State Workers’ Compensation Program Advisory Board Meeting, September 13, 2022
The State Workers’ Compensation Program Advisory Board held its meeting September 13, 2022 via Webex. In attendance were Jack Engle (Chairperson), Ken Werts (Senate Minority Leader Appointee), Kevin Botha (Senate President Appointee), Michael Brennan (Workers’ Compensation Commission), Jim Nichelson (Department of Revenue), Kari Wolfe (CMS), Laura Hammann (CMS Risk Management), Nicole Featherstone (CMS Risk Management), Joli Schroeder (CMS Risk Management), Jim Sterr (DOT), Justin Hammersmith (DOI-Department of Insurance), George Sweeney (DOI), John Street (DOI), Richard Glisson (Attorney General) and Jill Otte (Attorney General).
Jack Engle opened the meeting discussing the favorable trends over the past three fiscal years for record only injuries, medical only injuries, and indemnity only dollars incurred. Jack expressed concern with the accuracy of the data provided by Tristar and is waiting for a response regarding the validity of the numbers provided. The overall trends are accurate; however, the dollar amount provided for indemnity is being questioned. This concern stems from a discrepancy of approximately $7,000,000 in the numbers provided last year for FY20 and FY21 and the numbers provided this year for those same fiscal years. Once the issue has been resolved and accurate figures provide Jack will send out an updated PowerPoint to the audience.
Jack moved on to discuss the fiscal year analysis for average costs which are trending favorably downward. The top highest spend agencies were the Department of Corrections (DOC), Department of Human Services (DHS), Department of Transportation (DOT), Illinois State Police (ISP) and Juvenile Justice. Overall, the agencies are seeing favorable trends except Juvenile Justice which shows a slight increase. Jack noted that Jim Sterr has done an excellent job providing almost real time reports of any new claims within the Department of Transportation which allows the Risk Management team to identify individuals who have frequent claims and respond immediately in the instance of a catastrophic event. Jack also advised that Nicole Featherstone and Laura Hammann have a monthly meeting with the Illinois State Police (ISP) to review claims and gather a better understanding of the health of the injured workers and determine what is needed for those employees to return to work. ISP recently reached out to Jack regarding a policy manual they are creating which addresses wellness exams ISP conducts and how to address concerns regarding an injured employee’s ability to return to work. Ideally, this will lead to a reduction in claims volume among ISP workforce.
The discussion returned to loss data provided by Tristar. The top five causes of work-related injuries are hit by coworker or patient, fall (ice/snow), pandemic, patient assist, and collision with another vehicle. The pandemic numbers do show a slight increase; however, at this time those claims have all but stopped for the most part. The top 5 nature of injuries remains multiple physical injuries, strain, contusion, all other, and laceration. Most of these claims are in mental health and correctional facilities. There have not been any large changes but overall, there is less being spent on these claims. It should be noted that we have accepted more claims than in the past as litigation experience indicates that people who are paid for their time off and medical bills do not tend to pursue a claim with the commission. Loss data by occupation remains the same as it has been in the past with mental health technicians topping the list followed by correctional officer, highway maintainer, unassigned, sec therapy aide, and juvenile justice specialist. The top 5 five body parts injured by type are multiple body parts, body systems & multibody systems, finger, back area lower, and knee, right. Lastly, the top 5 losses by incident type are job task, patient assist, handling an inmate, walk/run, and patient restraints.
Jack advised that subrogation recoveries were just short of $2,000,000 for the fiscal year coming in at $1.960,902.09. Our subrogation approach is contributing to the overall incurred cost as Nicole has been settling subrogation claims on a dollar contract. A dollar contract is where they will accept our money and forgo a claim before the commission and then pursue their claims recovery through the negligent third party. Looking at the 3rd quarter of the current calendar year we have collected nearly $500,000.00 already and expect to recover $1,000,000.00 in the first half of the fiscal year.
Updates to Risk Management include the Workers’ Compensation Manager vacancy being posted which closes on Friday. Nicole and Laura will continue to maintain production until a suitable replacement is hired.
Tristar meetings continue to be conducted bi-weekly if not more frequently. Laura has been working with the account manager and agencies to conduct case reviews and develop claim strategies to get employees back to work in a more timely manner.
The RFP for the next contract has been issued and the technical portion is complete; pricing will be evaluated soon with an initial award being issued by October 1, 2022.
Notable FY22 improvements include the WCC websites being functional, we are seeing the claims analysis tool being utilized at an increased rate, but we would like to see even more agencies requesting this data. Laura has developed a PowerPoint training for all new coordinators which helps develop a sense of ownership in the claims process and encourages them to be more proactive than in the past. Lastly, Nicole’s subrogation intercept project has created 15 recoveries to date totaling $8,215.96.
Michael Brennan initiated the open discussion by commending Jack on the information provided which is phenomenal compared to where the meetings started a few years back. Michael also indicated he was extremely impressed with subrogation recoveries as he knows that it was very difficult to get recoveries started. Finally, Michael advised that the Workers Compensation Commission has gone completely paperless and if CMS would like to mine their data, within reason, that could be done. Jack advised he would take Michael up on the offer once he receives validation of the data provided by Tristar. There was a brief conversation regarding the spike in Juvenile Justice claims which Jack believes may be attributed to a staffing shortage. Finally, Jack wrapped up the discussion by inquiring about any updates with the Department of Insurance investigations. George Sweeney advised there are approximately 20 cases in active investigation status and they are working to address the back log. Cases are prioritized in order of the statute of limitations expiration date.
Our next meeting will be after the calendar year and will include updated news on the contract award.