At the 2016 WCRI Annual Issues & Research Conference, a panel discussed the CompScope findings on system differences in indemnity and medical payments. CompScope is an annual benchmarking study produced by WCRI that analyzes the workers’ compensation benefits in 18 states. The focus of this presentation was information from Georgia and Kentucky. It should be noted that the study is not published yet so this information could change. The panel was:
- Dr Rebecca Yang, WCRI
- Molly Flanagan, WCRI
- Carol Telles, WCRI
It is important to note a baseline differences between states for study purposes.
Wage loss states
- LA, MA, MI, PA, VA
PPD Benefit States
AR, CA, FL, IA, IL, IN, KY, MN, NJ, TX, WI
Elements of both Wage Loss and PPD
In wage loss states you expect to see fewer indemnity claims, but usually there are longer durations of disability.
Georgia had the second highest indemnity benefits per claim of the 18 study states. Second only to North Carolina. This is attributed to the fact that there is no MMI concept in the state. Workers continue to receive temporary disability benefits as long as there is no return to work at full wages, subject to a 400 week cap on benefits.
Georgia has the lowest maximum compensation rate of the study states at $525 per week. Almost 1/3 of claims involved benefits that were capped by the maximum rate. Because of the lack of MMI, Georgia had one of the highest average duration of temporary disability among the study states. Georgia also had one of the highest percentages of claims with lump sum settlements and one of the highest lump sum settlement payments among study states.
Litigation is a significant cost driver in Georgia with average litigation expenses 42% higher than the 18-state median. Given the high percentage of claims with lump sum settlements this is to be expected.
Indemnity benefits per claim in Kentucky were right at the 18-state median. Kentucky considers more than just impairment in a PPD settlement as there are multipliers for age, education, and ability to return to work. Kentucky also had the lowest percentage of claims with PPD settlements among the study states with PD benefits.
The average duration of TD benefits in Kentucky was among the highest of the PD states. Some of this is is attributed to the fact that Kentucky has no provision for payment of temporary partial disability if a person returns to work at less than full wages.