North Carolina: Battle begins before reform legislation filed
Richard Victor, executive director of the Workers Compensation Research Institute, gave the panel details of recent studies showing average costs per claim in the state are higher than the median in a 16-state study. Injured workers, trial attorneys, and others lobbied to prevent changes they believe will undercut benefit levels.
WCRI's research indicates claims frequency in North Carolina is lower than that of the typical state while the average cost per claim is higher. The organization cites several reasons.
Hospital costs, both inpatient and outpatient, have been higher than other states in previous studies. Reforms implemented in 2009 that sought to address the higher costs by changing reimbursement rates have not been in place long enough to determine whether those costs have declined, according to Carol Telles, WCRI senior analyst.
Additionally, surgery rates have been higher while lump-sum settlements are more frequent and higher on average than in many states.
Concerns over higher average costs per claim led Rep. Dale Folwell to introduce legislation that includes these changes to the workers' comp system:
- Defines "suitable employment" pertaining to an employee's return to work within restrictions or after reaching maximum improvement.
- Makes willful misrepresentations grounds for disqualification from receiving benefits.
- Provides that parties may reach a separate contemporaneous agreement to resolve issues not covered by the act.
- Clarifies the rights and responsibilities of employers and employees regarding medical examinations, treatment, and access to medical information.
- Caps the duration of compensation for temporary total disability.
- Extends from 300 to 500 the number of weeks an injured employee is eligible to receive compensation for partial incapacity.
- Increases the death benefit and burial expense allowance.
- Reduces the Industrial Commission from seven to five members subject to legislative confirmation.
- Provides that commissioners and deputy commissioners are subject to the code of judicial standards.
- Repeals the commission's full exemption from the Administrative Procedure Act.
Read more at the WorkersComp Forum homepage.
April 28, 2011
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