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Building a Workers’ Comp System for the 21st Century

Abstract

Workers’ compensation systems in the United States were intended to be efficient and inexpensive. Over the years, however, systems throughout the country have developed a variety of dispute resolution procedures and practices that add significant, unnecessary costs and delay.

As a result, policymakers and regulators have paid more attention to certain key elements of workers’ compensation agencies’ dispute resolution systems in recent years, prompting agencies to seek ways to reduce administrative costs, reduce litigants’ costs, reduce delays, improve effectiveness, ensure fairness and enhance constituent satisfaction.

The Challenge

A large state’s Division of Workers’ Compensation (DWC) had been hindered by ineffective and inefficient business practices that had led to delays in resolving disputes, higher litigant costs and, consequently, higher workers’ compensation premiums.

There were several reasons for this:

  • Paper-intensive business processes led to a significant number of missed deadlines required by the state’s Labor Code regulation.
  • Lack of technology to efficiently share workload among DWC’s various offices led to operational inefficiencies and to larger case backlogs.
  • Significant costs were incurred by DWC for the receipt, processing, forwarding and storage of the millions of pages it receives each year.
  • Limited automated interaction between DWC’s various business units led to delays in information sharing and processing.
  • Lack of automated workflows and an inefficient escalation process limited the ability of management to intervene and process cases efficiently.
  • Limited access to documents and information in a case often meant that parties did not know the current status of their case or what had been recently filed. As a result parties were unprepared at the time of hearings, and more hearings were required to adjudicate a case.
  • Lack of automated scheduling of hearings resulted in inefficient judge and hearing calendars and slower adjudication of cases.

How We Helped

In response to these challenges, the state’s DWC chose Deloitte Consulting LLP to begin helping it in efforts to develop an Electronic Adjudication Management System (EAMS).

As the systems integrator, Deloitte Consulting worked with DWC to help identify ways software solutions could be customized to meet the division’s unique needs. The outcome is an integrated system for all of DWC’s 24 district offices and six disparate business units. EAMS replaces six legacy systems that have historically housed duplicate, sometimes conflicting, data, and includes interfaces with external data sources. The following are key components of EAMS:

  • EAMS allows DWC to rid itself of the millions of incoming pages each year that would have been stored on shelves, and instead store this information in an electronic case file. It also allows external users (e.g., attorneys, employers, insurance companies) to file and view case documents. Additionally, users can annotate and make notes on electronic documents in a secure manner.
  • All information about participants and cases is stored in one central repository, allowing data sharing across units and offices. It also allows supervisors to view their staff members’ workload and easily reassign work when necessary. Judges are easily able to prepare orders and other correspondences using an integrated MS-Word component. A full history of all events that have occurred on each case is maintained. EAMS also allows parties to a case access to detailed case information, case status and documents associated with a case.
  • Workflow integrates document management and case management components – alerting users when documents are filed in a case and storing data extracted from documents in the case management component. Workflow also alerts users when deadlines are approaching. When deadlines are missed, workflow escalates to supervisors to allow them to take necessary action.
  • EAMS provides a shared calendar system that is accessible by various users within DWC, including judges, presiding judges, managers, clerks and secretaries. Hearings can be scheduled that do not conflict with various parties’ availability, while at the same time fully utilizing the resources (rooms, judges, timeslots). It also automatically schedules hearings upon receipt of certain moving documents based on DWC business rules.
  • EAMS provides supervisors and managers with a variety of automated, regularly distributed reports that allow them to effectively monitor and manage the workload and production of their staff.

Solution

We applied our understanding and the lessons we have learned over the years to help this state’s Division of Workers’ Compensation develop and implement the right system to accomplish its goals. We understand that new systems bring significant change to large organizations, and that sometimes these changes are difficult to embrace. For this reason, we have an entire service line with professionals dedicated to helping public sector agencies be successful in the midst of changes such as these.

Today, EAMS is a pioneer in the workers’ compensation arena and is the most comprehensive and largest system of its kind in the United States.

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