Texas-Sized Mess Serves as a Cautionary Tale for the North Carolina Workers’ Compensation System

December 9, 2010, by Michael A. DeMayo

Analysts often get mired in the details of internal state policy, spending time reviewing in-state cases and poring over announcements from individuals like Insurance Commissioner Steve Poizner to understand factors shaping the North Carolina workers’ compensation system.

But sometimes it’s instructive to attend to the trials and tribulation of other state’s workers’ comp programs. To wit, a November 23 report out of Austin, Texas highlights a slew of nagging problems with that state’s Division of Workers’ Compensation (DWC). The report identified four serious problems that “significantly inhibit” the DWC’s ability to offer benefits and care for workers hurt on the job. The points get technical and dry, but they are worth quickly reviewing:

1. The Texas DWC allegedly does not process complaints about medical practitioners well, so system auditors cannot evaluate the consistency and appropriateness of any disciplinary actions.
2. The complaint process the DWC uses fails to comply with the Texas Labor Code.
3. The way healthcare providers get chosen creates major inefficiencies and results in the “overutilization” of healthcare.
4. DWC also has problems in engaging in sanctions and enforcing its decisions.

Texas professionals plan to meet on December 14 in Austin to discuss how to rehabilitate the Division of Workers’ Compensation. But the ongoing struggles in the Lonestar State should alert analysts and policymakers who focus on North Carolina workers’ compensation to the sheer size and scope of some of the crises we face.

One major theme that emerges here is the idea that failure to process information effectively can have serious systemic consequences. State bureaucracies are not exactly known for being efficient. But lack of a structured set of processes and systems gums-up the whole system. It forces people to engage in extra paperwork. It drains resources from already resource-strapped and time-strapped individuals.

New developments in information processing theory may be useful. For instance — and this may sound silly at first — but imagine if everyone in the system adopted the “K.I.S.S. principle” (keep it simple, stupid) when developing their systems and procedures. A return to simplicity could make regulations and restrictions clearer, allow employers and hurt workers to make better decisions and foster a more genial overall spirit.

Stepping back from these global and philosophical implications…

If you’ve recently been put out of work by an injury or occupational disease, or if your family has been struggling to collect benefits from an insurance carrier, you are probably less concerned with what’s going on in Texas and much more concerned with questions like: “How am I going to feed my family if my benefits run out?” and “What can I do to heal faster so I can get back to work?”

To tackle all your concerns, you may benefit greatly from a free consultation with a North Carolina workers’ compensation law firm.

More Web Resources

Division of Workers’ Compensation (DWC)

Texas’ workers comp agency’s oversight faulted: Auditor


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