It is rare for workers’ compensation insurance regulations to be revised; however, recently the coverage has been and is going through significant changes that affect employers. These are occurring at the state and national levels, and are changing how it’s priced, what it covers and more. Below is a quick overview of some of the key changes.
1) Split Point Change
In 2013, the split point for all NCCI experience modification calculations increased from $5,000 to $10,000. It increased to $13,500 in 2014, and is expected to increase again to $15,000 in 2015. The NCCI bureau reserves the right to increase it after 2015 based on inflation.
This changes the dollar amounts used when determining experience modification ratings (EMRs), and it typically benefits good-performing employers and is detrimental to those with less-stellar claim histories. In general, if your experience modification rating was less than 1.00 prior to the change, you will typically see a lower modification rating. However, if your experience modification rating was greater than 1.00, you are more likely to see your EMR increase. Experience modification ratings close to 1.00 will typically not see much of a change.
2) Mental Injury (Sometimes Refferred to as Menatl/Mental)
For injuries on or after Oct. 1, 2013, mental impairment resulting in post-traumatic stress disorder (PTSD) diagnosed by a licensed psychiatrist or psychologist will be compensable under workers’ compensation insurance in Minnesota.
A claim of mental impairment is not compensable if it results from disciplinary action, work evaluation, job transfer, layoff, demotion, promotion, termination, retirement, or similar action taken in good faith by employer.
3) Salary Continuation
Although an employer may still choose to practice salary continuation, the workers’ compensation insurance carrier will now reimburse the employer at the Temporary Total Disability (TTD) rate. Because this indemnity benefit is reported to the ratings bureau for the experience modification calculation, there is no readily apparent incentive to practice salary continuation. This directive was issued on Dec. 14, 2011.
4) Attorney Fees
Effective for dates of injury on or after Oct. 1, 2013, claim-related attorney fees will now be paid on a straight 20% contingency fee. The maximum fee has increased to $26,000 per injury. The contingency fee is payable from the employee’s compensation benefits.
5) Job Placement
If an employee is not able to return to work with the pre-injury employer, the employee is assigned a Qualified Rehabilitation Consultant (QRC) and placed in Job Placement by the workers’ compensation insurance carrier. The QRC will test the injured worker to determine their skills and attributes and then help the injured worker find suitable employment.
For injuries occurring on or after Oct. 1, 2013, Job Placement may not exceed 20 hours a month for 26 consecutive or intermittent weeks per claim. If a worker remains on Job Placement for 13 weeks, the QRC must meet with all parties to agree to continue Job Placement or file for a conference to discuss a rehabilitation plan designed to return the employee to a comparative wage job with another employer.
6) Fusion Surgeries
Fusion surgeries can have consequences beyond medical outcomes. Because of this, injured workers recommended for a fusion surgery after Oct. 1, 2013, have available to them a two-year patient advocate program that advises them of treatment options and ensures they receive treatment according to accepted medical standards.