# Presentation: 787655

## Department of Labor & Industries

**Adding Workers’ Compensation Information To PARIS****.**

- A Discussion Of How Workers’ Compensation Data May Help Both Public Assistance Programs And Government Run Workers’ Compensation Programs **.**

**Doric Olson, Fraud Detection Manager ****.**
**(360) 902-6639 / olsd235@lni.wa.gov ****.**
**Washington State Department of Labor & Industries ****.**
**March 2007 PARIS Conference Presentation ****.**

## Department of Labor & Industries

_**The Basics of Workers’ Compensation Insurance**_**.**
**What Does Workers’ Compensation Insurance Cover?**
- Provides Primary medical insurance for on-the-job injuries **.**
- Provides partial wage replacement for someone unable to return to work **.**
- Provides monetary compensation for permanent injuries or lifetime pensions for someone unable to ever return to work**.**
- May provide retraining or other vocational assistance to help someone return to work after an injury (Depending on the circumstances) **.**

## Department of Labor & Industries

_**The Basics of Workers’ Compensation Insurance**_**.**
**How Does Workers’ Compensation Insurance Work?**
- “No Fault” Insurance **.**
- Required by law in most states **.**
- No national standard **.**
- At least 27 states have public State Funds that provide publicly funded workers’ compensation insurance **.**
- North Dakota, Wyoming and Puerto Rico have exclusive state funds**.**
- Washington and Ohio have either state fund or authorized self-insurance **.**
- Many other states have a combination of private insurance, state fund, or authorized self-insurance:
- Arizona, California, Colorado, Hawaii, Idaho, Kentucky, Louisiana, Maine, Maryland, Minnesota, Missouri, Montana, New Mexico, New York, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Texas and Utah

## Washington State Workers’ Compensation State Fund.

**Washington State Workers’ Compensation State Fund****.**

**Background**
- L&I provides insurance coverage for about 2.3 million employees working for 161,000+ employers.
- L&I provides more than $1.2 billion in insurance benefits for about 139,000 claims each year.
- Only four states have higher benefit levels while 34 states have higher premium rates.
- L&I uses a voluntary reporting system of risk classifications by type of work and the claims experience of each individual employer to determine and assess premiums. Premiums are paid by worker hour.
- About 90% of premiums are paid voluntarily, with the rest collected through department compliance actions.

- Financial Data Source: 2005 Washington State Workers’ Compensation State Fund Year in Review

## Department of Labor & Industries

_**How Would Workers’ Compensation Data Help Public Assistance Programs?**_
**Workers’ Compensation should be the Primary Payer ****.**
- Wage replacement benefits are often higher than public assistance payments / eligibility levels **.**
- May discover dual payment of medical benefits (Including pharmaceuticals) **.**
**Many pensioners move out of state: **
**Approximately 5375 (with valid SSN) ****.**
**Many claimants also move out of state: **
**Approximately 2199 per quarter (with valid SSN) ****.**
**Very difficult to track what someone does once they cross state lines ****.**

## Department of Labor & Industries

_**How Will The Match Be Done?**_
**The proposal is to add workers’ compensation data starting in August 2007****.**
**States providing workers’ comp data must work with their own designated PARIS State Public Assistance** **Agency (SPAA) to ensure only one entity per state is submitting PARIS data through Connect: Direct ****.**
**Only submit active cases during the quarter (to prevent garbage-in-garbage-out) ****.**
**Each state submitting workers’ comp data will identify a point of contact in their state to supply more information if a match occurs ****.**
**If a match occurs then your state will receive the other state’s entire submission record ****.**** **

## Department of Labor & Industries

_**How Will The Match Be Done?**_
**In general, the match will be done in the same way as everything else.**
**If a record already exists for a client simply add the additional workers’ compensation elements ****.**
**If you are adding a client just for a workers’ comp case then:**** **
_**Input the following standard data**__ __**(Only one record per SSN):  **_
**Client’s Social Security Number ****.**
**Client’s Name Information ****.**
**Client’s Date of Birth ****.**
**State Postal Code (must be capitalized) ****.**
**Client’s Address Information ****.**

## Department of Labor & Industries

_**How Will The Match Be Done?**__** **_
_**Input the following standard data**__ __**(Only one record per SSN):**_
**Gender   (M=Male, F=Female) ****.**
**Marital Status (M=Married, S=Single,                                                    W=Widow/Widower, D=Divorced) ****.**
**Number of Dependents claimed ****.**
**“****C“ indicates match with all three PARIS matches                               (Interstate, Veteran, and Department of Defense)**** ****.**** **

## Department of Labor & Industries

_**How Will The Match Be Done?**_
_**Add the new workers’ compensation elements:**__** **_
**Workers’ comp indicator (“Y” = Client receives workers’ comp wage replacement benefits) ****.**
**Workers’ comp eligibility start date (payment) YYYYMMDD ****.**
**Workers’ comp eligibility end date (payment) YYYYMMDD****.**
**Workers’ comp monthly payment (whole number, no decimal)****.**

## Department of Labor & Industries

_**How Will The Match Be Done?**_

-  **Should you have any questions on this format, Howie Wheeler, a member of the PARIS Board of Directors (Responsible for coding issues on the Board) will address any questions you have.  He can be reached at **_**howard.wheeler@po.state.ct.us.**_** **

## Department of Labor & Industries

_**Questions?**_