Workers’ compensation claims compliance can be incredibly complex on a state-by-state basis. With variation across 50 jurisdictions, how can organizations mitigate the complexity of state forms?
Between keeping up with ever-changing laws to ensuring that internal reporting requirements are adhered to, carriers, TPAs, and self-insureds have a lot of things on their plates. If not given the proper attention, workers’ compensation state form requirements can quickly take up a huge amount of time and possibly become a liability.
The 50 State Headache
With workers’ compensation insurance regulated at the state level, form requirements can differ from state to state. There is differentiation in types of forms, what triggers their completion, where they need to be sent, and deadlines for submission. These complexities are further compounded when factoring in that states can also adhere to different manuals, classification systems, and experience rating formulas. While some states, like Alabama and Illinois, adhere to the National Council on Compensation Insurance (NCCI), others have their own independent rating bureaus—Minnesota, for example, s cheekily referred to as the “state of 10,000 forms” by adjusters. Factoring in that some employees may work over state lines only adds to an already intricate compliance process.
Inundated with numerous forms, even the most experienced adjusters can struggle with the nuances of form compliance requirements when multiplied against their caseload. For those that handle cases across multiple states, it can quickly become almost a quarter of their overall workload, especially in cases where the injured worker looks to piggyback benefits, or double collect between states. Not only is this a burdensome and time-consuming process, failure to comply with state form requirements can result in heavy penalties, fines, and fees.
Time Away from Workers’ Care
According to a 2019 Workers’ Compensation Benchmarking Survey, 58% of frontline claims professionals spent over 20% of their time on internal or external compliance activities. When adjusters spend considerable time on compliance requirements, like state forms and other administrative tasks, their focus is taken away from more impactful tasks like return-to-work or resolution of their claims.
While state compliance is important, adherence to it can quickly turn into a time-consuming process for adjusters, no matter their caseload. As the industry continues to shift toward injured worker advocacy, time spent on compliance tasks takes away from adjusters working with injured employees and other individuals to help them recover in the most efficient manner possible.
Opportunity in Automation
This complexity is all compounded by the COVID-19 pandemic. Some states like California have ordered that any COVID-19 diagnosis can qualify an employee for workers’ compensation benefits, further complicating an already difficult-to-navigate system. As a patchwork of states continue passing assumptions of causation due to the coronavirus, adjusters are now having to factor in more work with fewer resources. Fortunately, risk technology can offer reprieve from the nuances of state forms and automate repetitive tasks, freeing up time to focus on high-importance items.
With numerous software vendors that work to ease the burden of repetitive or administrative tasks on adjusters, it’s important for carriers, TPAs, and self insureds to find a technology that goes beyond automating and digitizing state forms and find one that works to further efficiency with various tools and integration, all wrapped into one system. Integration into claims software, rate calculators, rules engines, and more gives adjusters the ability to accelerate previously time consuming tasks and form and enables them to remain compliant while spending less time on forms and paperwork.
With the right technology, adjusters can be more informed, efficient, and effective, no matter their seniority in the field, while staying compliant and better advocating for their injured workers.
For more information on how the Origami Risk platform can help your organization resolve the complexity of state form requirements, our integration with various claims platforms and other third-party systems, request a demo. For more information on Origami Risk’s workers’ compensation compliance tool and a case study of it in action, click here.