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Definitions of the Performance
Measures |
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Performance Measure |
Definition |
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Time to notice of injury and first
indemnity payment |
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Date of injury to payor notice of injury |
Cumulative percentage of lost-time claims
by period based on the number of days from the date of
injury to the date of payor notification of injury |
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Date of employer notice to payor notice
of injury |
Cumulative percentage of lost-time claims
by period based on the number of days from the date of
employer notification to the date of payor notification
of injury |
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Date of injury to first indemnity payment |
Cumulative percentage of lost-time claims
by period based on the number of days from the date of
injury to the date of the first indemnity payment |
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Date of payor notice of injury to first
indemnity payment |
Cumulative percentage of lost-time claims
by period based on the number of days from the date of
payor notification of injury to the date of the first
indemnity payment |
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Average benefit payments and claim costs |
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All paid claims |
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Total cost (medical and indemnity
benefits and benefit delivery expenses and vocational
rehabilitation provider expenses) per claim |
The sum of the average medical and
indemnity payments
per claim and benefit delivery expenses and vocational
rehabilitation provider expenses per claim for all paid
claims |
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Benefit payment (medical and indemnity
benefits) per claim |
The sum of medical and indemnity payments
for all paid claims,
divided by the total number of all paid claims |
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Medical payment per claim |
The sum of medical payments for all
paid claims, divided by the total number of all paid
claims |
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Indemnity payment per claim |
The sum of indemnity payments for
all paid claims, divided by
the total number of all paid claims |
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Benefit delivery expense per claim |
The sum of benefit delivery expenses for
all paid claims,
divided by the total number of all paid claims |
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Total incurred cost (medical and
indemnity benefits and other) per claim |
The sum of incurred medical and indemnity
benefits and other for all claims, divided by the total
number of all claims |
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Incurred medical benefit per claim |
The sum of incurred medical benefits for
all claims, divided by the total number of all claims |
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Incurred indemnity benefit per claim |
The sum of incurred indemnity benefits
for all claims,
divided by the total number of all claims |
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Claims with more than 7 days of lost time |
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Total cost (medical and indemnity
benefits and benefit delivery expenses and vocational
rehabilitation provider expenses) per claim |
The sum of the average medical and
indemnity payments
per claim and benefit delivery expenses and
vocational
rehabilitation provider expenses per claim for lost-time
claims |
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Benefit payment (medical and indemnity
benefits) per claim |
The sum of medical and indemnity payments
for lost-time claims, divided by the total number of
lost-time claims |
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Medical payment per claim |
The sum of medical payments for lost-time
claims, divided by the total number of lost-time claims |
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Indemnity payment per claim |
The sum of indemnity payments for
lost-time claims, divided by the total number of
lost-time claims |
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Percentage of claims with vocational
rehabilitation maintenance benefits as a percentage of
lost-time claims |
The number of claims with vocational
rehabilitation maintenance benefits, divided by the
total number of lost-time claims |
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Vocational rehabilitation maintenance
benefit per claim with vocational rehabilitation
maintenance benefits |
The sum of vocational rehabilitation
maintenance benefits for lost-time claims, divided by
the total number of claims with vocational
rehabilitation maintenance benefits |
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Benefit delivery expense per claim |
The sum of benefit delivery expenses for
lost-time claims, divided by the total number of
lost-time claims |
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Total incurred cost (medical and
indemnity benefits and other) per claim |
The sum of incurred medical and indemnity
benefits and other for lost-time claims, divided by the
total number of lost-time claims |
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Incurred medical benefit per claim |
The sum of incurred medical benefits for
lost-time claims, divided by the total number of
lost-time claims |
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Incurred indemnity benefit per claim |
The sum of incurred indemnity benefits
for lost-time claims, divided by the total number of
lost-time claims |
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Average benefit payments and claim costs |
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Temporary disability claims |
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Temporary disability claims as a
percentage of all lost-time claims |
The number of temporary disability
claims, divided by the total number of lost-time claims |
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Total cost (medical and indemnity
benefits and benefit delivery expenses and vocational
rehabilitation provider expenses) per claim |
The sum of the average medical and
indemnity payments
per claim and benefit delivery expenses and vocational
rehabilitation provider expenses per claim for claims
classified as temporary disability claims |
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Benefit payment (medical and indemnity
benefits) per claim |
The sum of medical and indemnity payments
for claims classified as temporary disability claims,
divided by the total number of temporary disability
claims |
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Medical payment per claim |
The sum of medical payments for claims
classified as temporary disability claims, divided by
the total number of temporary disability claims |
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Indemnity payment per claim |
The sum of indemnity payments for claims
classified as temporary disability claims, divided by
the total number of temporary disability claims |
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Temporary disability payment per
temporary disability claim |
The sum of temporary disability payments,
divided by the total number of lost-time claims
classified as temporary disability claims |
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Permanent disability claims |
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Permanent disability claims as a
percentage of all lost-time claims |
The number of permanent disability
claims, divided by the total number of lost-time claims |
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Total cost (medical and indemnity
benefits and benefit delivery expenses and vocational
rehabilitation provider expenses) per claim |
The sum of the average medical and
indemnity payments
per claim and benefit delivery expenses and vocational
rehabilitation provider expenses per claim for claims
classified as permanent disability claims |
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Benefit payment (medical and indemnity
benefits) per claim |
The sum of medical and indemnity payments
for claims classified as permanent disability claims,
divided by the total number of permanent disability
claims |
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Medical payment per claim |
The sum of medical payments for claims
classified as permanent disability claims, divided by
the total number of permanent disability claims |
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Indemnity payment per claim |
The sum of indemnity payments for claims
classified as permanent disability claims, divided by
the total number of permanent disability claims |
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Permanent disability payment per
permanent disability claim |
The sum of permanent disability payments,
divided by the total number of lost-time claims
classified as permanent disability claims |
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Permanent partial disability (PPD) claims
(and lump sums) |
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PPD/lump-sum claims as a percentage of all
lost-time claims |
The number of PPD or lump-sum claims, divided by the
total number of lost-time claims |
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Total cost (medical and indemnity
benefits and benefit delivery expenses and vocational
rehabilitation provider expenses) per claim |
The sum of the average medical and
indemnity payments
per claim and benefit delivery expenses and vocational
rehabilitation provider expenses per claim for claims
classified as PPD or lump-sum claims |
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Benefit payment (medical and indemnity
benefits) per claim |
The sum of medical and indemnity payments
for claims classified as PPD
or lump-sum claims, divided by the
total number of PPD
or lump-sum claims |
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Medical payment per claim |
The sum of medical payments for claims
classified as PPD
or lump-sum claims, divided by the total number of
PPD
or lump-sum claims |
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Indemnity payment per claim |
The sum of indemnity payments for claims
classified as PPD
or lump-sum claims, divided by the total number of
PPD
or lump-sum claims |
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PPD payment per PPD claim |
The sum of PPD payments
and lump-sum settlements, divided by the
total number of lost-time claims classified as PPD
or lump-sum claims |
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Temporary disability payment per PPD
claim |
The sum of temporary total disability and
temporary partial disability payments, divided by the
total number of lost-time claims classified as PPD
or lump-sum claims |
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Claims with lump-sum settlements as a
percentage of lost-time claims |
The number of claims with lump-sum
settlements, divided by the total number of lost-time
claims |
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Lump-sum settlement payment per claim
with lump-sum settlements |
The sum of lump-sum settlement payments,
divided by the total number of claims with lump-sum
settlements |
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Average benefit payments and claim costs |
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Three categories of PPD/lump-sum claims |
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Claims with lump-sum settlements but no
periodic PPD payments as a percentage of lost-time
claims |
The number of claims with lump-sum
settlements but no periodic PPD payments, divided by the
total number of lost-time claims |
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Lump-sum settlement payment per claim
with lump-sum settlement but no periodic PPD payments |
The sum of lump-sum settlement payments,
divided by the total number of claims with lump-sum
settlements but no periodic PPD payments |
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Claims with periodic PPD payments but no
lump-sum settlement as a percentage of lost-time claims |
The number of claims with periodic PPD
payments but no lump-sum settlement, divided by the total number of lost-time
claims |
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PPD payment per claim with periodic PPD
payments but no lump-sum settlement |
The sum of PPD payments, divided by the
total number of claims with periodic PPD payments but no
lump-sum settlement |
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Claims with both lump-sum settlements and
periodic PPD payments as a percentage of lost-time
claims |
The number of claims with both lump-sum
settlements and periodic PPD payments, divided by the
total number of lost-time claims |
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PPD/lump-sum payment per claim with both
lump-sum settlement and periodic PPD payments |
The sum of lump-sum settlements and PPD
payments, divided by the total number of claims with
both lump-sum settlement and periodic PPD payments |
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Permanent total disability claims |
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Permanent total disability claims as a
percentage of all lost-time claims |
The number of permanent total disability
claims, divided by the total number of lost-time claims |
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Total cost (medical and indemnity
benefits and benefit delivery expenses and vocational
rehabilitation provider expenses) per claim |
The sum of the average medical and
indemnity payments
per claim and benefit delivery expenses and vocational
rehabilitation provider expenses per claim for claims
classified as permanent total disability claims |
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Benefit payment (medical and indemnity
benefits) per claim |
The sum of medical and indemnity payments
for claims classified as permanent total disability
claims, divided by the total number of permanent total
disability claims |
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Medical payment per claim |
The sum of medical payments for claims
classified as permanent total disability claims, divided
by the total number of permanent total disability claims |
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Indemnity payment per claim |
The sum of indemnity payments for claims
classified as permanent total disability claims, divided
by the total number of permanent total disability claims |
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Permanent total disability payment per
permanent total disability claim |
The sum of permanent total disability
payments, divided by the total number of lost-time
claims classified as permanent total disability claims |
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Fatality claims |
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Fatality claims as a percentage of all
lost-time claims |
The number of fatality claims, divided by
the total number of lost-time claims |
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Total cost (medical and indemnity
benefits and benefit delivery expenses and vocational
rehabilitation provider expenses) per claim |
The sum of the average medical and
indemnity payments
per claim and benefit delivery expenses and vocational
rehabilitation provider expenses per claim for claims
classified as fatality claims |
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Benefit payment (medical and indemnity
benefits) per claim |
The sum of medical and indemnity payments
for claims classified as fatality claims, divided by the
total number of fatality claims |
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Medical payment per claim |
The sum of medical payments for claims
classified as fatality claims, divided by the total
number of fatality claims |
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Indemnity payment per claim |
The sum of indemnity payments for claims
classified as fatality claims, divided by the total
number of fatality claims |
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Fatality payment per fatality claim |
The sum of fatality payments, divided by
the total number of lost-time claims classified as
fatality claims |
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Vocational rehabilitation costs and
frequency |
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Percentage of lost-time claims with
vocational rehabilitation maintenance benefits |
The number of lost-time claims with
vocational rehabilitation maintenance benefits, divided
by the total number of lost-time claims |
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Percentage of lost-time claims with
vocational rehabilitation expenses |
The number of lost-time claims with
vocational rehabilitation expenses, divided by the total
number of lost-time claims |
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Average vocational rehabilitation expense
per lost-time claim with vocational rehabilitation
expenses |
The sum of payments for vocational
rehabilitation expenses, divided by the total number of
lost-time claims with vocational rehabilitation expenses |
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Attorney involvement and benefit delivery
expenses |
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Percentage of lost-time claims with
defense attorney payments |
The number of lost-time claims with
defense attorney payments greater than $500, divided by
the total number of lost-time claims |
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Average defense attorney payment per
lost-time claim with defense attorney payments |
The sum of payments to defense attorneys,
divided by the total number of lost-time claims for
claims with defense attorney payments greater than $500 |
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Percentage of lost-time claims with
medical cost containment expenses |
The number of lost-time claims with
medical cost containment expenses, divided by the total
number of lost-time claims |
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Average medical cost containment expense
per lost-time claim with medical cost containment
expenses |
The sum of payments for medical cost
containment, divided by the total number of lost-time
claims with medical cost containment expenses |
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Percentage of lost-time claims with
medical-legal expenses |
The number of lost-time claims with
medical-legal expenses, divided by the total number of
lost-time claims |
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Average medical-legal expense per
lost-time claim with medical-legal expenses |
The sum of payments for medical-legal
expenses, divided by the total number of lost-time
claims with medical-legal expenses |
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Duration and claim closure patterns |
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Lost-time claims by duration |
The cumulative percentage of lost-time
claims with equivalent weeks of temporary disability
payments (temporary total disability plus temporary
partial disability) within each specified period |
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Lost-time claims by duration, incurred
benefits as numerator |
The cumulative percentage of lost-time
claims with equivalent weeks of incurred indemnity
benefits within each specified period |
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Lost-time claims closed |
The percentage of lost-time claims closed
as of 6 months after the end of the accident year |
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Date of injury to date of claim closure |
The cumulative percentage of closed
lost-time claims in which the lag between the injury
date and the claim closure date falls within each
specified period |
