 30, 2017; thus, constant vigilance](https://reader033.vdocument.in/reader033/viewer/2022043004/5f85492f2994477a536299a2/html5/thumbnails/5.jpg)
Division Structure
TheOSHRSafety,HealthandWorkers’Compensation(SHWC)Divisionadministersthestate’sprogramspursuanttotheguidelinesinNCGSChapter143,Article63.
Division Functions:OversightofStatewideSafetyandHealthProgram,including:• Consultswithagenciesanduniversitiesintheareasofsafety,healthandindustrial hygiene• Reviewsagencysafetypolicies/programs;researchesandadvisesagencieson safety-relatedmatters• Audits agency, university and vendor performance regarding to adherence to safety activities• WorksinpartnershipwithstatewidesafetyprofessionalsaspartoftheStatewide Safety&HealthSteeringCommittee
Oversight of State Workers’ Compensation Program (SWCP),including:• Administersallvendorcontractsforworkers’compensation-related services• Directs claims management and administration practices by establishing business processesforagencies/universitiesandvendors• Monitors vendors’ adherence to contract requirements by establishing performance measures• Assistsagenciesanduniversitieswithproperclaims handling• Providesclaimshandling/managementtraining/education to agency and university employees• Servesason-callinformationresourceforagencyand universityworkers’compensationadministrators• Evaluates agency and university claims management practices as compared to established standards• Monitors claim litigation and settlements• HandlesprocessforawardingWorkers’Compensation SettlementReserveFunds appropriated by NC General Assembly• Identifiesongoingclaimsforimprovedoutcomeandcost containment opportunities
4
![Page 6: General Assembly on Article 63 State Employee Workplace ... · gagement program. The SWCP covers approximately 108,000 state employees as of June 30, 2017; thus, constant vigilance](https://reader033.vdocument.in/reader033/viewer/2022043004/5f85492f2994477a536299a2/html5/thumbnails/6.jpg)
Summary of FY 2017 Safety Activities
A. Workplace Requirements Safety and Health Outreach Program for Universities and Agencies
TheOfficeofStateHumanResources(OSHR),DivisionofSafety,HealthandWorkers’CompensationadministersStateprogramspursuanttoNCGSChapter143,Article63,StateEmployeesWorkplaceRequirementsProgramforSafety,Health,andWorkers'Compensation.Pursuanttothisstatutoryauthority,OSHRprovidesallStateagenciesandUNCSysteminstitutionswithsafetyexpertiseandadministersaworkers’compensationclaimsadministrationprogramontheirbehalf;however,OSHRisnotaregulatoryagencythatissuescitationsorfines.
InFY2017,OSHRdevelopedanOutreachProgramtoachievetherequirementsofNCGSChapter143,Article63whilesimultaneouslybuildingpartnershipswithStateagenciesanduniversities.
TheOutreachProgramconsistsofreviewingsafetyandhealthprograms,policies,procedures, documentation of safety reports, training programs and records, safety goals, injuryanalysis,hazardassessments,safetycommitteemeetingminutes,andacampusorfacilitytourincludingmaintenanceshops,grounds,andlaboratories.
OSHR’sgoalistoworkwithagenciesanduniversitiestoensureaworkplacefreeofhazards.Workplacesafetyfunctionsoperatebestwhenmanagementcommitment,employeeinvolvement,hazardrecognition,andeffectivetrainingcometogether.Afoundationofworkplacesafetybuiltwiththesefourprincipleswillyieldasuccessfulsafetyprogram.
Todate,theOutreachProgramhasbeenconductedatfiveUNCSysteminstitutions.TheOutreachProgramwillcontinuewithStateagenciesanduniversitiesthroughoutFY2018.
B. Safety and Hazard Education and Training
SHWCDivisionstaffconductednumerousergonomicevaluationsatvariousstateagencies.Ergonomicevaluationswereconductedfollowinganemployeereportofdiscomfortattheirworkstationorasapreventativemeasuretoreducepotentialfutureinjures.SHWCDivisionstaffarehelpingagenciestrainandestablishtheirownergonomicevaluationteamssocontinuedevaluationscanbeconductedbyagencypersonnel.
SHWCDivisionstaffhavealsodevelopedanduploadedtotheagencywebsiteseveralsafetymodelprogramsthatcanbeimplementedbyagenciesanduniversitieswithintheiroperationsortoenhancetheircurrentprograms.
5
![Page 7: General Assembly on Article 63 State Employee Workplace ... · gagement program. The SWCP covers approximately 108,000 state employees as of June 30, 2017; thus, constant vigilance](https://reader033.vdocument.in/reader033/viewer/2022043004/5f85492f2994477a536299a2/html5/thumbnails/7.jpg)
C. NC Department of Labor (DOL) Inspection Activity regarding citations & fines for State Agencies and Universities in FY 17
TheNorthCarolinaDepartmentofLabor,DivisionofOccupationalSafetyandHealthconductedinspectionsorrespondedtocomplaintsinStategovernmentfacilities.
Open Date
Inspection Number
Establishment Name
Total Violations
Other Violations
Initial Penalty
Current Penalty
Paid Penalty
Close Date
8/10/216 318084654 TheNonwovens Institute, North CarolinaStateUniversity
2 0 $8,700 $8,700 $0 Open
2/16/2017 318099009 NCDPS–Central Prison
3 0 $6,300 $6,300 $6,300 4/24/2017
2/28/2017 318100245 NCDPS–NC Correctional Institution for Women
1 0 $6,300 $6,300 $6,300 4/26/2017
5/25/2017 318107984 UNC at Chapel Hill
4 2 $4,125 $4,125 $0 Open
5/30/2017 318108057 NCDOTSafety&Risk Management
3 1 $9,000 $9,000 $0 Open
Total Inspections Listed: 5 13 3 $34,425 $34,425 $12,600 This list includes only agencies, universities or organizations that were levied
a financial penalty by the Department of Labor.
6
Description StateGovernment
Total Current Penalty Assessed $35,425
Total Initial Penalty Assessed $34,425
TotalCitationsIssued4 4
TotalInspectionswithoutCitations 20
TotalInspectionsStillPending(NotComplete)
TotalInspectionswithCitations1 0
Total Inspections Conducted 32
TotalInspectionsListed3 2
2
![Page 8: General Assembly on Article 63 State Employee Workplace ... · gagement program. The SWCP covers approximately 108,000 state employees as of June 30, 2017; thus, constant vigilance](https://reader033.vdocument.in/reader033/viewer/2022043004/5f85492f2994477a536299a2/html5/thumbnails/8.jpg)
Summary of FY 2017 Workers’ Compensation Activities
TheOSHRStateWorkers’CompensationManagerandWorkers’CompensationConsultantsworkdirectlywithstateagencyHRstaff,contractedvendors,andtheNCDepartmentofJustice-Workers’CompensationSectiontoadministerallStateWorkers’CompensationProgramclaims.Claimsmanagement includes ongoing implementation of adopted best practices throughout the entire claims administration processwhosedurationvariesfromonedaythroughtheremainderoftheinjuredemployee’slifetime.
Performance metrics reveal ongoing improvement in claim outcomes, cost containment,andfuturecostavoidance.The charts herein highlight several quantifiabletrendsattributabletoincreasedOSHRandagencyinvolvementindailyclaimshandlingworkingincollaborationwithcontractedvendors.
7
![Page 9: General Assembly on Article 63 State Employee Workplace ... · gagement program. The SWCP covers approximately 108,000 state employees as of June 30, 2017; thus, constant vigilance](https://reader033.vdocument.in/reader033/viewer/2022043004/5f85492f2994477a536299a2/html5/thumbnails/9.jpg)
Continuous Improvement - Number of Total Claims Continues to Decline in FY17
FY2013-2015:13%ReductioninWorkplaceInjuriesFY2013-2016:15%ReductioninWorkplaceInjuriesFY2013-2017:19%ReductioninWorkplaceInjuries
The4,379newclaimsfiledinFY17representsa19%percentdeclineoverthepastfourfiscalyears.ThissteadydecreaseindicatesanincreasedawarenessofworkplacehazardsbyStateagency/universityemployeesandemployersandtheimportanceofaddressingthembeforeaninjuryoccurs.TheSWCPcoversapproximately108,000stateemployeesasofJune30,2017;thus,constantvigilancetoreducesafetyhazards,ongoingsafetyandhazardawareness
8
![Page 10: General Assembly on Article 63 State Employee Workplace ... · gagement program. The SWCP covers approximately 108,000 state employees as of June 30, 2017; thus, constant vigilance](https://reader033.vdocument.in/reader033/viewer/2022043004/5f85492f2994477a536299a2/html5/thumbnails/10.jpg)
Increased Total Workers’ Compensation Expenditures for Claim Settlements Will Yield Future Cost Savings
Theincreaseintotalworkers’compensationexpendituresforFY17overFY16islargelyattrib-utabletotheincreaseinfullandfinalclaimsettlements.Withtheadjustmentforclaimsettle-ments,overalltotalworkers’compensationexpendituresactuallydecreasedfrom$76,982,082 to $75,063,945, a total cost savings of $1,918,137fromFY16toFY17.ThesesavingsareattributabletoincreasedagencyinvolvementinclaimshandlinginaccordancewithOSHRstandardoperatingprocedures,decreasedfeesforselectservicesinnewvendorcontractseffectiveJanuary1,2016,andsavingsderivedfromfullsettlementandclosureofmanyolderclaimsinFY16andFY17whichgeneratedsubstantialannualcostsforindemnityandongoingmedicaltreatmentincludingprescriptiondrugs.
SeveralagenciesanduniversitieshaveimplementedorarecurrentlyintheprocessofimplementingextensiveReturnToWorkprograms.Inaddition,someagenciesarenowmakingconcertedeffortstosettleclaimsassoonaspracticablerecognizingopportunitiesforconsiderablepotentialclaimcostsavingsbysettlingnowversuspayingbenefitsformanyyearsintothefuture.
9
![Page 11: General Assembly on Article 63 State Employee Workplace ... · gagement program. The SWCP covers approximately 108,000 state employees as of June 30, 2017; thus, constant vigilance](https://reader033.vdocument.in/reader033/viewer/2022043004/5f85492f2994477a536299a2/html5/thumbnails/11.jpg)
Theapproximately103%increaseinthenumberoffinalclaimsettlementsbetweenFY15(191)andFY17(387)hasresultedintremendousincreasesinprojectedfuturecostavoidancefortheSWCP.MorespecificallyfromFY15toFY17,stateagenciesincreasedsettlementexpendituresbyapproximately218%percentwithanapproximate1,572% percentincreaseinprojectedfuturecostavoidanceasdetailedbelow.
Number of
Settlements Settlement
Costs Cost Avoidance
FY 2015 191 $7,150,009 $ 5,712,632 Number of
Settlements Settlement
Costs Projected Future Cost Avoidance
FY 2016 352 $18,788,444 $66,207,101 Number of
Settlements Settlement
Costs Projected Future Cost Avoidance
FY 2017 387 $22,712,335 $95,506,329
SHWCstaffassistsstateagencieswithidentifyingofclaimsettlementopportunitiesonanongoingbasis.SHWCcontinueseducatingagenciesregardingthehighfuturecost-avoidancepotentialassociatedwithsettlingcertainclaims,especiallythosewithhighprojectedfutureindemnityandlowprojectedfuturemedicalcosts.
10
![Page 12: General Assembly on Article 63 State Employee Workplace ... · gagement program. The SWCP covers approximately 108,000 state employees as of June 30, 2017; thus, constant vigilance](https://reader033.vdocument.in/reader033/viewer/2022043004/5f85492f2994477a536299a2/html5/thumbnails/12.jpg)
Salary Continuation Payments Steadily Declining $3,866,250 Reduction Since 2013
SalarycontinuationpaymentshavesteadilydeclinedsinceenactingamendmentsinS.L.2014-100effectiveOctober1,2014.Thisstatutorychangelimitedsalarycontinuationeligibilitytospecifictypesofinjuries.FurtherclarificationsbecameeffectiveSeptember18,2015,thatprovidedsuchbenefitsareavailableonlywhentheinjuredemployee’sinabilitytoworkisaresultofaninjuryorinjuriesresultingfromorarisingoutofanepisodeofviolence,resistance,orduetootherspecialhazardsthatoccurwhiletheeligiblepersonisperformingofficialduties.(S.L.2015-241)Inaddition,theamountofsalarycontinuationpaymentsarenowstatutorilylimitedtotheeligibleperson’sbasepaywhichhasalsoreducedoverallsalarycontinuationcosts(S.L.2015-241).Thisoveralldecreaseinsalarycontinuationpaymentstranslatesintoanincreaseinregularworkers’compensationindemnitypaymentsaspersonspreviouslyeligiblearenowlimitedtoreceivingthestatutory662/3percentofaverageweeklywagestemporarytotaldisabilitybenefitsforlosttimefromwork.S.L.2017-57includesanamendmentensuringthatsalarycontinuationpaymentswillbeceasedorreducedifanemployeereturnstoworkelsewherewhileworkrestrictionsrelatedtothecompensableinjurycannotbeaccommodatedbytheemployingagency.
11
![Page 13: General Assembly on Article 63 State Employee Workplace ... · gagement program. The SWCP covers approximately 108,000 state employees as of June 30, 2017; thus, constant vigilance](https://reader033.vdocument.in/reader033/viewer/2022043004/5f85492f2994477a536299a2/html5/thumbnails/13.jpg)
12
![Page 14: General Assembly on Article 63 State Employee Workplace ... · gagement program. The SWCP covers approximately 108,000 state employees as of June 30, 2017; thus, constant vigilance](https://reader033.vdocument.in/reader033/viewer/2022043004/5f85492f2994477a536299a2/html5/thumbnails/14.jpg)
Claims Reporting Lag Time Decreased SignificantlyFY 2013-2017: 32% Percent Reduction Since 2013
Claimreportinglagtimeforallstateagencieshasdecreasedapproximately 32% percent from FY2013toFY2017.Thisindicatesstateemployeesandsupervisorsarereportingworkplaceinjuriesmorequicklywhichenablesbetterclaimshandlingandmanagementimmediatelyfollowinganinjury.EarlierclaimreportingempowerstheState’sthirdpartyadministrator,CorVel,tomorequicklyinvestigateinjuryreports,makecompensabilitydeterminations,andensureallinjuredemployeesreceivenecessary,promptmedicaltreatmentfortheirwork-relatedcondition.Thispromotesfasterhealing,expeditedreturn-to-work,andtotalclaimcostcontainment.
13
![Page 15: General Assembly on Article 63 State Employee Workplace ... · gagement program. The SWCP covers approximately 108,000 state employees as of June 30, 2017; thus, constant vigilance](https://reader033.vdocument.in/reader033/viewer/2022043004/5f85492f2994477a536299a2/html5/thumbnails/15.jpg)
Medical Costs
Total medical costs includes hospital and outpatient treatment, physician visits, prescription drugs,casemanagement,andMedicareSetAside(MSA)paymentsrequiredtosettleclaims.TheslightincreasefromFY2016toFY2017isattributabletothefollowing:
1)Paymentsformedicaltreatmentassociatedwithonecatastrophicclaimtotaling $1,891,563 inFY2017alone. 2)MedicareSetAside(MSA)paymentsrequiredforclaimsettlementsincreasedfrom $439,925inFY2016to$1,676,805inFY2017
Overall,medicalcostsassociatedwithSWCPclaimsaresteadilydecreasingduetotherevisedNCICMedicalFeeSchedulewhichincludeslowerreimbursementratesforsometreatment,prescriptiondrugsavingsresultingfromthenewvendorcontracteffectiveOctober1,2016,anddecreaseinoverallclaimsvolumeanddurationaidedbythesharpincreaseinfinalsettlementofclaimsinvolvingextensiveongoingmedicaltreatmentinFY2016andFY2017.
14
![Page 16: General Assembly on Article 63 State Employee Workplace ... · gagement program. The SWCP covers approximately 108,000 state employees as of June 30, 2017; thus, constant vigilance](https://reader033.vdocument.in/reader033/viewer/2022043004/5f85492f2994477a536299a2/html5/thumbnails/16.jpg)
$2 Million Settlement Reserve Fund Allocation Process Administered by OSHR
TheAppropriationsActof2015setaside$2millionfor“theclosureofexistingworkers’compensationclaims.”(S.L.2015-241).OSHR,inconjunctionwithOSBMandtheOfficeofStateController,hasdevelopedadetailedadministrativeprocessfortheallocationofthesefunds,withthegoalofsettlingclaimsthatwillresultinthegreatestpotentialfuturecostsavings.
TheAppropriationsActof2015alsodesignatedspecificunspentfundsoriginallyappropriatedforuseinFY2016tobetransferredtoOSHRforuseinsettlingworkers’compensationclaimsinFY2017.Asaresult,fundstotaling$4,389,797wereavailableforOSHRtoallocatetostateagenciesanduniversitiestoassistinclaimssettlementsduringFY2017.
All state agencies and universities are eligible to apply for settlement funds on an individual, per claimbasis.OSHRengagedinweeklymeetingstoassesseachSettlementReserveFundsapplicationindividuallyanddetermineifanyfundsshouldbeprovidedforclaimsettlement.BelowisthestatusofapplicationsreceivedandSettlementReservefundsapprovedbyOSHRasofJune30,2017.
Total applications received 145 Number of claims allocatedSettlement Reserve Funds withapprovedsettlements as of June30,2017 55
TotalFY2016fundsutilized $2,000,000 Total dollar cost of settlements for55settledclaimswith approved settlements $5,573,458
Totalprojectedfuture cost avoidance associatedwiththese55approved settlements $37,530,971
FY 2017 Funds - $4,389,797 availability: Data as of June 30, 2017
15
Total applications received 237 Number of claims allocatedSettlement Reserve Funds withapprovedsettlements 89
TotalFY2017fundsutilized $3,107,000
Total dollar cost of settlements for 89claimswithapprovedsettlements $9,422,175
Totalprojectedfuture cost avoidance associatedwiththese 89approvedsettlements $51,898,509
FY 2016 Funds - $2,000,000 availability
![Page 17: General Assembly on Article 63 State Employee Workplace ... · gagement program. The SWCP covers approximately 108,000 state employees as of June 30, 2017; thus, constant vigilance](https://reader033.vdocument.in/reader033/viewer/2022043004/5f85492f2994477a536299a2/html5/thumbnails/17.jpg)
OSHR’sdecision-makingprocessfordistributingthesefundsincludes,ataminimum,assessmentofthefollowingfactorsandanyotherpertinentinformationtodeterminethepotentialfuturecostsavingsthatwouldresultfromthesettlementofanindividualclaim:
a. Employee’sageandstatutorylifeexpectancy,baseduponNCGS§8-46 b. Numberofworkers’compensationclaimsfiledbytheemployeewhileemployedby the state c. Employee’spre-injurypositiontitleandjobdescription d. Employee’saverageweeklywage,weeklycompensationrate,andwhetherinjury qualifiedforsalarycontinuationbenefits e. Lengthofemployee’sentitlementtoongoingworkers’compensationdisability benefits(ifclaimisnotsettled) f. Documentedeffortstoreturntheemployeetowork g. Employee’sreturn-to-workpotential h. Employee’scurrentmedicalconditionrelatedtotheworkers’compensationclaim i. Employee’scomorbidities(i.e.,presenceofoneormorediseasesordisorders co-occurringwithaprimarydiseaseordisorder)orothermedicalconditions unrelatedtotheworkers’compensationclaim,ifapplicable j. Employee’sprojectedfuturemedicaltreatmentrelatedtotheworkers’compensation claim k. Whethertheclaimsettlementincludestheemployee’sresignation,ifstillemployed withtheState l. Whethertheemployeeisretired m. WhethertheemployeeiseligiblefororreceivingLong-TermDisabilitybenefits n. Whethertheemployeeiscurrentlyreceiving,hasappliedfor,isappealingadenial, orplanstoapplyforSocialSecurityDisability(SSDI)benefitsinthenearfuture o. WhetherMedicareSetAsideAgreement(MSA)willberequiredanddollaramount to be included in the claim settlement, if already calculated p. PriorIndustrialCommissionOrders,OpinionsandAwards,ConsentAgreements, or Consent Orders on record for the claim q. PendinglitigationandissuestobedeterminedincludedontheIndustrialCommission Form33RequestforHearingand/orForm33RResponsetoRequestforHearing r. Projectedfuturelitigation s. Totaldollaramountofexpendituresalreadypaidfortheclaim,includingbreakdown intoseparateamountsspentforindemnity,medical,andallocatedexpensecosts t. Totaldollaramountofcurrentclaimreserves,includingbreakdownintoseparate amountsprojectedtobepaidforfutureindemnity,medical,andallocatedexpenses u. Projectedtotaldollaramountoflifetimeexposureforallpotentialfuturecostsrelated to claim v. Nameofemployee’sattorneyandwhethertheattorneyiscurrentlyreceivinganon going attorney’s fee
OSHRreceivestheabovedatafromthefollowingsources:agencyapplicationforms,currentclaimsettlement evaluation prepared by the state’s third party administrator, CorVel, and Attorney General’sSettlementApprovalMemoforallclaimswithsettlementsprojectedtoexceed$74,999.99.OSHRalsorequestsadditionalinformationfromtheagencyorconsultstheclaimfilewhenneededtofullycompleteanindividualclaimassessment.
16
![Page 18: General Assembly on Article 63 State Employee Workplace ... · gagement program. The SWCP covers approximately 108,000 state employees as of June 30, 2017; thus, constant vigilance](https://reader033.vdocument.in/reader033/viewer/2022043004/5f85492f2994477a536299a2/html5/thumbnails/18.jpg)
Cost Containment
OSHRcommunicateswithstateagenciesandvendorstopromoteoverallclaimcostcontainmentby: a. Reviewingopenclaimsforcost-containmentpotential fraud,abuse,compliancewithclaimsmanagement standards,whenclosureisappropriate,etc. b. Workingdirectlywithvendorstoensurecontract complianceandimproveperformance. c. Providingagencieswithquarterlyperformancemetrics toanalyzetheirindividualperformance.
17
Technical Assistance to Agency/University Workers’ Compensation Administrators
OSHR’sStateWorkers’CompensationManagerandWorkers’CompensationConsultantsareassignedtoindividualstateagenciesanduniversitiesandengageinthefollowingactivitiestoensuretheState’sWorkplaceRequirementsinNCGS§§143-582through143-584arebeingachievedforworkers’compensation.
TheSHWCDivision’sSafetyDirector,SafetyandHealthManager,andStateSafetyConsultantprovide ongoing consultation and assistance to all stateagencies/universitiestoensuretheState’sWorkplaceRequirementsinNCGS§§143-582through143-584arebeingachievedforsafetyandhealth.TheSHWCDivision’sWorkers’Compensationstaffprovidesthefollowingservices:
a.Serveasaninformationresourcefor agencyworkers’compensationadministratorandvendorinquiries b. Communicatewithcontractedvendors,DepartmentofJustice-Workers’ Compensation Division, and others regarding claims management issues c. Engageininternalcommunicationtoensuresafetyandworkers’compensationstaff aremeetingtheState’sWorkplaceRequirements
![Page 19: General Assembly on Article 63 State Employee Workplace ... · gagement program. The SWCP covers approximately 108,000 state employees as of June 30, 2017; thus, constant vigilance](https://reader033.vdocument.in/reader033/viewer/2022043004/5f85492f2994477a536299a2/html5/thumbnails/19.jpg)
Return-to-Work Program Implementation
ThroughoutFY2016andFY2017,OSHR’sWorkers’CompensationConsultantshavefocusedonensuringeachagencyanduniversityhasacomprehensiveandfully-implementedReturn-to-WorkProgram.Agenciesanduniversitiesarecurrentlyatvaryingstagesofadoptionofsuchprograms.
ComprehensiveReturn-to-Workprogramsshouldbemaintainedineachagencytoinstilla“Return-to-WorkCulture”inemployees,supervisors,andmanagement.
MajorAgencyandUniversityReturn-to-WorkProgramgoalsareasfollows:
1. Maintainacontinuouslyupdatedlistoflight/modifieddutyand“makework”available forinjuredemployeesassignedtemporaryworkrestrictionswhohavenotyetreached maximummedicalimprovement(MMI)fortheirinjury. 2. DetailedpostMMIplanning,includingpotentialjobaccommodations,alabormarket survey,and/orvocationalrehabilitation,tobeginimmediatelywhenanagencylearns aninjuredemployeewilllikelybeissuedpermanentworkrestrictionsrelatedtotheir injuryuponreachingmaximummedicalimprovement. 3. Educatingallemployees,supervisors,managers,andhumanresources personnelregardingreturn-to-workexpectations. 4. Measuringandassessingtheeffectivenessandcostsavings resultingfromtheagencyanduniversityReturn-to-WorkProgram.
Ongoing Education/Training
OSHR’sStateWorkers’CompensationManagerandWorkers’CompensationConsultantshaveconductedinteractive,experientiallearning-basedworkers’compensationtrainingsessionsstatewideforapproximately435stateemployeesduringFY2016andFY2017.Thistrainingpro-gram,ManagingYourClaims:Part1,coveredthefollowingtopicscriticaltocompliancewithNCGS§§143-582through143-584:
1. InitialInjuryHandlingandReporting 2. IncidentInvestigations 3. ClaimAcceptanceandDenialDecisions 4. Return-to-Work 5. Workers’CompensationBenefits, Leave,andEffectonOther Benefits 6. ClaimsMonitoring 7. DetectingFraudandAbuse 8. CloseClaimsTimelyandFairly 9. RecordingWorkers’Compensation ActionsinBEACON 10. PerformanceMeasures
18
![Page 20: General Assembly on Article 63 State Employee Workplace ... · gagement program. The SWCP covers approximately 108,000 state employees as of June 30, 2017; thus, constant vigilance](https://reader033.vdocument.in/reader033/viewer/2022043004/5f85492f2994477a536299a2/html5/thumbnails/20.jpg)
Conclusion
OSHRwillcontinueutilizingavailableresourcestoensureSafety,HealthandWorkers’Compensationprogramrequirementsareachievedasdescribedinthisreport.OSHRisworkinginpartnershipwithvendorsandallstateagenciesanduniversitiestoensureprogramgoalsaremetwhilesimultaneouslyloweringclaimcostsandimprovingclaimoutcomes.
TheWorkers’CompensationSettlementReserveFundisaidingagencieswithclosureofopenworkers’compensationclaimsresultingindecreasesinoverallclaimcostsandtremendousincreasesinanticipatedfuturecostavoidance.
OSHRlooksforwardtoprovidingongoingguidanceanddirectionincoordinatingtheseeffortswithallstateagenciesanduniversitiesbyoverseeingprogramimplementation,trackingaccountability via performance measures, and providing training opportunities and online resourcesforemployeesatalllevels.
19
Thisclasswascreatedforworkers’compensationadministrators,supervisors,managers,safety,andotherhumanresourcesstaffthatregularlyreportormanageworkers’compensationclaimstoprovidethemwithclaimshandlinglaws,procedures,andbestpractices.OSHRplanstoprovidethistrainingatleasttwiceyearlytoallnewhiresandothersinneedofthistraining.
TheSHWCDivisionispartneringwiththeNCDepartmentofJusticeWorkers’CompensationSection,andDHHSandDPSworkers’compensationlegalcounselstoprovidedetailedtrainingonpreferredclaimshandlingpracticesandlitigationhandlingtoallCorVeladjustersandprimaryagencyworkers’compensationadministratorsinSeptember2017.
Inaddition,theOSHRWorkers’Compensationwebpage,www.workerscomp.nc.gov,isbeingrelaunchedandwillincludemanynewandrevisedchecklists,jobaids,andotherresourcesforinjuredemployeesandworkers’compensationadministration.Somehighlightsareasfollows:
1. StandardOperatingProcedures:aseriesofdetailedinstructionsforhandling situationsthatcommonlyariseinthecourseofclaimhandlingthatspecificallystate therolesandresponsibilitiesoftheinjuredemployee,employingagency,thirdparty administrator,AttorneyGeneral’soffice,etc. 2. Return-to-WorkProgramImplementationGuide:ahow-toguideforeachagencyto implementacustomizedreturn-to-workprogramtoensureinjuredemployeesreturn toworkoncereleasedtodosobytheirauthorizedtreatingmedicalprovider 3. BusinessProcessCharts:aseriesofstep-by-stepchartsdetailingbasicclaim handlingprocessessuchasreportingclaims,return-to-work,claimsettlement,etc.
TheBEACONLMSsystemalsoincludesresourcesintheHRLearningZonestoassistemploy-ees,supervisors,managers,andHumanResourcesstaffwithclaimsreporting,investigation,andmanagement.