Indicator 6: Accuracy of Weekly Rates & Total Payments

Indicator Description

This indicator measures both the accuracy of setting wages for computing TTD rates under ss. 102.11 and 102.43, Wis. Stats., and the accuracy of all temporary and permanent disability benefit payments due.

Compliance Requirement

Insurers are required to comply with ss. 102.11 and 102.43, Wis. Stats., and make accurate and complete payments in accordance with both of these sections in Chapter 102.

Standard or Benchmark

While there is no performance standard set by statute or rule the benchmark used for training purposes is to have a ratio of no more than 10% of claims requiring letters to correct rate calculation or payment accuracy vis-à-vis all claims.

Source of Indicator Data

The source of the data is from wage and rate computations shown on the Supplementary Report, form WKC-13, and the Wage Information Supplement, form WKC-13-A. The program selects balance due (letters WC77 and WC77P) and wage correction letters (letter WC119) sent during the quarter. Click here (Standard Letters) to view specific letter language.

Computation Methodology

Accuracy is computed by dividing the number of balance due and wage correction letters by the number of First and Final Supplementary Reports received during the quarter and establishing a ratio of these letters sent during the quarter vis-a-vis the number of First and Final Supplementary Reports received during the quarter. Counts and ratios will be made after combining the following two categories:

1. The accuracy of the wages used and TTD rate computation, and
2. The accuracy of the total temporary and total permanent disability payments

State of Wisconsin Averages

What This Indicator Measures

This indicator reflects the individual and combined performance of about 180 insurers with respect to determining the correct rate at which to pay worker's compensation temporary benefits and the accuracy of correctly paying all payments due. These insurers account for over 90% of the claims submitted. The benchmark for training purposes is that 90% of claims reported do not require the Department to send either a balance due or wage correction letter. Data is updated quarterly.

Explanatory Comments for Current Indicator

Industry performance for the past 12 quarters is at 89%. 1st quarter 2024 performance is at 88%. Continued monitoring, education and feedback by the WC Division, as well as insurance carrier and self-insured employer diligence, have enabled insurers and self-insured employers to meet or exceed the 90% benchmark for this very important aspect of claims adjusting.

Indicator 6: Accuracy of Weekly Rates & Total Payments

• Group A - Large Insurers (400 or more paid claims in the previous calendar year)
• Group B - Medium Size Insurers (less than 400 but at least 65 paid claims in the previous calendar year)
• Group C - Small Size Insurers (less than 65 paid claims in the previous year, but at least 65 claims in the previous three-year period)

PLEASE NOTE: Quarterly summary reports are static. As such they are a snapshot of performance reflected by our database on the 14^th day of every new quarter. As such, actual performance may be different due to changes to the claims for the given quarter after the reports are run.