scwcea one day seminar may 6, 2011 commission update gary m. cannon amanda underhill executive...

SCWCEA One Day Seminar

May 6, 2011

Commission Update Gary M. Cannon Amanda Underhill

Executive Director Applications Analyst

Commission UpdateTrends

Activities

What’s New

South Carolina Workers’ Compensation Commission

Accidents Filed1999 - 2010


Claims Activity

FY FY FY 08-09 09-10 10-11

(7 mths)

Hearings Set (Docketed) 9,866 10,912 6,107↓Benchmark 6,395

Hearings Held (Single Commissioner) 2,345 2,211 1,242 ↓

Benchmark 1,289

Settlements 10,506 10,715 6,117 ↓Benchmark 6,250



Informal Conferences

AssignedConducted

FY 09-10 6,264 3,549

FY 10-11 (7 mths) 3,410 2,518 ↑Benchmark 3,654 2,070


Appeals to Full Commission

FY FY FY08-09 09-10 10-11

(7 mths)

Docketed 700 647 397 ↑

Benchmark 377

Hearings 450 357 168 ↓Benchmark 208


Total System Cost FY 09-10

(millions) % of Total

Medical $ 296.0 36%

Indemnity (Comp.) $ 528.2 64%

Total $ 824.2 * 100%

*Does not include legal fees for defense


Cost Control Measures

Medical Services Provider Manual(Physician’s Fee Schedule)

Hospital Fee Schedule - 2006Medicare + 40%

Ambulatory Surgery Centers Fee Schedule


Medical Expense Reduction

Actual (millions) FY FY 08-09 09-10 Difference

MedicalExpense $422.4 $296.0 ($126.4)


IndemnityTotal

% of Total

(millions) Indemnity System*

Agreements $ 498.9 94.46% 60.54%

Awards Awards $ 29.3$ 29.3 5.54% 5.54% 3.55% 3.55%

Total $ 528.2 100%

*System Cost = Medical and Indemnity


Premiums Paid (millions) % of total

Commercial Market CY 2009 $586.9 63.10%

Self Insurance FY 2010 $253.3 27.23%

State Accident Fund FY 10 $ 90.0 9.67%

Total $ 930.2 100.0%


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

What’s New?

Issues

Form 21

Electronic filing

eCase


Issues

Legislation H 3111 – limits on fee schedule

Fee SchedulesNotice of Drafting R 67-1302 (A)

conversion factor

Advisory CommitteesSurgical Implant Fee Pharmacy Fee


Electronic filing


•Hearing Notices

•Decision and Orders

•Consent Orders

pilot project – April 15

•Full Commission Orders Service

June 1

eCase

Amanda UnderhillSenior Applications Analyst


eCase Benefits


Real – Time access

Case information

Scheduling

Hearings, Conferences and Appeals

Recent Claim Activity

List of Cases in a status group

Registration


• Register at www.wcc.sc.gov

“eCase Status”

• Registered users

Attorneys

Paralegals

Legal Assistants

Adjusters and TPAs

http://www.wcc.sc.gov/

Registration


• Create account • Party approval required

• Attorney• Claim Manager

•SCWCC Confirmation•Three user types:

ATTORNEY

CARRIER or SELF-INSURER

TPA

Are you a Carrier?


Are you a TPA?


Attorney User


• Restricted access to cases

• Linked attorney – attorney of record

• Search for claims and report representation to the Commission

Attorney of Record


•Electronic notification (attorney add)

•Replaces the letter of representation

(R.67-1202)

•Withdrawal Not allowed electronically (R.67-1203)

Attorney Add


• User must be linked to attorney

• User may search for WCC#

• All searches are logged and audited by SCWCC

Select Party


User designates party to be represented

•Claimant

•Carrier

•Employer (direct)

Select Party


Case Search


Enter Information:

•Claimant SSN / Last Name or WCC#

•Date of Injury

•Attorney Bar ID

Search Result


Confirmation

Attorney Add


Are you sure?

Confirmation Attorney


Confirmation message

WCC Case Display Data

WCC #

Caption

DOI

Attorney for Defendant

Claimant’s Attorney

Status



WCC Case Display Data

Report Options


Registered User Reports 4 options:

•WCC#•SSN•Hearing Date Range•Status Group


WCC# Report WCC# or SSN Report

Hearing Date Range



Status Groups


Hearing Request Pending –

Status Group

Attorney Registration Questions

User Guide Available on www.wcc.sc.gov

Amanda Young, Judicial Analyst(803) 737-5747

[email protected]


http://www.wcc.sc.gov/

Contact Information

Amanda UnderhillApplications Analyst

(803) [email protected]


scwcea one day seminar may 6, 2011 commission update gary m. cannon amanda underhill executive...

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