Cambridge, MA, May 9, 2017—The average total cost per workers’ compensation claim in Florida grew moderately from 2010 to 2015, according to a study by the Workers Compensation Research Institute (WCRI).
“Total costs per claim in Florida grew 3 percent per year from 2010 to 2015 for claims with more than seven days of lost time and 12 months of experience,” said Ramona Tanabe, WCRI’s executive vice president and counsel.
The study, CompScope Benchmarks for Florida, 17th Edition, reflects research in the period before the following Florida Supreme Court decisions, both of which were expected to increase workers’ compensation system costs:
- The Castellanos decision in April 2016 declared the mandatory worker’s attorney fee schedule in workers’ compensation unconstitutional as a violation of due process.
- In its June 2016 Westphal decision, the Supreme Court ruled the state’s 104-week limitation on receipt of temporary total disability (TTD) benefits unconstitutional on the grounds that the limitation denied a right of access to the courts.
“Before the Castellanos decision, Florida had a higher use of defense attorneys and a higher average defense attorney payment per claim than most of the other 17 states included in this WCRI study,” said Tanabe. “Nearly 40 percent of 2013 workers’ compensation claims with more than seven days of lost time and three years of experience had defense attorneys involved, about 9 percentage points higher than in the typical state, with the average defense attorney payment per claim coming in 22 percent higher than the 18-state median.”
Prior to the Westphal decision, WCRI found that the average duration of temporary disability benefits in Florida was shorter than in many study states. Several system features may be related to this result. For example, Florida has clear rules governing TTD payments. “Also, the statutory limit on TTD benefits in Florida was set at 104 weeks prior to the Westphal decision, while in many other states there were either longer statutory caps, or no caps, on TTD benefits,” Tanabe said.
The following are among the study’s other findings:
- Indemnity benefits per claim in Florida were lower than typical of the WCRI study states, which may be related to rules governing temporary disability and impairment benefits.
- The percentage of claims with attorneys in Florida increased again after the decrease following the implementation of a worker’s attorney fee schedule in 2003.
Florida had typical medical payments per claim of the 18 states, a result of lower prices for nonhospital services offsetting higher prices for hospital outpatient care prior to the recent fee schedule changes after 2015.
For more information on this study, visit https://www.wcrinet.org/reports/compscope-benchmarks-for-florida-17th-edition.
The Cambridge-based WCRI is recognized as a leader in providing high-quality, objective information about public policy issues involving workers’ compensation systems.
The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Cambridge, MA. Organized in 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.