Employee Comp claims fall for first time

Santa Monica City Worker Compensation Claims decreased for the first time in history this fiscal year.

The value of all outstanding receivables (referred to as the program’s total liabilities) decreased 5 percent this year, while the number of new receivables (claims frequency) decreased 14 percent. The total cost of the program decreased by three percent.

The program includes medical and indemnity payments, staff-approved claims adjustments, and general claims and cost trends as required by law. Staff said the cost reductions are likely a mix of systemic savings from cost control efforts and temporary reductions due to COVID-induced cuts in city operations.

According to a report presented to the council this week, the city spent approximately $ 12.5 million on medical treatment and compensation for injured employees this fiscal year, up from $ 12.8 million the previous year. Medical expenses increased approximately $ 100,000 to $ 4.9 from a total of $ 12.5 million. Temporary and permanent disability compensation payments decreased from $ 8 million to $ 7.6 million.

Staff said the city settled 106 claims for a total of $ 2,621,075 in fiscal year 2019-20, compared to 150 claims settlements in fiscal year 2018-19 with a total value of $ 4,133,833.

The report said the claims were on track to match the previous year before the COVID crisis and that the declines were due to fewer city workers on duty, with the Big Blue Bus doing most of the Reduction matters (38 fewer claims) year).

While costs have come down this year, staff said the forecast for the future is not good as new claims suggest future cases will be costly. In particular, 27 percent of the new claims related to injuries from “cumulative trauma” resulting from repetitive physical or mentally strenuous tasks over long periods of time.

“Cumulative trauma injury claims are common among aging workers and typically involve multiple body parts and legal representation, which makes them extremely costly,” the report said.

Total costs were expected to increase 5 percent for the year before the emergency order closed many services in mid-March. Employees said an analysis of temporary disability payments and a 25% reduction in sworn public security payments were good news. According to the report, public safety workers sworn under the law receive 100 percent of their salary while they are recovering and often charge additional costs to fill their positions.

Program liabilities decreased to $ 31 million, a decrease of $ 1.6 million due to an expense management program. According to the report, participants in the program lost 41 days compared to 127 days for non-participants, and participant payments averaged $ 29,031 versus $ 120,865 for non-participants.

“The Wow That’s Fast” program is designed to help reduce the number of disputed compensation claims by sworn employees by providing them with a full case management service without the fees that lawyers charge, “the report said. “This in turn helps reduce program costs by lowering medical costs, 4,850 disability benefits, permanent disability expenses and legal costs.”

The city also saved money by reassigning some injured workers to new jobs that could be done despite their injuries.

A pilot program to identify the most cost-effective claims settlement model also bore fruit, reducing the total debt for BBB (the pilot agency) from $ 7.4 million to $ 5.6 million.

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