On July 12-16, 2021, the Southern Association of Workers’ Compensation Administrators (SAWCA) held its annual conference, gathering an audience that included state regulators and judges for the workers’ compensation system.
“The pandemic has created many questions from a regulatory perspective,” says Mark Walls, Vice President – Communications and Strategic Analysis at Safety National, who also leads Safety National’s government affairs efforts. “Whether it be the impact of telemedicine, labor shortages or presumption laws, workers’ compensation advocates have had to reassess their fundamentals.”
SAWCA’s week-long event provided some key takeaways that every industry professional should have on their radar.
1. There is a massive labor shortage across most industries. Because of this, many employers are limiting or eliminating pre-employment drug screening with the exception of safety critical positions, such as drivers. This gradual exit from drug screening predates the pandemic, however, since many companies found years ago they were unable to find enough workers who could pass the screening. However, the pandemic has accelerated the reduced use of drug testing.
2. Telemedicine was a big success story during the pandemic, and states and payers hope utilization continues. The use of telemedicine slowed considerably once physician offices reopened. The most significant objections to the use of telemedicine came from plaintiff attorneys who argued that virtual exams should not be allowed to determine work capacity or maximum medical improvement.
3. Virtual hearings produced mixed results, primarily because not everyone has a strong, reliable internet connection. However, some states are looking at continuing preliminary hearings virtually to cut down on costs, since they are typically under 15 minutes in length.
4. There are widespread concerns that we have opened the door for workers’ compensation to cover future disease outbreaks. Some new laws passed in 2021 provide presumptions pertaining to any infectious disease in which the governor has declared a public health emergency. Increasingly, legislators are looking to workers’ compensation to solve societal risks that the employer cannot control.
5. Some workers’ compensation judges have voiced negative opinions of employers and carriers because of claim denials. However, these judges typically only see the small percentage of claims that end up litigating to a conclusion instead of the vast majority of claims that go through the system with little conflict.
6. Retirements have resulted in a significant talent drain from the entire insurance industry, including state agencies. It is challenging to replace the knowledge associated with these retirements. Training the next generation is a priority, but restrictions on workforce expansions can make this difficult.
7. Data is more important, accessible and plentiful than ever before. However, the data needs to be timely, accurate and complete for thorough analysis. COVID-19 exposed flaws in workers’ compensation data analysis because there is no single source that provides a complete picture. In addition, data analysis usually lags at least six months, which makes it impossible to determine trends in real time.
8. The acceptance rates on COVID-19 claims for the most impacted industries, healthcare and first responders, were not substantially higher in presumption states. Employers accepted and paid these claims without the presumptions in place, and implementing them created an unnecessary change to the burden of proof.
9. Few payers take advantage of the rare opportunities to interact with industry regulators that events like SAWCA and the International Association of Industrial Accident Boards and Commissions (IAIABC) provide. Only four carriers, three third-party administrators (TPAs) and one employer attended SAWCA this year. Regulators need to hear from these groups to understand the impact of various workers’ compensation rules and regulations. In addition, it is important that stakeholders have open discussions with regulators on how to improve the system. As an industry, we need more payers participating in these conversations.
10. Virtual conferences allow for greater attendance than in-person events because of decreased time and financial commitment. These virtual events work well for educational content, but there is no substitute for in-person interaction when it comes to collaboration and casual networking conversations.