|
The Oregon Workers’ Compensation Division (WCD) began working on an initiative called Voice of the Customer in December of 2001.
Its goals were to identify our customers’ and stakeholders’ priorities as they relate to workers’ compensation information and services, to develop a sustainable process to measure
the levels of satisfaction with our services, and to develop processes and materials for continuous input. The following activities occurred as a result of survey responses for surveys completed
between January and December 2005.
|
Voice
Of The Customer (VOTC) Vocational Consultant Survey
|
|
Website
|
|
|
The Preferred Worker Program Web site was reorganized, the job-listing page
was streamlined, and more resource links were added such as a link to the iMatchSkills Web site.
|
|
|
An online order form was developed to order recorded training sessions on
DVD.
|
|
|
A
WCD "Who to call" directory for vocational consultants was created and posted online.
|
|
|
The Reemployment Assistance Unit set up an e-mail address for customers
and stakeholders to use in order to send questions about training, program benefits, rule interpretations, or anything else they want a response to. The e-mail address is pwp.oregon@state.or.us.
|
|
|
House Bill 2091 transferred all cases not related to a claim to the Hearings
Division of the Workers' Compensation Board. The board will hear appealed vocational cases.
|
|
|
Customer
Service
|
|
The Rehabilitation Review Unit has gained online access to some Employment Department labor
market issues information. Regarding other reports from the Employment Department, the Rehabilitation Review Unit can print job reports if requested by the vocational counselor. |
|
The Rehabilitation Review Unit has a vocational consultant assigned each day to take general
assistance calls from stakeholders. In addition, each consultant's e-mail and telephone number is given out at each training session, and is listed on the Web site. |
|
|
|
Improved
Product
|
|
The Reemployment Assistance Unit has gone through the Preferred Worker and Employer-at-Injury
Program reviews, and worked with the Management Labor Advisory Committee to expand the usage of the programs including making the rules easier to use and has revised the rules with external advisory
input including that of vocational consultants. These rule revisions effective July 1, 2005 incorporated several changes that have made the programs easier for everyone to use according to feedback
from the Management Labor Advisory Committee, employers, insurers, and other stakeholders. |
|
|
|
Process
Improvement
|
|
In July 2003, the Reemployment Assistance Unit completed a project involving worksite modifications.
The objective was to improve the process and improve the timeliness of decisions. Since that time the number of days from a request to a decision have decreased. |
|
The Rehabilitation Review Unit instituted a new dispute resolution process in the fall of 2005,
and the unit has received many positive comments from stakeholders. This new process will reduce the amount of time to resolve disputes, which was the focus of most of the comments about dispute
resolution. One response category thought decisions were "worker biased." For calendar years 2003-2005 workers prevailed in 36 percent, 37 percent, and 31 percent of the orders written
respectively. The Rehabilitation Review Unit makes every attempt in its order to objectively apply the facts of the case to the administrative rules and statutes governing vocational assistance. |
|
The Policy Section has a process in place to review return-to-work orders going out. The Policy
manager and the Legal Issues Coordinator review the order, making any suggestions for change, and when sufficiently satisfied with the quality of the order, gives the okay for the draft order
to go to the appropriate section manager for review. In this way, the order is reviewed for completeness, clarity, and legal correctness. |
|
|
|
Training
|
|
The Reemployment Assistance Unit has provided rules training to many insurers, self-insured
employers, and third party administrators. |
|
The Rehabilitation Review Unit schedules training (in at least three locations throughout the
state) each time a new set of rules is released. |
|
The Rehabilitation Review Unit presents a six hour ethical training class at every WCD Educational
Conference. |
|
A training event was added in Medford for vocational consultants. |
|
|
|
Rule
Changes
|
|
Administrative Order 05-080, effective January 1, 2006
(Senate Bill 119) The amended rules describe a process for reimbursement from the Workers' Benefit Fund of the insurer's vocational assistance costs if:
 The
Workers' Compensation Division orders the insurer to provide vocational assistance
The
insurer appeals the order
The
order is overturned on appeal
In order to streamline penalty processes, the division deleted a penalty matrix for three types of violations of the vocational assistance rules. The matrix was not comprehensive in its potential
application and limited agency discretion.
(Senate Bill 172) The rules provide that the director may impose a civil penalty for violation of ORS chapter 656, in addition to violation of rules and orders of the director. |
|
Administrative Order 05-059, effective July 1, 2005
These amended rules:
Combine
vocational evaluation with eligibility evaluation for vocational assistance, thus shortening the vocational preparation time by up to 45 days.
Require
that the insurer contact the Workers' Compensation Division to schedule a conference if the insurer has not approved a return-to-work plan within 90 days of finding the worker is entitled to
a training plan, or within 45 days of finding the worker is entitled to a direct employment plan. The conference may be postponed for a period of time agreeable to the parties. The insurer or
worker may also request a conference when any other delays in the vocational rehabilitation process occur.
Clarify
the process for calculating the adjusted weekly wage when the worker held multiple jobs at the time of injury or aggravation, or held one or more jobs in addition to receiving unemployment insurance
benefits.
Clarify
that extraordinary circumstances, for the purpose of determining attorney fees, are not established by merely exceeding eight professional hours or exceeding a benefit to the worker of $6000.
Require
that if the employer at injury has activated Preferred Worker benefits, the insurer must send the worker notice of "deferral of vocational assistance eligibility determination," to
inform the worker that the insurer will not complete the vocational eligibility process.
Provide
that modified or new employment that results from an employer activated use of the preferred worker program, under OAR 436-110, will be considered "suitable": (a) nine months from the
effective date of premium exemption if there are no worksite modifications, (b) twelve months from the effective date of a worksite modification agreement, (c) when the worker is terminated for
cause; or (d) when the worker voluntarily resigns for a reason unrelated to the work injury.
Require
that the notice of eligibility also include a notice of entitlement that informs the worker which type of assistance will be provided, direct employment or training.
|
|
Administrative Order No. 04-056, effective April 1, 2004
These rules have been amended in part to replace temporary rules issued to implement changes in the law due to legislation passed by the 2003 Oregon Legislature:
Senate
Bill 233 changed the time frame for appeal of a proposed order or proposed assessment of civil penalty from 60 days following the party's receipt of notice to 60 days from the date the order is
mailed by the department.
Senate
Bill 620 modified ORS 656.385 to require payment of fees to workers' attorneys when a worker prevails in certain medical and vocational disputes. An attorney fee matrix has been added to these
rules, and the maximums apply to all work the worker's attorney has done relative to the proceeding at all levels before the department, absent a showing of extraordinary circumstances.
House
Bill 3669 gave additional authority to nurse practitioners to treat injured workers and authorize temporary disability payments. This bill was a result of legislative action after development
of the legislative concepts by nurse practitioners and the Management Labor Advisory Committee.
In addition, these rules:
Require
the insurer to notify the worker in writing, within 14 days of a request for vocational assistance when the insurer is not required to determine eligibility.
Refer
vocational professionals to the Oregon Wage Information (OWI) publication in lieu of the Oregon Automated Reporting System (OARS) Job Order Wage Report, both published by the Oregon Employment
Department. The OARS publication will no longer provide job/wage data effective April 1, 2004. When using the OWI wage information data, the presumed standard shall be the 10th percentile unless
there is sufficient evidence that a higher or lower wage is more appropriate.
Eliminate
the requirement that vocational counselors sign statements that their eligibility determinations were based on substantial handicap assessments.
Specify
the conditions under which training may be terminated for failure to attend.
State
additional circumstances that require vocational eligibility to be re-determined.
Provide
that for workers found to have an exceptional disability or exceptional loss of earning capacity, certain fee schedule spending limits are increased by 30 percent.
Increase
the direct worker purchase training category fee schedule maximum by 10 percent due to statewide tuition increases.
Provide
that to conduct only labor market research and/or job development does not require certification when conducted under the supervision of a certified vocational rehabilitation counselor. |
|
|
|
Voice
Of The Customer (VOTC) Claims Examiners Survey
|
|
Web
site
|
|
A WCD "Who to call" directory for claims examiners was created and posted online. |
| |
|
Training
|
|
Boards Own Motion training was added to the Workers' Compensation 101 training. |
|
Training for claims examiners was offered in the Southern Oregon region. |
|
After the Wang to Oracle database conversion and higher priority projects are completed, there's
a plan to enhance the Employer Coverage database look-up feature on the Website. |
|
The Appellate Review Unit will continue to provide outreach training. |
|
Sanctions staff will conduct training at the Education Conference in May 2006, including tips
on how to avoid penalties from the Sanctions Unit. |
|
The Policy Section developed and delivered a course on plain language rule writing to all employees
within the division who have responsibility for bulletins and rules. The focus was on writing plainly, using easily understood language. It is too early to tell what the effects of the training
were, but anecdotally, we have seen employees using this new knowledge to make review suggestions regarding bulletins and rules going out for peer review. We have direct evidence that some of
the concepts from the class actually took root in the daily practice of the division. |
|
|
Marketing
|
|
Training advertisements were added to flyers and e-mail notifications for continuing education
credit. |
|
The survey responses indicated toll-free numbers were needed for workers with Non-Complying
Employer claims. Toll-free numbers are provided to both injured workers and employers for claims processing. Toll-free numbers are provided for contacting the Employer Compliance Unit. Toll-free
numbers are provided on the Workers' Compensation Division's Web site, brochures, and presentation material. Further consideration is being given to additional placement as appropriate. |
|
|
Customer
service
|
|
The Reemployment Assistance Unit has made customer service a priority. All Reemployment Assistance
Unit staff have taken customer service classes since this survey. |
|
|
Improved
product
|
|
The Appellate Review Unit has rewritten the OAR 030 and 035 rules twice to improve readability
and reduce confusion on the meaning of certain rules. |
|
In each rule revision, the Medical Review Unit holds external advisory meetings with stakeholders
and gets input and suggestions on how to better write our rules. A significant amount of their input has been incorporated into the rules. Each rule revision we review the wording in rules being
revised to add clarity. |
|
In each rule revision, the Medical Review Unit holds external advisory meetings with stakeholders
and gets input and suggestions on how to better write our rules. A significant amount of their input has been incorporated into the rules. Each rule revision we review the wording in rules being
revised to add clarity. |
|
|
Process
improvement
|
|
The Rehabilitation Review Unit implemented a new dispute resolution process that has shortened
the time it takes to resolve disputes, and it has received many favorable comments from stakeholders. |
|
To make decisions in a more timely manner, the Medical Review Unit has been continually reviewing
processes to identify areas for streamlining. The unit continues to review each step of our process in regulatory redesign to further identify areas to streamline, eliminate or improve. This process
started in November 2005 and will continue for MRU through May 2006. The unit has emphasized more alternative dispute resolution (ADR) activities in order to enable the parties to reach agreement
on disputes versus a formal Order from the director. The unit's ADR has increased dramatically over the past 3 years, going from 1%-3% of all disputes being resolved by ADR to approx. 20-25%.
We are planning on having all medical reviewers become certified mediators. So far, there are 4 reviewers that have gone through training and become certified mediators. |
|
Two internal process improvement projects were conducted from late 2004 through mid-2005. Those
recommendations were implemented in the subsequent months and we increased the level of timely decisions, thereby reducing the number of status requests and customer complaints. In 2005, we completed
98.2 percent of 1,588 suspension request cases within twenty days of receipt, compared to 97 percent of 1,466 cases in 2004. |
|
The Policy Section instituted tracking measurements for timeliness of its resolving policy research,
policy projects, legal issues, and survey responses. The information is tracked by quarter, showing what percentages of resolved projects were completed on time. |
|
The Policy Section is rethinking its current measurements of delivery of services. Nothing will
occur, however, until Regulatory Redesign frees up time and resources necessary to undertake a significant modification. |
|
|
Timely
dispute resolution
|
|
The Policy Section modified its approach to mediation by sending out an invitation to parties
to mediate on each request for hearing as soon as the case is docketed. Prior to this, it was impossible to gain the attention of some insurers. For example, an insurance company would not assign
anyone to a case unless it was scheduled for hearing. |
|
Additional discussion about where the temporal focus of mediation should be has taken place
between the Policy Section and the Dispute Resolution Section. Preliminarily, it appears that the greatest possibility for successful mediation exists prior to the division's issuing an order.
After Regulatory Redesign has made its first changes, both the Policy Section and the Dispute Resolution Section will re-visit the mediation issue. |
|
|
Automated
Claims Reporting Survey
|
|
Technology
|
|
The Operations Section implemented a fax reporting option for claims reporting in November 2005. |
|
The Automated Claims Reporting committee recommended that secure e-mail not be implemented until
further research is completed. Operations section and the Information Management Division are working on this; however, it is not a high priority for the division. The committee believes that
there may be additional opportunities throughout WCD for receiving documents through secure e-mail. The Executive Team approved implementing hybrid Electronic Data Interchange for claims; however,
this is on hold until regulatory redesign function reviews are completed. |
|
Reemployment
Assistance Unit Performance Measure 8 Survey
|
|
Customer
service
|
|
Reemployment Assistance Unit staff will continue to take customer service classes as they become
available to maintain the high satisfaction level with their knowledge, courteousness, responsiveness, clear communication, and flexibility in finding solutions. |
|
Bulletin
209 Survey
|
|
Technology
|
|
The Bulletin 209 survey team recommended that the division look into allowing alternative methods
for reporting Bulletin 209 data such as Internet or e-mail transfer. The Self-insurance group will look into this. |
