The Workers’ Compensation Advisory Council (WCAC) met in Baton Rouge on Thursday, January 26th, in the LaSalle Building, to map out next steps for several ongoing issues including the body’s by-laws and potential reform priorities.
Members pass by-laws
The by-laws were the only action item for the day. After Shannon Dartez moved to “clean up” some of the language so that the words used to reference the Chair and Co-Chair are consistent, as well as other language in a passage in section 16, the Council voted in favor of the document. Michael Morris, with the Homebuilders Self-Insurers’ Fund, was the only dissenting vote. Morris said that decision was because he wanted to see the by-laws designate a supermajority, rather than a simple majority when the WCAC members vet legislation.
Office of Workers’ Compensation Administration (OWCA) Director and WCAC Chair Sheral Kellar voiced her satisfaction with the passage of the new rules because “up until this point we’ve been flying by the seat of our pants.” A copy of the final version of the by-laws will be posted online soon on the WCAC web page, according to the Office.
Safety plans for state contracts and 1123 IMEs up for debate
The matters for which the Council should take legislative or administrative action was the next item on the docket. Incorporating a requirement for the 10 Point Safety Plan as part of the RFP for state contracts was already a popular proposal at previous meetings. The Plan was previously developed by the Council’s safety task force, Chaired by current WCAC Co-Chair Chuck Davoli. Uncertain whether or not legislative action or an executive order would suffice to enact the requirement, Davoli volunteered to get the consensus of the task force before meeting with the Division of Administration and reporting back.
Director Kellar’s other suggestion for legislative action was a new policy for 1123 IMEs, which are appointed by the Director of the OWCA. She noted that these have “always been a source of contention […] because attorneys will use the IME to get a continuance” and skirt the rules. She explained further: “my suggestion is to only have the Director appoint an IME doctor in cases where there is no pending claim” (i.e. before a 1008 has been filed.)
Michael Morris said that he has concerns about the randomness of the selection of doctors for 1124 IMEs (which are appointed by a judge rather than the Director) if the system were to move to have more of them. Shannon Dartez countered that to help alleviate that concern, the Council could look at the allowable evaluation criteria for the two types of IMEs because, “in practice, [1123 IME doctors are] addressing causation and medical necessity, even though technically they are only supposed to look at return to work and condition.”
After further debate, Kellar reached the conclusion that 1123 and 1124 IMEs need to be studied in further detail to determine two things: the extent to which 1123 IMEs are being used to circumvent the decision of the Medical Director, and whether the limited criteria of 1123 IMEs is being adhered to by the physicians appointed to perform them. Shannon Lindsey, a new WCAC member and an attorney in the system, added that she would like to see a matching evidentiary standard for the two types as well.
Urine drug screens and fraud unit ideas and announcements
Urine drug screens, increasingly necessary in the face of the opioid epidemic and usually mandatory in the workers’ comp system, have come up numerous times before as costs for the tests and confirmatory lab work can escalate into the several thousand dollar range. Raising the issue again, member David Gallagher, MD, suggested that the Medical Advisory Council (MAC) of which he is also a member, take up a proposal to create a set of guidelines for urine drug screens that matches that of the Louisiana Board of Medical Examiners for pain management specialists. This was met with general approval.
Finally, Director Kellar announced that the fraud unit is restructuring, due to the fact that the department has had four resignations and a retirement in quick succession. According to Kellar, Louisiana Workforce Commission Executive Director Ava Dejoie and Governor John Bel Edwards have met to discuss an increase in monitoring and investigation of employer fraud and decided that the unemployment insurance and the workers’ comp auditors will now join forces. The coalition has a goal to audit 1.3 percent of all employers in the state, a significant increase from the 1 percent which is statutorily required by federal law. LWC will also add an attorney to the fraud team and has created a new arrangement with the Department of Labor for the reporting of data.
The next meeting of the WCAC will be in the LaBelle Room of the LaSalle Building in Baton Rouge on February 23rd at 9:30 AM.