State more aggressive in attempts to deny comp claims, consultant says
Maddy Bowling, president of Chicago-based Maddy Bowling & Associates Consulting Inc., recently testified before the state Legislature's Audit and Fiscal Review Committee. Lawmakers heard testimony regarding a preliminary report by Berry, Dunn, McNeil & Parker, an accounting and consulting firm in Maine that was hired by the state to examine its Workforce Safety and Insurance agency. Gov. John Hoeven urged the agency to look into its operations after receiving alarming reports from the WSI's internal auditor that some claims were being improperly denied.
For the report, the consultants randomly selected 100 workers' comp claims that were denied by the WSI from 2006 to 2007. Researchers found that the agency did not violate any policies or state laws in denying the claims. The findings backed up an audit issued in early March by Marsh USA Inc., which found that there was no evidence that WSI officials unfairly denied injured employees' benefits.
However, Bowling said that North Dakota's workers' comp law is "extremely conservative" in allowing the agency to deny a claim if the employee's injury can be linked to an existing medical condition. Bowling said the state has become more aggressive in recent years in examining whether a work-related injury claim can be connected to an individual's previous medical history or to conditions related to the aging process.
Because of the emphasis on investigating claims, the report found that the amount of time it took the state to deny a claim rose from 26.9 days in 2006 to 28.8 days in 2007. In addition, it took two additional days for claims to be accepted in 2007 -- jumping from an average of 11.9 days in 2006 to 13.9 days the following year.
Bowling urged the committee to form a study group to examine how other states handle similar issues. That group, she said, should include representatives for injured workers and labor groups, in addition to officials from the WSI.
The WSI has been under public scrutiny since late last year when it fired its chief executive officer, Sandy Blunt. Criminal charges had been filed against Blunt and Romi Leingang, investigations director, for allegedly misappropriating state funds and conspiring to release confidential information. However, the charges were later dropped.
November 4, 2008
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