WSI paying more out-of-state claims

2013-04-21T16:30:00Z WSI paying more out-of-state claimsBy JESSICA HOLDMAN | Bismarck Tribune Bismarck Tribune

BISMARCK, N.D. _ Out-of-state North Dakota Workforce Safety and Insurance claims, which officials say are more difficult to manage, have grown 121 percent since 2010.

“There is a big increase,” WSI Director Bryan Klipfel said.

The number of out-of-state claims climbed from 2,689 in 2010 to 5,955 projected for 2013. And the number of oil field career-type claims grew from 747 in 2010 to 3,411 projected for 2013, a 357 percent increase.

Historically, WSI dealt mostly with North Dakota companies and employees.

“They worked here, their home state was here and they received treatment here,” Klipfel said.

Now, with increased activity driven by the oil boom, more workers and companies are coming from out of state. Once a company does a certain percentage of work in the state, it is required to get WSI coverage for its employees working in North Dakota.

Klipfel said it was easier for claims adjusters to talk to doctors and other health care providers, but now that out-of-state claims make up a greater portion, the agency is having to adjust to a heavier workload.

“They (injured workers) want to go back and treat where their family is,” he said. “When you have that distance, it makes it hard to manage those claims.”

Klipfel said it’s easier to handle in-state claims because claims adjusters work with doctors on a day-to-day basis and develop a rapport.

The vocational rehab process is more difficult with out-of-state claims, he said. Assigned nurse case managers can no longer go to appointments and physicians may choose not to follow the agency’s fee schedule.

“It’s not quite as smooth,” Klipfel said.

Peggy Hill, a return-to-work case manager for the Sanford Health Occupational Medicine Clinic, said WSI has gone out of its way to work with major facilities in North Dakota.

Hill said it is her job to help people get back to work sooner, help employers find work their employees can do while healing, help make appointments and organize paperwork like progress notes and doctors’ assessments.

When she works with out-of-state companies, Hill said, she encourages them to try to keep their employees here for treatment. She said it makes it easier for things like physical therapy, for example.

When injured workers are here, she can make sure they make it to appointments and that the therapy is working.

Many of out-of-state workers spend two weeks here and two weeks at home. Hill said when that happens, she helps them set up physical therapy in their hometown and forwards the necessary paperwork.

“What happens is that injured worker is required to find a provider who will take a workman’s comp case, and in some states that’s pretty difficult,” she said.

Because WSI is the only workplace injury insurance agency in the state, Hill said, it’s also much more efficient when she has to track down a worker’s past claims. If a person has worked in other states, it becomes more difficult to track down a claims history because most other states have multiple providers.

The number of employers WSI works with has increased from 20,316 in 2010 to a projected 24,764 employers in 2013, Klipfel said. The number of employees has gone from 340,000 to a projected 382,000.

The number of claims has increased 33 percent from 19,388, to a projected 25,763.

To deal with the increase, WSI has added nine adjusters over the last couple of years. It is adding

32 temporary employees, bringing the agency’s workforce to about 270 employees, a big jump.

Klipfel also said there is a different “culture” at WSI than in other states.

“We want that injured worker back to work again,” he said.

Many states have a limit to the number of years they’ll cover a worker whereas WSI covers them for life, he said.

If a worker suffers a knee injury at work and 30 years later has knee issues attributed to that injury, WSI will cover the medical costs. That means as more out-of-state claims come in, WSI will have to adjust to working with out-of-state providers over the long term.

Reach Jessica Holdman at 701-250-8261 or jessica.holdman@bismarcktribune.com.

Copyright 2015 Bismarck Tribune. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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