- Report Published -
|Timing of Resolution of Workers' Compensation Claims and Employee Leasing|
|Workers' Compensation Commission|
|HJR 186 (Regular Session, 1998)|
| House Joint Resolution 186 directed the Workers' Compensation Commission to "study ways to expedite the receipt of workers' compensation benefits for employees injured on the job. " The Resolution noted that "unnecessary delay in providing an employee or his dependents with the compensation they are entitled to under the law is unconscionable and is antagonistic to the legislative intent of the Act," and "can lead to unnecessary loss of property, further health problems, family discord and strife, and personal financial crisis."|
Growth of the Workers' Compensation System
The Commission's challenge is to adapt its procedures to the increasingly large and complex case load.
The Commission processes approximately 200,000 accident reports each year, including nearly 60,000 of which involve at least seven lost work days and more than $1,000 in medical expense. Parties file approximately 20,000 applications for hearings.
Litigation has grown in numbers and complexity. Deputy Commissioners decided 4,178 cases in 1996. This is up from 3,938 in 1986, and 2,857 in 1976. These cases are longer than cases in previous decades, and involve extensive discovery. By increasing the number of Deputy Commissioners, the Commission has prevented a significant increase in the length of time for resolving cases. The average length of time from application to Opinion after an on-the-record determination is 115 days, compared to 189 days for an evidentiary hearing. In 1991, the length of time was 187 days for the evidentiary docket.
Parties may appeal Deputy Commissioner Opinions to the Full Commission, and in 1996 the Full Commission decided 1,623 cases. This compares to 914 cases in 1986, and 297 cases in 1976. The average length of time from a review request to a Full Commission decision is 179 days. In 1991 the length of time for issuance of a Review Opinion was 146 days.
Parties may appeal Full Commission decisions to the Court of Appeals. In 1997 there were 335 such appeals, and the average length of time involved is about 200 days from appeal to decision.
Commission Initiatives to Expedite the Process
The Commission is committed to resolving claims as quickly as possible, and has adopted several initiatives to expedite the process. They include:
1. Upgrade of Computer System - The Commission has invested in a major upgrade of its information system to achieve efficiencies in claims processing, better networking capabilities among the regional offices, and increased options for interaction with the public including electronic filing and a Web page.
2. Emergency Case Docket - Cases involving a demonstrated hardship, upon the agreement of parties, can be heard on an emergency basis in Richmond in the Commission's newly constructed second courtroom.
3. Mediation - The Commission will adopt mediation procedures for issues which lend themselves to mediation.
4. Ombudsman - The Commission has created a new position, Ombudsman, to facilitate better understanding of the system and better communication between the parties.
5. Public Education - The Commission is expanding its public seminars, brochures, and Telephone Response Unit to improve public understanding of procedures.
6. Staff Attorneys - To assist with the growing Review caseload, the Commission has created the position of Staff Attorney. Staff Attorneys are experienced practitioners who assist Commissioners in Opinion research and drafting.
7. Decision on Acceptance or Rejection of Claims - The Commission currently sends out a twenty-day Order to the employer/insurer seeking either an acceptance or denial of the claim. If no response is received, this is followed-up with a ten day Order. The Commission will streamline this process by sending out only the twenty-day Order, after which the case will be referred immediately to the docket if there is no response.