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TRANSCRIPT
SC Workers’ Compensation Commission
SC Workers’ Compensation Educational Association Medical Seminar
Commission Update
March 1, 2011
COMMISSION
UPDATE
South Carolina Workers’ Compensation Commission
Claims Activity
FY FY FY 08-09 09-10 10-11
(YTD)
Hearings Set (Docketed) 9,866 10,912 6,107
Hearings Held (Single Commissioner) 2,345 2,211 1,242
Settlements 10,506 10,715 6,117
South Carolina Workers’ Compensation Commission
South Carolina Workers’ Compensation Commission
Informal Conferences
AssignedConducted
FY 09-10 6,264 3,549
FY 10-11 (YTD) 3,410 2,518
South Carolina Workers’ Compensation Commission
Informal Conferences
Adjusters please bring ………
14B’s
Medical Narrative
South Carolina Workers’ Compensation Commission
South Carolina Workers’ Compensation Commission
Don’t Request a Hearing Unless You Are Ready……
Hearing Requests Processed 29 days
Hearings Scheduled 102 days
Appellate Appeals 117 Days
South Carolina Workers’ Compensation Commission
Appeals to Full Commission
FY FY FY08-09 09-10 10-11
(YTD)
Docketed 700 647 397
Hearings 450 357 168
Legislative Audit Council Report
September 2010
IssuesDepositing of ChecksVocational Rehabilitation ReferralsInformal Conference MediatorsIncreased Compliance Enforcement
South Carolina Workers’ Compensation Commission
Focus Groups
Attorney Add
Additional Case Status Information
Register at www.wcc.sc.gov
South Carolina Workers’ Compensation Commission
eCase
• Website: WWW.WCC.SC.Gov
• Commissioners Preferences
• Case Status Information eCase
• Business Meetings Agendas
South Carolina Workers’ Compensation Commission
Medical Fee Schedule
Surgical Implant Fee
Repackaged Pharmaceuticals
Claims Administrations Workshops
South Carolina Workers’ Compensation Commission
South Carolina Workers’ Compensation Commission
Electronic ServiceHearing NoticesOrders
Coming SoonConsent OrdersClinchersFee Petitions
South Carolina Workers’ Compensation Commission
LegislationH 3653
Annual Review MSPMAppeals to ALJ
S 407Transfer 10% Earmarked FundsFY 2010-11FY 2011-12
South Carolina Workers’ Compensation Commission
Legislation
FY 2011-12 Budget
10% Reduction General Fund
$193,675
South Carolina Workers’ Compensation Commission
Comp System CostHospital Fee Schedule
Reductions
Actual FY FY 08-09 09-10 Savings
MedicalExpense $422.4 $296.0 $126.4
South Carolina Workers’ Compensation Commission
Premiums Paid (millions) % of total
Commercial Market CY 2009 $586.9 63.10%
Self Insurance FY 2010 $253.3 27.23%
State Accident Fund FY 10 $ 90.0 9.67%
Total $ 930.2 100.0%
South Carolina Workers’ Compensation Commission
Premium Tax Paid To General Fund
Commercial Market (CY 2009) $ 14,673,877 Self Insurance Tax (FY 2010) $ 4,909,000
___________Total $ 19,582,877
Commission Budget General Fund FY10-11 $ 1,919,955
Proposed FY11-12 $ 1,743,070
South Carolina Workers’ Compensation Commission
System Cost Total
(millions) % of Total
Medical $ 296.0 36%
Indemnity (Comp.) $ 528.2 64%
Total $ 824.2 100%
South Carolina Workers’ Compensation Commission
IndemnityTotal
% of Total
(millions) Indemnity System*
Agreements $ 498.9 94.46% 60.54%
Awards Awards $ 29.3$ 29.3 5.54% 5.54% 3.55% 3.55%
Total $ 528.2 100%
*System Cost = Medical and Indemnity
South Carolina Workers’ Compensation Commission
Indemnity – TemporaryAwards
% of Total (millions) Awards
System*
Partial $ .7 2%
Total $ 14.3 98%
Total $ 15.0 100% 1.82%
*Total System Cost = Medical and Indemnity
South Carolina Workers’ Compensation Commission
Indemnity – PermanentAwards
% of Total (millions) Awards
System*
Partial $ 10.5 73%
Total $ 3.7 26%
Disfigurement $ .068 <1%
Total $ 14.3 100% 1.74%*Total System Cost = Medical and Indemnity
South Carolina Workers’ Compensation Commission
Indemnity – PermanentAgreements
% of Total (millions) Agmts System*
Partial $ 48.3 13%
Total $ 16.0 5%
Disfigurement $ .4 <1%
Clinchers $ 291.0 82%
Total $ 355.7 100% 43.15%
*System Cost = Medical and Indemnity
South Carolina Workers’ Compensation Commission
Average Cost Per Case Closed
FY 2009 FY 2010
$12,821 $13,181
Medical ($ 5,869) ($ 4,734)Indemnity ($ 6,951) ($ 8,448)
South Carolina Workers’ Compensation Commission
Questions?
Comments?
Suggestions?
Thank you!
www.wcc.sc.gov
South Carolina Workers’ Compensation Commission
Compliance Activities
Increased enforcementSC DEW Wage Information
Fines/Assessments
Show Cause Hearings
South Carolina Workers’ Compensation Commission
ComplianceFY09 FY10 FY11
(YTD)
Investigations Initiated 1,092 1,375 1,204
Show Cause Hearings Set 111 193 100
Compliance Agreements 344 409 185
Total Investigations Closed 443 1,257 751
Claims Activity
FY FY FY 08-09 09-10 10-11
(YTD)
Accidents Reported 71,973 58,783 N/R
Ind. Reported Accidents 26,313 23,686 15,278
Reopened ( 1,575) (1,738) (1,669)
South Carolina Workers’ Compensation Commission
South Carolina Workers’ Compensation Commission
FY FY FY 08-09 09-10 10-11
(YTD)
Cases Closed 71,973 62,536 N/R
Ind. reported (26,313) (29,044) 18,026
Minor Medical (45,660) (33,492) N/R
South Carolina Workers’ Compensation Commission
Indemnity – TemporaryAgreements
% of Total (millions) Agmts System*
Partial $ 3.0 2%
Total $ 140.0 98%
Total $ 143.0 100% 17.38%
*Total System Cost = Medical and Indemnity
Claims Administrations Workshops
May 5, 2011
September 29, 2011
South Carolina Workers’ Compensation Commission
South Carolina Workers’ Compensation Commission
Hospital Fee Schedule
Approved 2006
Inpatient Outpatient Ambulatory Surgery Centers
Medicare + 40%