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SC Workers’ Compensation Commission

SC Workers’ Compensation Commission. SC Workers’ Compensation Educational Association Medical Seminar Commission Update March 1, 2011. COMMISSION UPDATE. South Carolina Workers’ Compensation Commission. South Carolina Workers’ Compensation Commission. Claims Activity

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SC Workers’ Compensation Commission

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

  2. COMMISSION UPDATE South Carolina Workers’ Compensation Commission

  3. South Carolina Workers’ Compensation Commission Claims Activity FY FY FY 08-0909-1010-11 (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

  4. South Carolina Workers’ Compensation Commission Informal Conferences Assigned Conducted FY 09-10 6,264 3,549 FY 10-11 (YTD) 3,410 2,518

  5. South Carolina Workers’ Compensation Commission Informal Conferences Adjusters please bring ……… 14B’s Medical Narrative

  6. South Carolina Workers’ Compensation Commission • Single Commissioner Hearings • FY FYFY • 08-0909-1010-11 • (YTD) • Docketed 9,866 10,9126,107 • Hearings 2,345 2,2111,242

  7. 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

  8. South Carolina Workers’ Compensation Commission • Appeals to Full Commission • FY FYFY • 08-0909-1010-11 • (YTD) • Docketed 700 647397 • Hearings 450 357168

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

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

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

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

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

  14. 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

  15. South Carolina Workers’ Compensation Commission Legislation FY 2011-12 Budget 10% Reduction General Fund $193,675

  16. South Carolina Workers’ Compensation Commission Comp System Cost Hospital Fee Schedule Reductions Actual FY FY 08-09 09-10Savings Medical Expense $422.4 $296.0 $126.4

  17. South Carolina Workers’ Compensation Commission Premiums Paid (millions)% of total Commercial Market CY 2009$586.9 63.10% Self InsuranceFY 2010$253.3 27.23% State Accident Fund FY 10 $ 90.0 9.67% Total $ 930.2 100.0%

  18. 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

  19. South Carolina Workers’ Compensation Commission System Cost Total (millions)% of Total Medical $ 296.0 36% Indemnity (Comp.)$ 528.264% Total $ 824.2 100%

  20. South Carolina Workers’ Compensation Commission Indemnity Total % of Total (millions)IndemnitySystem* Agreements $ 498.9 94.46% 60.54% Awards $ 29.3 5.54% 3.55% Total $ 528.2 100% *System Cost = Medical and Indemnity

  21. South Carolina Workers’ Compensation Commission Indemnity – Temporary Awards % of Total (millions) AwardsSystem* Partial $ .7 2% Total $ 14.3 98% Total $ 15.0100% 1.82% *Total System Cost = Medical and Indemnity

  22. South Carolina Workers’ Compensation Commission Indemnity – Permanent Awards % of Total (millions) AwardsSystem* Partial $ 10.5 73% Total $ 3.7 26% Disfigurement $ .068 <1% Total $ 14.3 100% 1.74% *Total System Cost = Medical and Indemnity

  23. South Carolina Workers’ Compensation Commission Indemnity – Permanent Agreements % of Total (millions) Agmts System* Partial $ 48.3 13% Total$ 16.0 5% Disfigurement $ .4 <1% Clinchers $ 291.082% Total $ 355.7100%43.15% *System Cost = Medical and Indemnity

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

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

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

  27. South Carolina Workers’ Compensation Commission Compliance FY09FY10FY11 (YTD) Investigations Initiated 1,092 1,375 1,204 Show Cause Hearings Set 111 193 100 Compliance Agreements 344 409185 Total Investigations Closed 443 1,257751

  28. South Carolina Workers’ Compensation Commission Claims Activity FY FY FY 08-0909-1010-11 (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)

  29. South Carolina Workers’ Compensation Commission FY FYFY 08-0909-10 10-11 (YTD) Cases Closed 71,973 62,536N/R Ind. reported (26,313) (29,044)18,026 Minor Medical (45,660) (33,492)N/R

  30. South Carolina Workers’ Compensation Commission Indemnity – Temporary Agreements % of Total (millions)AgmtsSystem* Partial $ 3.0 2% Total$ 140.098% Total $ 143.0100% 17.38% *Total System Cost = Medical and Indemnity

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

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

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