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SCWCEA One Day Seminar May 6, 2011

SCWCEA One Day Seminar May 6, 2011. Commission Update Gary M. Cannon Amanda Underhill Executive Director Applications Analyst . South Carolina Workers’ Compensation Commission. Commission Update Trends Activities What’s New.

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SCWCEA One Day Seminar May 6, 2011

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  1. SCWCEA One Day SeminarMay 6, 2011 Commission Update Gary M. Cannon Amanda Underhill Executive Director Applications Analyst

  2. South Carolina Workers’ Compensation Commission Commission UpdateTrendsActivities What’s New

  3. South Carolina Workers’ Compensation Commission

  4. South Carolina Workers’ Compensation Commission

  5. South Carolina Workers’ Compensation Commission Accidents Filed1999 - 2010

  6. South Carolina Workers’ Compensation Commission Claims Activity FY FY FY 08-0909-1010-11 (7 mths) Hearings Set (Docketed)9,866 10,9126,107↓ Benchmark 6,395 Hearings Held (Single Commissioner)2,345 2,211 1,242 ↓ Benchmark 1,289 Settlements10,506 10,7156,117 ↓ Benchmark6,250

  7. South Carolina Workers’ Compensation Commission Informal Conferences Assigned Conducted FY 09-10 6,264 3,549 FY 10-11 (7 mths) 3,410 2,518 ↑ Benchmark 3,654 2,070

  8. South Carolina Workers’ Compensation Commission • Appeals to Full Commission • FY FYFY • 08-0909-1010-11 • (7 mths) • Docketed 700 647397 ↑ • Benchmark 377 • Hearings 450 357168 ↓ • Benchmark 208

  9. South Carolina Workers’ Compensation Commission Total System Cost FY 09-10 (millions)% of Total Medical $ 296.0 36% Indemnity (Comp.)$ 528.264% Total $ 824.2 * 100% *Does not include legal fees for defense

  10. South Carolina Workers’ Compensation Commission Cost Control Measures Medical Services Provider Manual (Physician’s Fee Schedule) Hospital Fee Schedule - 2006 Medicare + 40% Ambulatory Surgery Centers Fee Schedule

  11. South Carolina Workers’ Compensation Commission Medical Expense Reduction Actual (millions) FY FY 08-09 09-10Difference Medical Expense $422.4 $296.0 ($126.4)

  12. 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

  13. 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%

  14. 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

  15. What’s New? Issues Form 21 Electronic filing eCase South Carolina Workers’ Compensation Commission

  16. Issues Legislation H 3111 – limits on fee schedule Fee Schedules Notice of Drafting R 67-1302 (A) conversion factor Advisory Committees Surgical Implant Fee Pharmacy Fee South Carolina Workers’ Compensation Commission

  17. South Carolina Workers’ Compensation Commission • Form 21 Amendments • Stop payment of compensation….sixty days of the date of the request. II. Address suspension, termination, or reduction of temporary disability payments for any cause. a. At any time pursuant to § 42-9-260(E). III.Determine if compensation is due… (copy of medical report must be attached).

  18. South Carolina Workers’ Compensation Commission • Form 21 Amendments (cont’d) IV. Determine amount of compensation for claims involving a fatality. (Dependency investigation must be attached).

  19. Electronic filing South Carolina Workers’ Compensation Commission • Hearing Notices • Decision and Orders • Consent Orders • pilot project – April 15 • Full Commission Orders Service • June 1

  20. eCase Amanda Underhill Senior Applications Analyst South Carolina Workers’ Compensation Commission

  21. eCase Benefits South Carolina Workers’ Compensation Commission • Real – Time access • Case information • Scheduling • Hearings, Conferences and Appeals • Recent Claim Activity • List of Cases in a status group

  22. Registration South Carolina Workers’ Compensation Commission • Register at www.wcc.sc.gov • “eCase Status” • Registered users • Attorneys • Paralegals • Legal Assistants • Adjusters and TPAs

  23. Registration South Carolina Workers’ Compensation Commission • Create account • Party approval required • Attorney • Claim Manager • SCWCC Confirmation • Three user types: • ATTORNEY • CARRIER or SELF-INSURER • TPA

  24. Are you a Carrier? South Carolina Workers’ Compensation Commission • Does your company handle ALL SC claims for an carrier or self-insured? • YES • Carrier User • Link to Carrier • Gives access to ALL Carrier’s claims • Multiple Carriers

  25. Are you a TPA? South Carolina Workers’ Compensation Commission • Do you handle some of a carrier’s or self-insured’s cases in SC? • YES • TPAUser • Link to Individual Cases • Your claim number, WCC# (EDI) • Multiple Cases • Unlimited timeframe

  26. Attorney User South Carolina Workers’ Compensation Commission • Restricted access to cases • Linked attorney – attorney of record • Search for claims and report representation to the Commission

  27. Attorney of Record South Carolina Workers’ Compensation Commission • Electronic notification (attorney add) • Replaces the letter of representation • (R.67-1202) • Withdrawal • Not allowed electronically (R.67-1203)

  28. Attorney Add South Carolina Workers’ Compensation Commission • User must be linked to attorney • User may search for WCC# • All searches are logged and audited by SCWCC

  29. Select Party South Carolina Workers’ Compensation Commission • User designates party to be represented • Claimant • Carrier • Employer (direct)

  30. Select Party South Carolina Workers’ Compensation Commission

  31. Case Search South Carolina Workers’ Compensation Commission • Enter Information: • Claimant SSN / Last Name or WCC# • Date of Injury • Attorney Bar ID

  32. South Carolina Workers’ Compensation Commission

  33. Search Result South Carolina Workers’ Compensation Commission

  34. Confirmation Attorney Add South Carolina Workers’ Compensation Commission Are you sure?

  35. Confirmation Attorney South Carolina Workers’ Compensation Commission Confirmation message

  36. WCC Case Display Data WCC # Caption DOI Attorney for Defendant Claimant’s Attorney Status South Carolina Workers’ Compensation Commission

  37. WCC Case Display Data South Carolina Workers’ Compensation Commission

  38. Report Options South Carolina Workers’ Compensation Commission • Registered User Reports 4 options: • WCC# • SSN • Hearing Date Range • Status Group

  39. WCC# or SSN Report South Carolina Workers’ Compensation Commission WCC# Report

  40. Hearing Date Range South Carolina Workers’ Compensation Commission

  41. Status Groups South Carolina Workers’ Compensation Commission

  42. Hearing Request Pending – Status Group South Carolina Workers’ Compensation Commission

  43. Attorney Registration Questions User Guide Available on www.wcc.sc.gov Amanda Young, Judicial Analyst (803) 737-5747 ayoung@wcc.sc.gov South Carolina Workers’ Compensation Commission

  44. Contact Information Amanda Underhill Applications Analyst (803) 737-5714 aunderhill@wcc.sc.gov South Carolina Workers’ Compensation Commission

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