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WCRI – Attorney involvement; data says…

A really interesting (nerd alert!) presentation from the ever-informative Dr Rebecca Yang dug into factors associated with attorney involvement in work comp claims.

Dr Yang contrasted states with very low vs very high attorney involvement.

NJ and IL both had attorneys involved in almost half of LT claims with defense attorney payments over $500. However costs were relatively low considering the high involvement rate…

Multiple factors are involved in determining a permanent partial award in IL, and before 2011 there were no published standards for determining awards. That lack of standardization and potential for additional payments for PPD vs TTD benefits in IL may well have motivated patients to seek attorney assistance.

NJ also had higher attorney involvement.  To get a permanency rating, patients have to attend two hearings, and there are often dueling medical experts disputing each others’ findings. For experienced attorneys, these hearings can go quickly as benefits are resolved by negotiation and agreement.  Thus, there is more attorney involvement, but lower per-claim costs for attorneys.

In contrast, Texas and Wisconsin had the lowest incidence of attorney involvement, at 14% and 13% respectively.

In TX, maximum attorney fees were set by regulation and just increased in January of this year.  WI’s standards, fee structures, and processes are efficient an relatively easy to navigate for the layperson.


One thought on “WCRI – Attorney involvement; data says…”

  1. Interesting that Texas and Wisconsin are the lowest states for attorney representation. I would have intuitively suspected it to be Indiana.

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Joe Paduda is the principal of Health Strategy Associates



A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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