Last week, I attended the 74th Annual Convention of the Southern Association of Workers’ Compensation Administrators (SAWCA). As I have done for the past 8 years or so, I moderated the event’s closing session, called “Things That Make Bob Go, Hmmm.” It is a panel where I am allowed to select the guests and discuss, well, anything that makes me go “hmmm.”

At an earlier point of the conference, during a Regulators Roundtable, the topic of standardizing some components of workers’ comp was discussed. The focus was primarily on what would appear to be fairly simple elements of the system; for example, a “standard” First Report of Injury that could be used by all jurisdictions. The topic produced lively input, until a regulator from one state asked a moderator, “So you are endorsing the federalization of workers’ comp?” That seemed to shut the topic down, cold.

The potential federalization argument is often used when discussing any level of standardization for workers’ compensation across jurisdictional lines. It could be a legitimate concern, and many people, myself included, are not proponents of the Feds gaining oversight into the system. There are too many economic, cultural, and regional differences across our country to accommodate a federal “one size fits all” solution. 

Still, the fact remains that navigating workers’ comp in multiple states can be a herculean task, and there are elements of each state’s system that could certainly benefit from streamlining and standardization. The question falls as to who will ultimately step in and perform that task – if it happens at all. 

And if the perceived pain becomes great enough, we may find ourselves with an unwanted intrusion where Uncle Sam deems it necessary to “fix” the problems we are unable or unwilling to correct ourselves. And many of us agree that the Feds rarely “fix” anything without adding additional levels of complexity and confusion. 

So, a multi-part question I posed to my panel was, could SAWCA or the IAIABC (International Association of Industrial Accident Boards and Commissions), or perhaps SAWCA working with the IAIABC, establish a “Council of States” for the express purpose of standardizing some elements of workers’ comp across state lines?” Would that be effective, and if so, what specifically should it address? The topic produced a great deal of discussion, not just with my panel, but from the audience as well.

Interestingly, no one said the idea wouldn’t work. There seems to be a sense that issues exist, but a level of stubbornness and intransigence could be a major stumbling block. Also, the debate centered around some things that could never be standardized, such as benefit payment levels or adjudication procedures. A clarifying point was made by one attendee, Brian Allen of Mitchell Pharmacy Solutions. He suggested that any such attempt should focus on “process rather than policy.” 

It was an excellent point, and worthy of consideration.

In theory, something like first reports or posting notices should be “low hanging fruit” for simplification efforts. The FROIs all collect essentially the same data. The posting notices broadly advise of the same rights. Yet, resistance exists to change, mostly because we continue to do things in the way we’ve always done them. The point was highlighted by one regulator who, in the earlier Regulator Roundtable, jokingly suggested their state would be happy to standardize the FROI, as long as every state agreed to use the one their state currently uses. 

Challenges would exist with even the simplest of efforts. One of my panelists pointed out that they are statutorily bound to certain processes, and that legislative changes may be required for even the simplest of deviations. Bureaucratic obstinacy, will quite simply, also be a problem. Change can be difficult for some, and those agencies where CAVE (Citizens Against Virtually Everything) people are dominant would throw roadblocks at any effort. Still, the industry is intended to serve two distinct groups: employers and their injured workers. We should listen to and respect the former while tending to the needs of the latter.

And the former is telling us that we are not making this easy for them.

I suppose the point is that this is an excellent example of “physician, heal thyself.” There are elements within our industry – process elements – that could be simplified with a bit of common sense and a healthy dose of cooperation. And those solutions would best be offered from within our own industry. A “Council of States” may not ultimately be able to fix what ails us, but it is likely a better concept than the alternative solutions we may one day find thrust upon us. 

Or, we could just wait for the Feds to tell us what is best.

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