The Management Labor Advisory Committee (MLAC) held what is most likely its final meeting of 2020. Much of the meeting was recapping the significant changes we have already seen in our system this year and outlining their plan for next year.
There were a few areas of note from the WCD:
The WCD is currently auditing 9 insurers and 3 self-insurers related to the new reasonable investigation rules related to COVID claims. The summary report from how these investigations have been going should be available in the next month or two. One common theme was many workers’ claims were being initiated by medical providers after an employer referred the worker for testing and not from the workers themselves.
The WCD is still in its rule making process for the new permanent rules related to the investigation process for COVID claims as well. They will take public comments through January 8, 2021.
The WCD has implemented rules removing the requirement to include a worker’s social security number on claim reporting documents. They will be issuing a bulletin and updated 801 forms shortly. The new forms will need to be used by March 1, 2021.
The WCB also raised a few issues from recent board and court cases for MLAC to potentially consider:
Currently claim costs are limited to $1,500 absent extraordinary circumstances. That threshold was set in 2007 and might need to be adjusted.
Workers currently are not entitled to a Worker Requested Medical Examination when the insurer relies on a medical expert without an in-person exam (i.e. a record review). Some proponents have argued to broad the process to allow for WRME any time an insurer is relying on a medical expert.
Many appeals in our system allow a worker to submit a late appeal with good cause for the late appeal, but the deadline to appeal a closure does not include a similar exception. The process may need broadened to allow for an exception.
There are pending meetings with the WCD, WCB, MLAC, and the legislature potentially address these and many, many other issues in our system. We continue to need input from employers, insurers, and administrators regarding all these issues. Please contact me if you are interested in participating in any of the upcoming meetings in 2021. I can be reached at 503-595-2130 or .