Indicator 1: Promptness of Submitting First Reports of Injury, Form WKC-12
This indicator measures insurers compliance with DWD s. 80.02(2)(a) relating to submission of first reports of injury to the Department.
Insurers are required to submit the Employers First Report of Injury or Disease, form WKC-12, to the Department on or before the 14th day after an accident or the beginning of a disability from an occupational disease for all compensable injuries where disability exists beyond the 3rd day after the employee leaves work as a result of an accident or disease.
Standard or Benchmark:
DWD s. 80.02(3)(b), sets the standard for prompt reporting at 70% of First Reports to be received by the Department within 14 days of the date of injury or the last day worked after injury before the first day of compensable lost time.
Source of Indicator Data:
The source of the data is from the WKC-12, specifically the "date of injury" and the "last day worked". The data reflected in the tables represents only compensable claims for which supplemental reports, WKC-13s, were received during the quarter indicating that the first indemnity payment was made.
Only claims for compensable injuries are included in the measurement. Denials and "no-lost-time" claims are not included. Those claims "under investigation" are included at the time they become compensable. Claims put on the information system without the receipt of a First Report of Injury are considered late. These are known as "non-reported" claims. These include those set up as claims because of the receipt of applications for hearing, medical reports or other documents.
Promptness for the first report of injury is measured by computing the number of days from the day following the date of injury or last day of work prior to the first day that caused the first day of lost time to be paid, whichever is later, to the day the report is received. There is no time lapse for "non-reported" claims, but they are included as late and shown as No WKC-12 on the claim detail. Permanent disability claims are excluded.
State of Wisconsin Average:
What this Indicator Measures:
This indicator reflects the combined performance of about 180 insurers with respect to their promptness of submitting First Reports of Injury to the Department. These insurers account for over 90% of the claims submitted. The legal standard for insurers is to submit 70% to the Department within 14 days of the date of injury. Data is reported quarterly and the year to date and 12 quarter history data are updated quarterly.
Explanatory Comments for Current Indicator:
The industry average for the past 12 quarters is steady at 76%. This is well above the 70% standard. 4th quarter 2015 performance has dropped a bit, to74%.Most delays in reporting the First Report of Injury are caused by employer failure to report, in a timely manner, lost time injuries to their insurance carriers. Performance improvement measured by this indicator can be directly attributed to intense monitoring by the WC Division as well as insurance carrier concern to engage in informational outreach to employers regarding when the former should be reporting injuries to the latter. In quarters to come the WC Division will continue to look closely at individual insurance carrier/self-insured employer performance measured by this Indicator with an eye towards improving performance even more
Indicator 1: Promptness of First Reports
Group A - Large Insurers (400 claims or more per year)
Group B - Medium Size Insurers (65-399 claims per year)
Group C - Small Size Insurers (equal to or greater than 65 claims every 3 years)
PLEASE NOTE: Quarterly summary reports are static, a snapshot of performance reflected by our database the day prior to the reports being run. As such, actual performance may be different due to changes to the claims for the given quarter after the reports are run than performance captured in the PDF.