Indicator 3: Promptness of Submitting the First Supplemental Reports

Indicator Description:

This indicator measures insurers’ compliance with DWD s. 80.02(2)(b) relating to the submission of first supplementary reports, forms WKC-13’s.

Compliance Requirement:

Insurers are require to submit a first supplementary report with information required on form WKC-13 on or before the 30th day following the day on which the injury occurred.

Standard or Benchmark:

While there is no statutory standard set by rule for performance, a benchmark that is used for training purposes is that 80% are submitted timely.

Source of Indicator Data:

The source of the data is the "date of injury" and last day of work from the WKC-12. The program selects only the first supplemental reports, forms WKC-13’s, received during the evaluation quarter. Only first WKC-13’s that are "first final" (all first payment data, i.e. amount and date paid, has been included) and were received during the quarter are measured. Only claims for compensable injuries are included in the measurement. Denials and "no-lost-time" claims are not included.

Computation Methodology:

Promptness of the first supplementary report is measured by computing the number of days from the date of injury, or last day of work prior to the first day of lost time that caused the claim to become compensable, whichever is later, to the date the "first final" WKC-13 was received by the Department.

State of Wisconsin Average:

What This Indicator Measures:

This indicator measures the promptness of insurers for submitting first supplemental reports to the Department. These are the reports that provide information about liability and the first indemnity payment. Insurers have 30 days by rule to submit this report. This indicator measures performance quarterly, on a year-to-date and a 12 quarter basis.

Explanatory Comments for Current Indicator:

Since the 4^th quarter of 2009 there have been very slight undulations in performance but at the end of the 1^st quarter 2013 performance is at an excellent 88%. 12 quarter performance is also right at 88%. Both of these comfortably exceed the benchmark. Late reporting of lost time injuries by employers is one factor that adversely affects the timeliness of first supplemental reports. Continued education of employers by insurers regarding the importance of prompt lost time injury reporting should allow for more improvement in this measure.

Indicator 3: Promptness of First Supplemental 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.

First Quarter 2013