Shining Light on the Sunshine State: The DWC Annual Report
By Joan E. Collier
For all you policy and data wonks out there, the Florida Division of Workers’ Compensation has issued its annual report, replete with enough graphs and numbers to satisfy anyone. The report is remarkably free of hyperbole (ProPublica should take note) while presenting a comprehensive picture of the division’s various teams along with the requisite data on claims and costs.
Some of the key information regarding Fiscal Year 2014-015:
- In the contentious world of physician dispensing, the report offers some compelling graphs showing the astronomical difference in costs between pharmacy-dispensed and physician-repackaged medications (although significant progress is being made in reducing the instances of physician dispensing—see page 45).
- Costs for lost-time claims were comprised of 68 percent medical, 20 percent indemnity, and 12 percent settlement, compared to 55.2 percent, 21 percent, and 23 percent respectively in 2008 (see page 53). Why the big drop in settlements?
- Strains continue to be the leading cause of lost-time claims, far outpacing all other injuries. Indeed, the “injury” graph shows a notable consistency on types of injuries through the years (see page 57). Ditto the “cause of injury” and “body parts” (see pages 58, 59).
In specific section and team news:
- The Medical Services Section received over 9,600 Petitions for Resolution of Reimbursement Disputes during Fiscal Year 2014-2015. The section issued 5,761 determinations (65 percent) and 3,091 dismissals (35 percent). The section discovered that the petitioner had been underpaid in 92 percent of all determinations. Most of the underpayments were related to medical bills involving medication dispensed by the practitioner.
- The self-Insurance unit developed a new program to improve the accuracy of self-insurers’ reporting data on overtime payroll, executive officer payroll, and classification codes. The industry training efforts resulted in an improvement in the accuracy of data reported by 25 percent.
- The Bureau of Compliance processed 99 percent of online exemption filings within five days of receipt; utilized data from various agencies to identify and successfully target non-compliant employers; investigated 1,794 public referrals alleging non-compliance; conducted 48 seminars and 23 webinars on workers’ compensation and workplace safety for over 2,522 employers statewide.
- The division conducted two statewide construction sweeps to identify noncompliant employers, which resulted in 1,203 construction site visits, 1,928 employer investigations, and 123 enforcement actions.
- The First Report of Injury Team contacted 29,116 injured workers by telephone and 3,511 employers/carriers when the team was unable to reach injured workers.
- The Injured Worker Helpline Team handled 40,517 calls, including 8,559 Spanish-speaking callers.
- The Ombudsman Team was involved in resolving 91 percent of the 754 disputes received. The medical bill disputes totaled $22,995 in previously unpaid medical bills. The team resolved indemnity benefit disputes totaling $182,814.
- The Reemployment Services Team received 264 requests for screenings through the division’s Injured Worker Web Portal. Additionally, the team screened 277 injured workers for services and provided assistance to 164 injured workers who were eligible to return to suitable employment.
- The Audit Section completed 56 on-site insurer audits and examined 5,303 insurer claim files. The section discovered 491 indemnity claim files with underpayments resulting in $226,318.12 of additional injured worker payments for indemnity benefits, penalties, and interest.
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