SC Workers Compensation Commission SC Workers Compensation Educational

SC Workers’ Compensation Commission SC Workers’ Compensation Educational Association Medical Seminar Commission Update March 1, 2011

South Carolina Workers’ Compensation Commission 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 10, 506 10, 715 6, 117 Settlements

South Carolina Workers’ Compensation Commission Informal Conferences Assigned Conducted 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 ……… 14 B’s Medical Narrative

South Carolina Workers’ Compensation Commission Single Commissioner Hearings FY 08 -09 FY 09 -10 FY 10 -11 (YTD) Docketed 9, 866 10, 912 6, 107 Hearings 2, 345 1, 242 2, 211

South Carolina Workers’ Compensation Commission Don’t Request a Hearing Unless You Are Ready…… Hearing Requests Processed Hearings Scheduled Appellate Appeals 29 days 102 days 117 Days

South Carolina Workers’ Compensation Commission Appeals to Full Commission FY 08 -09 FY 09 -10 FY 10 -11 (YTD) Docketed Hearings 700 450 647 357 397 168

South Carolina Workers’ Compensation Commission Legislative Audit Council Report September 2010 Issues Depositing of Checks Vocational Rehabilitation Referrals Informal Conference Mediators Increased Compliance Enforcement

South Carolina Workers’ Compensation Commission e. Case Focus Groups Attorney Additional Case Status Information Register at www. wcc. sc. gov

South Carolina Workers’ Compensation Commission • Website: WWW. WCC. SC. Gov • Commissioners Preferences • Case Status Information e. Case • Business Meetings Agendas

South Carolina Workers’ Compensation Commission Medical Fee Schedule Surgical Implant Fee Repackaged Pharmaceuticals Claims Administrations Workshops

South Carolina Workers’ Compensation Commission Electronic Service Hearing Notices Orders Coming Soon Consent Orders Clinchers Fee Petitions

South Carolina Workers’ Compensation Commission Legislation H 3653 Annual Review MSPM Appeals to ALJ S 407 Transfer 10% Earmarked Funds FY 2010 -11 FY 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 Cost Hospital Fee Schedule Reductions Actual Medical Expense FY 08 -09 FY 09 -10 Savings $422. 4 $296. 0 $126. 4

South Carolina Workers’ Compensation Commission Premiums Paid (millions) Commercial Market % of total $586. 9 63. 10% $253. 3 27. 23% State Accident Fund FY 10 $ 90. 0 9. 67% $ 930. 2 100. 0% Self Insurance Total CY 2009 FY 2010

South Carolina Workers’ Compensation Commission Premium Tax Paid To General Fund Commercial Market Self Insurance Tax Total (CY 2009) (FY 2010) $ 14, 673, 877 $ 4, 909, 000 ______ $ 19, 582, 877 Commission Budget General Fund FY 10 -11 $ 1, 919, 955 Proposed FY 11 -12 $ 1, 743, 070

South Carolina Workers’ Compensation Commission System Cost Total (millions) % of Total Medical $ 296. 0 36% Indemnity (Comp. ) $ 528. 2 64% $ 824. 2 100% Total

South Carolina Workers’ Compensation Commission Indemnity Total % of Total (millions) Indemnity System* Agreements $ 498. 9 94. 46% 60. 54% Awards Total $ 29. 3 5. 54% $ 528. 2 100% *System Cost = Medical and Indemnity 3. 55%

South Carolina Workers’ Compensation Commission Indemnity – Temporary Awards % of Total (millions) Awards Partial $ . 7 2% Total $ 14. 3 98% Total $ 15. 0 100% *Total System Cost = Medical and Indemnity System* 1. 82%

South Carolina Workers’ Compensation Commission Indemnity – Permanent Awards % of Total (millions) Awards Partial $ 10. 5 73% Total $ 3. 7 26% Disfigurement $ Total $ *Total System Cost = Medical and Indemnity . 068 14. 3 System* <1% 100% 1. 74%

South Carolina Workers’ Compensation Commission Indemnity – Permanent Agreements % of Total (millions) Agmts Partial Total Disfigurement Clinchers $ 48. 3 $ 16. 0 $. 4 $ 291. 0 13% Total $ 355. 7 100% *System Cost = Medical and Indemnity System* 5% <1% 82% 43. 15%

South Carolina Workers’ Compensation Commission Average Cost Per Case Closed FY 2009 FY 2010 $12, 821 $13, 181 Medical Indemnity ($ 5, 869) ($ 6, 951) ($ 4, 734) ($ 8, 448)

South Carolina Workers’ Compensation Commission Questions? Comments? Suggestions? Thank you! www. wcc. sc. gov

South Carolina Workers’ Compensation Commission Compliance Activities Increased enforcement SC DEW Wage Information Fines/Assessments Show Cause Hearings

South Carolina Workers’ Compensation Commission Compliance FY 09 FY 10 FY 11 (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

South Carolina Workers’ Compensation Commission 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, 738) (1, 669) ( 1, 575)

South Carolina Workers’ Compensation Commission FY 08 -09 FY 09 -10 FY 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 – Temporary Agreements % of Total (millions) Agmts Partial $ 3. 0 2% Total $ 140. 0 98% Total $ 143. 0 *Total System Cost = Medical and Indemnity System* 100% 17. 38%

South Carolina Workers’ Compensation Commission Claims Administrations Workshops May 5, 2011 September 29, 2011

South Carolina Workers’ Compensation Commission Hospital Fee Schedule Approved 2006 Inpatient Outpatient Ambulatory Surgery Centers Medicare + 40%