The International Association of Industrial Accident Boards and Commissioners (IAIABC) brings together workers’ compensation regulations from around the world with the industry they regulate to discuss a variety of issues. It is a great opportunity for the workers’ compensation community to interact with the industry regulators.
One of the highlights of the event is the Heads of Delegation Forum. In this event, the non-jurisdictional members get the opportunity to ask questions to the jurisdictional representatives.
There were 29 United States jurisdictions representatives for the session, along with representatives from Germany, Russia, Canada, Australia and others. The session I was in question and answer format.
Share victories or successes within your organization.
MD – In an enterprise modernization process and just won an award for their process.
FL – Been focused on telling their “data story” to provide information to their legislature. Very involved in passage of the PTSD bill last year.
MT – Just completed almost 3 year process implementing drug formulary. These efforts included all stakeholders. Received Governors award for collaboration and transparency.
WA – Finalizing rules around vocational providers in their system to have them focused on assisting workers actually return to work vs old model that simply focused on assessments.
NM – Passed PTSD presumptive bill for firefighters.
OR – Efforts to increase industry engagement including semi annual meetings with insureds and insurers to talk about challenges and solutions.
OH – Working with employers on providing employment services to workers who are recovering from addiction.
MO – Tornado impacted state capital and their offices which tested their disaster response capabilities and demonstrated their efforts in breaking down silos between departments.
CA – Bills passed included PTSD presumption and AB5 regarding the definition of independent contractors.
DC – Introduced cost containment program which lowered their assessments to carriers and employers.
What plans do you have for innovation?
TN – Next Step program gives a $5000 award to workers who sustain injuries that prevent them from returning to prior occupation. Goal is for them to use this for job training to return to the workforce.
Also have test model with large healthcare employer on an enhanced claims handling model designed to expedite benefits and reduce conflict.
How can the industry participate in your enhancement projects to make them more effective?
TN – Industry heavily involved in Next Step program before bill was ever passed. This included conversation with the Chamber of Commerce.
NV – Trying to change worker engagement process as state was not involved in. communications with injured workers. They are trying to set up stakeholder meetings to get more engagement in this area.
MI – Very important to engage stakeholders in everything we do.
Are there legislative changes in your state you want to highlight?
FL, NM, CA passed PTSD legislation.
CA- AB5 focused on redefining independent contractor. Takes effect to workers compensation July 2020. They expect lots of litigation around this.
MD – Legislation on medical marijuana failed on last day of session. This would have required workers’ compensation to make direct payment for medical marijuana.
PA – Protz fix was passed and signed into law which reimplements the impairment rating process using the AMA 6th edition. Even with significant stakeholder participation there was a Constitutional challenge to the new law that was recently upheld by the courts.
PA – Just had their first medical marijuana case come before the WC Appeals Board. They are expecting no finality on this issue until it reaches the state Supreme Court.
FL – Passed firefighter cancer bill which provides benefits outside the workers’ compensation system. This provides presumptive coverage and benefits for certain cancers. It is NOT part of the workers’ compensation benefits.
OH – PTSD bill for first responders is still being debated in the legislature. There is a new firefighter cancer bill looking to pay the costs for such claims from the surplus fund.
What are some other areas of focus for you besides workers’ compensation?
MO – We are focused on how we in the Dept of Labor can work better together within our own agency which includes WC, unemployment, wage and hour, safety, public accommodation and many other things. Worker classification will be an increased focused because we have seen conflicting decisions from different departments on the same employer. We are also focused on a system modernization and data sharing efforts to make all aspects of the Dept of Labor more efficient.
TN – We have multiple entities working to develop loss and safety programs for employers in the assigned risk pool.
NV – We are trying to break down silos within departments to be more efficient.
PA – We are collaborating with other state agencies and educational institutions within the state to create things such as opioid education, worker safety, and data analytics programs to make evidence based decisions.
MN – We are trying to look at things more holistically and work with other state agencies on enforcement efforts.
WI – Multiple state agencies working together on the subject of employee classification so that they can try and come up with a common definition across agencies.
What one thing about the WC system would you change?
FL – We wish we had more control over the statutory language because constantly trying to fix the system through the rule making process is not efficient.
UT – Would like to see universal definition for independent contractors applied nationally in every area.
WA – I wish employers would stay more involved in claims and wish injured workers would engage without an attorney more.
NV – Would like to reduce the time it takes for things to move through their system.
TN – One universal First Report of Injury for all states.
MT – Bring back humanity to workers’ compensation.
OR – They would like all claims handlers to understand the law.
CA – Better communication between all parties in the system.
IL – The ability to better leverage technology to improve the system.
VA – Need to get things back to being simpler and faster.
PA – Wish they had better systems that were secure against hacking threats. This is a challenge everyone in the industry faces.
Are there ways you try to review judges decisions to enforce consistency in how the Statues are applied?
TN – Every opinion from the court is reviewed by a peer judge, a staff attorney, and the chief judge before it is published.
CO – We have head judges that review cases for consistency. Regulators also meet with the judges to discuss how they feel the statutes should be interpreted.
VA – Judicial review by higher courts should be monitored to see if certain judges are getting overturned regularly. They also have informal discussions with judges who they feel may be misapplying the statutory intent.
NY – Group training of judges to ensure consistent application of the law. There is also counseling and disciplining for judges who are issuing rulings that are inconsistent with the statute.
IL – We have semi annual judicial training to review case law and discuss issues.
RI – Our judges are not governed by workers’ compensation and they are lifetime appointments so we have little influence over them.
CA – They have training programs for judges and they monitor appellate decisions.
MD – The judges meet twice a month to discuss cases and concerns. They feel this assists them in being more consistent with their decisions.
Workers’ compensation was designed for traumatic injuries. More states are passing laws focused on occupational diseases such as cancer or PTSD. Do you feel the WC industry has the expertise to effectively handle occupational disease claims?
FL – The Florida firefighter cancer statutes were intentionally placed outside the workers’ compensation system. On the PTSD side, they are working to educate medical providers on the workers’ compensation system and what first responders are experiencing on the job so they have a better understanding of the patients they are seeing.
MI – Their cancer statutes are very tight so there is not much dispute over whether claims are compensable. From the claims handing standpoint, these are handled like any other claim and we find that injured workers are treating with medical providers that have the appropriate expertise in this area. There are no occupational cancer experts, they simply treat with the same cancer experts they would in group health.
MT – Their presumption laws are fairly new and the carriers are not used to these types of claims. Carriers are asking about utilization and treatment guidelines for cancer claims.
NV – A big concern is access to care. Carriers are required to have a certain number of providers in each specialty in their network. This has been a challenge in certain areas.
CO – An authorized treating provider can refer to any specialist so there are no network considerations.