Today’s issue of WorkCompRecap features the release of a new study from CWCI that found legislative proposals to cut the amount of time workers’ comp claims administrators have to investigate work-related injuries and determine employer liability may be easier said than done given existing statutory and regulatory time frames.
CWCI notes that legislation currently under consideration would reduce investigation periods for claims with presumption of compensability to 75 days from the employer notification of injury, and remain at 90 days for other claims. Key points from the analysis include that accepted claims without litigation are the most frequent and least complex, and in 98%, compensability is determined within 90 days, and in 96.7% and 93.2% the decision is made within 60 and 30 days respectively. When non-litigated and litigated non-COVID-19 claims are combined, more than 90% have a decision within 75 days. Investigation periods are longer for litigated and denied claims and require significantly more time to gather information – at 75 days, only 49.2% of litigated claims that are eventually denied have a compensability decision, strongly suggesting that under current rules and regulations, 75 days is an insufficient amount of time.