This year’s Southern Association of Workers’ Compensation Administrators (SAWCA) Annual Convention brought together a diverse group of industry stakeholders, including workers’ compensation state regulators and judges. The setting provides a rare opportunity for this community to discuss the legislative changes impacting the workers’ compensation system, which can be incredibly beneficial to injured workers.
Mark Walls, Vice President of Client Engagement at Safety National, attended while also moderating the Regulator Roundtable. Here he provides his key takeaways from the convention.
1. Roadblocks Remain in Technology Adoption
Many regulatory agencies have made impressive strides in recent years to innovate, but several challenges still need to be solved in their progress. Antiquated systems and paper-driven mail processes restrict any advancements, particularly in states that require this type of communication or payment method. Technology usage could provide significant opportunities for system improvements at these agencies in order to reduce redundancies and speed up the claims process.
2. Accessible Care Has Many Challenges
A primary concern for all stakeholders is ensuring that injured workers have adequate access to timely and appropriate medical care. Access to available medical providers, particularly specialists, in rural areas, can be very challenging. However, even larger cities are not immune to this since many medical providers do not want to handle fee schedules or manage the workers’ compensation system’s paperwork requirements. Unfortunately, these same issues are even more complicated to attain mental health provider access.
3. Quality is Declining in Claims Handling
Many regulators expressed growing concern about the declining quality of the claims handling process. The solution may rely on upskilling and cross-training newer adjusters as senior-level adjusters retire, causing an industry “brain drain.” Furthermore, adjusters need to have the capacity to focus on higher-level tasks rather than simple processing, which is yet another reason to embrace technology’s role in creating efficiencies. Additionally, regulations must adapt to reflect new adjuster staffing models where most are working remotely. Even with electronic claim files, some states still require in-state handling, which may not be necessary in all cases.
4. Judges are Concerned About Increasing Litigation
Some discussions lead to a perception that there is an increasing amount of litigation from employers and carriers, leading some attendees to believe there is a lack of understanding and care for the injured workers. However, this was refuted because those litigated cases account for less than 10% of the claims in the workers’ compensation system. Most claims are processed through the system with little-to-no issues, and the injured worker returns to their occupation without any residual physical effects. Most employers highly value their employees and seek to do everything possible to ensure the best care for their injured workers. It was critical for regulators and judges to hear this message.
When creating new standards, regulators and legislators should keep in mind that the workers’ compensation system works very well and delivers the desired results when used effectively. Applying changes that focus on a small number of challenging claims can adversely impact the vast majority of workers’ compensation claims.