Council on Worker's Compensation
December 11, 2002
Members present: Mr. Bagin, Mr. Beiriger, Mr. Buchen, Ms. Connor, Mr.
Glaser, Mr. Newby, Ms. Norman-Nunnery, Mr. Olson, Ms. Vetter, Mr. Welnak,
Mr. Rostan for Rep. Hundertmark
Staff present: Mr. John Conway, Mr. O’Malley, Ms. Knutson, Mr. Shorey
- Minutes . Ms. Norman-Nunnery
convened the meeting in accordance with Wisconsin’s open meetings law. Ms.
Vetter moved adoption of the minutes of the June 6, 2002 meeting; Mr. Bagin
seconded the motion. The motion was unanimously approved.
- Letter of Resignation. After serving 28 years on the Council, Mr.
Emil Muelver submitted a letter of resignation for health reasons. He
previously received a plaque for years of service on the Council. The
Council will send a letter of appreciation to Mr. Muelver. Mr. Newby
introduced Mr. Ron Kent with AFSME to replace Mr. Muelver as a labor
representative on the Council. A nomination letter and his resume will be
forwarded to the Department Secretary.
- Council Retreat Follow-up. Mr. Conway reported that training for
council members was discussed at the retreat several and topics were
considered including a general orientation to worker’s compensation with
an online tutorial. There also would be the possibility of e-mail
connectivity to experts at the Division. Advanced/master level topics could
be presented once a year at one of the council meetings and could address
future trends in worker’s compensation. Ms. Connor researched the
possibility of revitalizing the John R. Commons seminars. The last few years
the seminars were not well-attended. The Council would need to breathe new
life into whatever seminar format was considered. Mr. Glaser recalled that
the Commons seminars were presented at UW-Madison with national speakers on
controversial topics. Mr. Bagin commented that Arthur Larsen was the initial
presenter. Ms. Norman-Nunnery indicated that the Division’s role in
organizing and conducting the Commons seminars was minimal. Funding for the
program was provided by UW and Wausau Insurance. Mr. Glaser indicated that
while council members attended the seminar, they did not get involved in the
organization or funding of it. Ms. Connor will continue to research the
issue of organizing and funding a worker’s compensation seminar. The
Council is not directing the Division to use its resources to fund a
John Conway indicated that the Division would supply
information to the Council including critical indicators and emerging issues
in worker’s compensation. A bulletin could be developed and sent out on a
quarterly basis. The published critical indicators were included in a
handout for the Council. Ms. Norman-Nunnery proposed that basic information
on worker’s compensation (e.g. top ten topics) be available in an
electronic, self-paced format with links to individual staff members to
answer questions on individual topics. Mr. Glaser indicated that a synopsis
of significant court cases should be included in the information, which
would be especially helpful to new council members. Ms. Norman-Nunnery
indicated that the Division would make sure that the Council had updates to
the Neal & Danas Handbook. Mr. Bagin indicated that the council members
would benefit from a short synopsis, in layman’s terms, of recent court
cases. Mr. Beiringer commented that the tutorial should contain information
on processes including what happens after the point that an injury occurs,
including the forms that are completed, and the procedures involved in the
hearing process after a claim is disputed. Mr. Glaser inquired whether there
could be access to this tutorial outside the Council, especially if there
was a considerable cost in its development. Ms. Norman-Nunnery indicated
that the Division could launch the tutorial from its website. New York State
has a wonderful document for workers and the Division could incorporate some
of those ideas. The Division’s first objective would be to educate the
Council, and later access to the public could be incorporated. Ms.
Norman-Nunnery indicated the Division would move forward with contacting UW
about developing a tutorial.
Mr. Newby indicated that information contained in the
critical indicators would be beneficial to the Council. Mr. Buchen indicated
that the steady decline in first open claims and first payment of
compensation was a positive trend. Mr. Shorey explained that ever since
1993, that number has been declining. For 2002, the Division was projecting
4000 fewer first open claims. Mr. Glaser inquired whether there was
information concerning the types of industry with the most claims. Mr.
Shorey indicated that the database does contain the industrial code
associated with each employer. Mr. Newby indicated that it would be useful
to have the critical indicator report at each meeting with the Division’s
objective reflected for each indicator. Ms. Norman-Nunnery indicated that
the Division would continue to share at future meetings the critical
indicator information provided to the Council at this meeting. Regarding
claim trend information, Division staff would provide brief explanation of
the cause and effect of the trend. Mr. Glaser indicated that it would be
good to provide to the Council a chart of indemnity cost comparisons. Mr.
Bagin commented that the information provided by the Division revealed that
the Uninsured Employers Fund accounts receivable had increased. Mr. Conway
stated that the Division’s collections of fines had also increased. Mr.
Glaser questioned the data that indicated $20 million was uncollected. Mr. O’Malley
indicated that the number was a rolling total average. Mr. Conway indicated
that the Division was now levying employers if bank accounts can be located.
Some amounts were uncollectible, bad debt. The data provided at this meeting
does not show the amounts collected by the Division. Ms. Norman-Nunnery
indicated that Mr. Brian Krueger would be invited to the next Council
meeting to further explain the amount of collections and accounts receivable
for the Uninsured Employers Fund. Mr. Buchen indicated that he would like to
see the critical indicator information prior to the next meeting.
Mr. O’Malley reported on the pilot project and
judicial critical indicators. The number of hearing applications is a
rolling total to 1999. The average is 570 per month, with close to 7000
total for 2002 projected. The Division is streamlining the hearing process
through the pilot project, which officially started on November 1, 2002.
Mary Lynn Endter is the administrative law judge assigned to this project.
Some initial computer-generated data has been gathered on this project.
The Division will follow cases to see what happens to them after they go
through this process and a hearing is scheduled. In addition, cases with
partial success will be followed. So far, 213 cases have been routed
through the process, with results reported on 81 cases. Hearings have been
scheduled on 72 cases. In addition, 7 cases were resolved in part and two
cases were resolved by compromise settlements. Most cases are put on a 60
to 90 day follow-up. By March 1, 2003, the Division will be able to have a
better analysis of the process when more data is available and more files
have completely moved through the hearing process. Ms. Knutson indicated
that defense attorneys are pleased with the Division’s actions in
streamlining hearing applications.
- Hearings Update.
Medical Databases Update. Mr. Shorey provided information that was
requested at the Insurance Focus Group meeting. He indicated that that the
Division has one-half dozen certified databases with one decertified and an
addition of a couple. Some databases have consolidated. The Division does
not have any technical or official audit of the databases. The Division
looks at new databases to see how they align with existing ones. If there is
a big change or irregularities, the Division will question it. If there is a
problem with customers, the Division will try and follow-up to get at the
source data to see if the changed data is not accurate. The source data is
twelve months old. The bill reviewers use private databases, and are
required to indicate which database and specific CPT code was used. The
process has not changed over the years. Wisconsin does not have a unified
database like some other states. The data is based on 1.5 standard
deviations from the mean on charged data. There are database comparisons
from year to year. Ms. Connor inquired as to whether this was in line with
overall medical inflation. Mr. Shorey responded that this is not a cost
containment system. Most charges are between the 85th to 93rd
percentile. Mr. Buchen indicated that it was a start when it was first
implemented, but it is not enough. Mr. Shorey added that pharmacy charges
are not included in this bill review system. Mr. Scott Shaver from Briggs
and Stratton stated that there was a noted increase in third party
administrators involved in prescriptions and that some pharmacies were
billing two to three times more for worker’s compensation claims. He
stated this occurred with pharmacies that direct bill the insurance
companies or self-insured employers. Mr. Glaser indicated that there were
regulatory agencies in Wisconsin that could address this issue, including
any ethical problems. Mr. Shorey commented that some states have price
indexes for the cost of drugs, with averaging of wholesale prices. Ms.
Norman-Nunnery indicated that this is an emerging issue. She questioned
whether the Council wanted to address this issue or whether the information
was too limited for a systemic solution. Mr. Glaser indicated that in
contrast to this issue, the chiropractors brought 400 problem cases to the
attention of the Council. Mr. Bagin suggested that the Council explore
whether the reasonableness of fee databases should be applied to
prescription drugs. Mr. Buchen indicated that if the Council deals with
medical cost charges, prescription charges should be included. Ms. Connor
indicated that Wausau Insurance’s data for prescription drug payments is
itemized. She agreed to look at trend data. Mr. O’Malley agreed to look at
the legal issues involved in this issue.
Videotape – Plan for Legislators. Mr. Buchen reported that the
videotape was completed and there would be systematic visits to the
Legislature, with the bulk of the visits done by outside consultants.
Insurers were willing to pay for part of the cost. The process would begin
early in the next session. The plan was to retain an individual with
experience in the legislature. Ms. Norman-Nunnery indicated that the
videotape should be shared with the Council at the next meeting.
Compscope Public Briefing. Ms. Norman-Nunnery reported that the
Worker’s Compensation Research Institute has scheduled a public briefing
tentatively for January 29th and 30th in Milwaukee.
Agreed Bill Timeline/Meetings. Ms. Norman-Nunnery indicated that the
Department proposals would be ready in December, and ready to be shared at
the January 16, 2003 meeting. There will be no meeting in February. At the
March 25, 2003 meeting the management/labor proposals will be
reviewed. The April 22, 2003 meeting will be time for caucuses. There are
also meetings scheduled for May 13, 2003 and June 9, 2003.
Correspondence. Ms. Norman-Nunnery presented several pieces of
correspondence to the Council.
Small pox vaccinations are still an issue. Ms.
Connor indicated that there have been inquiries from insureds concerning
the Department’s position with respect to vaccinations if mandated by
the government versus vaccinations that are voluntarily received by
employees. Mr. Glaser commented that if the vaccination was suggested
for employment purposes, any reaction was probably work-related. Mr.
Bagin indicated that if there was a possibility of exposure to small
pox, it was likely related to work issues, similar to EMT and first
responder shots. Mr. Newby stated that decision had not yet been made as
to whether it would be voluntary or mandatory. Mr. Beiringer stated that
the situation may involve the employer providing the shot or the
employer receiving the shot to be available for work. Mr. Glaser
commented that a license requires a registered nurse to treat patients
with contagious diseases. Mr. O’Malley stated that Professor Larsen
addresses this issue in his treatise and indicates that if there is some
employer inducement or guidance, it would fall into the compensable
category and the consequences would be work-related. If the employer
gives time off work to get the shot or the employer suggests it, that is
enough to make it compensable. Mr. Bagin commented that there may be a
reasonable expectation that health care workers get the shot with the
threat of an epidemic. Mr. Buchen stated that this issue is likely to
get resolved through some federal legislation. The Council agreed to
table the issue for now. Ms. Norman-Nunnery indicated that the
Department would keep the Council apprised of any further developments.
Senator Baumgart had contacted the Department with
questions regarding the three-day waiting period, and the Department
Correspondence was received from Mr. Koehler and Ms.
Linde concerning changes to the worker’s compensation law. Ms. Linde
also appeared at the public hearing and testified. The Department
responded to this correspondence.
The Department received an e-mail from Senator
Lazich’s office concerning eligibility for temporary disability
benefits when an employee is discharged for misconduct or cause. Mr. O’Malley
responded to this e-mail. However, the Department has since received
another letter from the senator and the issue of amending Administrative
Rule DWD 80.47 will be placed on the agenda for the next Council
Ms. Norman-Nunnery expressed her thanks to the
Council for their support. She is leaving her position on January 6, 2003
at noon. Mr. Glaser, on behalf of the Council, expressed appreciation to
Ms. Norman-Nunnery for her service as the Division Administrator and
Council chair. The Council adjourned until the next meeting.