'Significant WC Changes' Seen at Trump's DoL

Westlaw Today and sister company Reuters on Thursday published attorney analysis of what they called “significant changes” at the Labor Department under President Donald Trump.
Those include the removal of the Director of the Office of Workers’ Compensation Programs; which is typical following a change in administration, the analysis noted.
While a new Director hasn’t yet been appointed, but Douglas A. Pennington is the Acting Director.
As well, two of the District Directors covering the three Compensation Districts have retired, leaving only two District Directors to cover the entire country.
Several Claims Examiners have retired or left government employment, significantly delaying action on requests for intervention and slowing the pace of settlement reviews.
“At the Office of Administrative Law Judges (OALJ), there have been a number of ALJ retirements, and law clerk positions are unfilled. While the volume of claims referred for formal hearing (trial) has exponentially increased, staffing has remained static or decreased, meaning the adjudicatory process could potentially take years for an injured worker to receive a decision on their claim for benefits.”
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Our sister publication Workers’ Comp Executive reports that California Gov. Gavin Newsom has made major changes to the leadership at the Department of Industrial Relations (DIR).
DIR administers and enforces laws on wages, breaks, retaliation, workplace safety and health, apprenticeship and claims for medical care for injured workers. The agency includes the Division of Occupational Safety & Health (DOSH), also known as Cal/OSHA.
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Ohio’s Bureau of Workers’ Compensation (BWC) is providing the state’s employers with incentives and financial support to encourage their support of substance use prevention and recovery programs.
The updated initiative combines BWC’s previous substance use grants and programs to help employers to enroll and receive reimbursement for their prevention and recovery efforts.
Among the benefits are reimbursements for drug-free workplace policy development, training, drug and alcohol assessments, and drug testing.
BWC is also offering workers’ comp premium rebates for successfully completing program requirements.
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New research by Workers Compensation Research Institute (WCRI) has examined factors associated with high-cost claims involving rotator cuff disorders, that is, medical payments exceeding $65,000 within 36 months of injury.
The analysis draws on nearly 50,000 rotator cuff disorder claims from a larger dataset of over 930,000 lost-time claims across 32 states. These claims involved injuries occurring between October 2015 and March 2019, with detailed medical billing and treatment data tracked for three years postinjury.
Among the questions addressed, the research examines specific factors contributing to high medical payments for rotator cuff injuries.
Also, the data looks at whether patterns of medical care are consistent with guideline recommendations and expected medical practice regarding timing of surgery and pre- and postoperative nonsurgical treatments.
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While there has been a sharp decline in opioid use by injured workers, dermatological drugs have now become the costliest class in workers’ compensation, which some experts say highlights the need for smarter pharmacy strategies, according to Carrier Chronicles.
Recent data shows a significant decline in historically problematic drug classes in workers’ compensation, particularly opioids, followed by muscle relaxants, benzodiazepines, sedatives, and central nervous system stimulants, according to the report.
“Dermatologicals have now surpassed opioids as the top driver of cost and utilization, making cost-effective prescribing strategies critical,” said Lisa Haug, Assistant Vice President of Medical Management at Safety National.
“Rising spend and use are also anticipated for certain high-cost, low-volume drugs such as specific non-steroidal anti-inflammatory drugs (NSAIDs), migraine agents, anticoagulants, private-label topicals, and other specialty drug classes,” she said.
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The Pennsylvania and Delaware Compensation Rating Bureaus said they’ve started using WorkComp360, a business intelligence and analytics platform.
The dashboards are underpinned by Cloverleaf Analytics’ Insurance Intelligence platform.
The system will be used to assess market dynamics, claim severity, and carrier performance.
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Return-to-Work services provider ReEmployAbility said it has passed the 100,000 mark of injured workers referred through its program.
The 100,000th injured worker assignment was secured via the Family Service Association (FSA), a community organization that partners with the Florida provider.
ReEmployAbility partners with nonprofit organizations nationwide to offer modified duty assignments that align with injured workers’ capabilities and medical restrictions.
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