Monday, October 22, 2012

OK: Costs of Adjudication Are Only A Symptom

Oklahoma Labor Commissioner Mark Costello and Lt. Gov. Todd Lamb (R) are pushing the state to adopt an administrative adjudication system for workers' compensation claims that go litigated.

Lamb says the current system is too costly, impedes economic development and forces employers and injured employees to fight rather than focus on getting workers back on the job.

His position is supported by at least ten Republican state senators and in May they requested a study on the issue through the Senate Judiciary Committee. But Committee Chairman Anthony Sykes, R-Moore, has not called a meeting of the panel to begin the work.

Costello told WorkCompCentral that he met recently with representatives of the Arkansas Workers' Compensation Commission and came away believing that modeling an Oklahoma system after Arkansas would work.

The 2012 Oregon Department of Consumer and Business Services ranked Oklahoma as the sixth most expensive state for workers’ compensation, with an average premium rate of $2.77 per $100 of payroll, compared to the median of $1.88. In the 2010 Oregon study, Oklahoma ranked as the fourth most expensive state.

Lt. Gov. Lamb told WorkCompCentral that he believes moving to an administrative model for workers' compensation would make things less adversarial.

Costello told WorkCompCentral he believes much of the higher costs in Oklahoma are due to excessive involvement of attorneys in the workers' compensation process.

While an administrative system may prove to be more efficient in handling litigated claims, it is not the single answer to lowering the expense of delivering benefits to workers.

I think Lamb gets that idea, because he also told WorkCompCentral that he is willing to consider multiple options. "The goal is to reform the system ... and we'll know it's reformed when premiums start going down," he said.

Workers' compensation is a political compromise no matter what one does with resolving impediments to the delivery of benefits. Oklahoma isn't going to get an administrative adjudication system without also making other changes that the various interest groups (don't talk to me about "stakeholders"!) deem necessary to their respective positions.

Costello, however, is mistaken in attributing all of Oklahoma's problems to "involvement of attorneys in the workers' compensation process."

I've opined this before - workers' compensation is the poor man's dispute resolution system. There is study after study confirming that the number one driver of litigation in workers' compensation is job dissatisfaction. Many litigated claims are not about the injury, but about either "justice" or "revenge." Some just can't move on without closure of some emotional issue tied to work - and that is generally categorized as job dissatisfaction.

Job dissatisfaction takes on many permutations. It could be that the worker just believes that his boss is an ass. Or the worker is disgruntled because he or she can't get the vacation time requested. Or it could be that the worker simply feels that flipping burgers for minimum wage is demeaning and there is nothing to lose with getting a little paid time off...

An administrative system isn't going to get the lawyers "out of the system" - per above, working folks need a place to air their grievances, rightly or wrongly - but I do believe that an administrative system is more efficient in resolving disputes. Sometimes rulings are right, sometimes they are wrong, but the bottom line is that the longer a dispute remains unresolved (i.e. a claim remains open) the greater risk there is for an adverse result due to increase disability duration (read "claims severity").

Another significant impact on claims adjudication is simply culture. What works in one state won't work in another state. Heck, even intra-state the same system won't produce exactly the same results. California is a prime example - just look at the issue of liens in litigated cases which are virtually not an issue in Northern California, but are a principal part of the system in Southern California.

But when one really gets down to basics, having a civil court resolve workers' compensation disputes is simply inefficient when compared to an administrative adjudication process. Civil courts deal with a myriad of issues from all segments of social interaction. Workers' compensation deals with only seven basic issues: causation (AOE/COE), medical treatment, medical billing, temporary disability, permanent disability, return-to-work/vocational rehabilitation, and medical-legal.

The bottom line is that moving to an administrative adjudication system is a good idea, but believing that it is the panacea to controlling a system is not realistic. The costs of adjudication are simply a symptom. There's a whole lot more to look at than just dispute resolution.

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