WCRI Study Examines Trends in N.Y. Workers’ Comp System

The Workers Compensation Research Institute (WCRI) in Massachusetts has published a new report that examines the performance of the New York workers’ compensation system following reforms enacted in 2007.

The new WCRI study, titled “Monitoring Trends in the New York Workers’ Compensation System,” is the seventh annual report to regularly track key metrics of the performance of New York’s workers’ compensation system following the implementation of the 2007 reforms.

WCRI said the key reform measures increased maximum statutory benefits, limited the number of weeks of permanent partial disability (PPD) benefits, created medical treatment guidelines, adopted a fee schedule for pharmaceuticals, established networks for diagnostic services and thresholds for preauthorization, and enacted administrative changes to increase speed of case resolution.

The report noted that the changes have various effective dates and have been instituted over time. As a result, WCRI said, it will be several more years before the full impact of the reforms will be realized.

The following are among the study’s key findings:

• In 2011 claims evaluated in 2012 (reflecting 16 months of experience under the treatment guidelines), the number of visits per indemnity claim decreased notably for chiropractors and physical/occupational therapists when compared with the prior year. There was a smaller decrease for physicians.

• From 2007 to 2010, for PPD/lump-sum cases at an average 24 months of experience, there was a nearly 15 percentage point decrease in cases that received PPD payments only (with no lump-sum payment) and a nearly 12 percentage point increase in cases with a lump-sum settlement only (with no PPD payments).

• From 2007 to 2011 (for claims at an average 12 months of experience), there was a 4 percent increase in the number of visits for major radiology services by non-hospital providers. The percentage of indemnity claims with major radiology services also grew over that same period, from 45 percent to 52 percent.

• There was little change in the average defense attorney payment per claim from 2009 to 2010, but an increase of nearly 9 percent in 2011.

The study uses open and closed indemnity and medical-only claims with dates of injury from October 2005 through September 2011, with experience as of March 2012. The data are representative of the New York system.

The WCRI is a not-for-profit research organization based in Cambridge, Massachusetts.

Source: The Workers Compensation Research Institute