A few weeks ago, I attended the International Forum on Disability Management (IFDM) and annual convention of the International Association of Industrial Accident Boards and Commissions (IAIABC) in Los Angeles. This was a great opportunity to hear from other systems about the hot issues, successes and challenges facing systems in the US and other jurisdictions. The following is sampling of what I heard:
- Dame Carol Black spoke about her review and report of the UK system for compensating for work injuries. She has been instrumental in changing the focus in that country to conform to the principles of Disability Management. It was fascinating to hear how engrained the system of ‘sicknotes’ was in legislation and practice. As simple and fundamental as it may seem to us, the move away from this terminology to ‘fit notes’ and a focus on ability has been a big challenge for the country and the transition is still underway.
- The German Social Accident Insurance system (DGUV) is celebrating its 125th year as a Bismarckian workers’ compensation system. It has also undergone a major consolidation from more than twenty industry-specific mutual systems to nine. They are also facing the same sorts of issues we are seeing in North America including a rising tide of occupational diseases and an increase in psychological injury cases.
- In New Zealand, the Accident Compensation Corporation (ACC) is a relatively young system of just 34 years. It covers work and non-work injuries that involve lost earnings. Interestingly, the change in accounting standards (known as IFRS) is creating a new challenge for the system that is driving a lot more attention on long-term claims. The new accounting standard requires the government to carry the expected lifetime cost of claims as a liability.
- Munich Re, the largest reinsurer highlighted its major concerns for the future. Its criteria acknowledge risks like nanoparticles and nanotechnology but did not list them because they cannot yet quantify a cost impact. Of the items that they can make some estimates on, obesity, the aging labour force, the use of temporary foreign workers, psychological injuries, and long latency occupational diseases topped the list.
- On the IAIABC side of the agenda, a presentation from the National Council on Compensation Insurance (NCCI) highlighted obesity. Their economist concluded that there were marked differences in outcomes for obese and non-obese workers who sustain similar work-related injuries. Their analysis of members’ workers’ compensation claims found that injuries sustained by obese workers are more likely to result in permanent disabilities and the range of medical treatments and costs are greater for obese claimants.
- Tungsten Inert Gas (TIG) welding was highlighted by the IAIABC as an emerging issue with respect to its apparent linkage to Parkinson’s disease. There was speculation that this sort of occupationally-specific exposure-linked health condition may well work its way into presumptive clauses in the near future, in part because of pressure elsewhere on medical costs.
- Medical costs came up again in a discussion of the required switch in the US from the medical coding system known as ICD-9 to ICD-10. The change is mandated now for October 1, 2013 having been pushed back several times. The reporting has implications for workers’ compensation systems. There is no general equivalent matching that can be applied to ‘crosswalk’ old codes to new ones. The example used suggested that the code for the amputation of a finger go from one code to more than twenty.
- Finally, we got a preview of data to be released in the Oregon Department of Consumer and Business Services' Workers’ Compensation Rate Ranking Survey. This survey is completed every couple of years. It lists a series of classifications that are the most costly from a workers’ compensation perspective in Oregon. It then applies the rates from other states to that set of classifications and payrolls from Oregon. The result is what the average rate would be in Oregon if Oregon had the other states’ rates. The study should be released in the coming weeks and will likely receive some media attention.
That’s a small portion of what was covered. In the coming weeks, I will have more details on some of these issues.