WCRI | View WCRI Benchmarks

View WCRI Benchmarks

Definitions of the Performance Measures
Performance Measure	Definition
Time to notice of injury and first indemnity payment

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

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

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

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

Average benefit payments and claim costs

All paid claims

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

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

Medical payment per claim	The sum of medical payments for all paid claims, divided by the total number of all paid claims

Indemnity payment per claim	The sum of indemnity payments for all paid claims, divided by the total number of all paid claims

Benefit delivery expense per claim	The sum of benefit delivery expenses for all paid claims, divided by the total number of all paid claims

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

Incurred medical benefit per claim	The sum of incurred medical benefits for all claims, divided by the total number of all claims

Incurred indemnity benefit per claim	The sum of incurred indemnity benefits for all claims, divided by the total number of all claims

Claims with more than 7 days of lost time

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

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

Medical payment per claim	The sum of medical payments for lost-time claims, divided by the total number of lost-time claims

Indemnity payment per claim	The sum of indemnity payments for lost-time claims, divided by the total number of lost-time claims

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

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

Benefit delivery expense per claim	The sum of benefit delivery expenses for lost-time claims, divided by the total number of lost-time claims

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

Incurred medical benefit per claim	The sum of incurred medical benefits for lost-time claims, divided by the total number of lost-time claims

Incurred indemnity benefit per claim	The sum of incurred indemnity benefits for lost-time claims, divided by the total number of lost-time claims

Average benefit payments and claim costs

Temporary disability claims

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

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

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

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

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

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

Permanent disability claims

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

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

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

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

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

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

Permanent partial disability (PPD) claims (and lump sums)

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

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

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

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

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

PPD/lump-sum payment per PPD/lump-sum 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

Temporary disability payment per PPD/lump-sum 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

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

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

Average benefit payments and claim costs

Three categories of PPD/lump-sum claims

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

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

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

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

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

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

Permanent total disability claims

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

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

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

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

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

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

Fatality claims

Fatality claims as a percentage of all lost-time claims	The number of fatality claims, divided by the total number of lost-time claims

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

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

Medical payment per claim	The sum of medical payments for claims classified as fatality claims, divided by the total number of fatality claims

Indemnity payment per claim	The sum of indemnity payments for claims classified as fatality claims, divided by the total number of fatality claims

Fatality payment per fatality claim	The sum of fatality payments, divided by the total number of lost-time claims classified as fatality claims

Vocational rehabilitation costs and frequency

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

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

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

Attorney involvement and benefit delivery expenses

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

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

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

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

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

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

Duration and claim closure patterns

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

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

Lost-time claims closed	The percentage of lost-time claims closed as of 6 months after the end of the accident year

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

955 Massachusetts Avenue Cambridge, Massachusetts 02139 617-661-WCRI (9274)