Performance Details

Department of Labor and Workforce Development - Workers" Compensation

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Mission

Ensure the efficient, fair and predictable delivery of indemnity, medical and vocational rehabilitation benefits intended to enable workers to return to work at a reasonable cost to employers.

Core Services

• Ensure compliance with the Workers" Compensation Act.
• Conduct timely Workers" Compensation hearings.
• Operate a timely and efficient appeals program.
• Process Fishermen"s Fund claims timely.
• Administer a vocational rehabilitation benefits and training program for injured workers.

Mission Results	Core Services
A: All employers comply with AS 23.30, the Alaska Workers" Compensation Act. Details > TARGET #1: Maintain ratio of uninsured injuries at .01% or less of Alaska"s Workforce. TARGET #2: All uninsured employers take responsibility for uninsured injuries.	A1: Ensure compliance with the Workers" Compensation Act. Details > TARGET #1: Investigate all alleged uninsured employers. TARGET #2: Investigate all alleged Workers" Compensation Act fraud. TARGET #3: 75% of investigations are completed within six months. TARGET #4: Educate employers about the Workers" Compensation Act requirements.
Mission Results	Core Services
B: Improved delivery of efficient, low cost and legal informal and formal dispute resolution. Details > TARGET #1: Resolve at least 90 percent of disputed issues without a formal hearing. TARGET #2: Process open cases at the Appeals Commission within 250 days.	B1: Conduct timely Workers" Compensation hearings. Details > TARGET #1: All written decisions will be issued within 30 days of record closure. TARGET #2: Hearings will be scheduled within an average of 90 days from receipt of readiness for hearings. B2: Operate a timely and efficient appeals program. Details > TARGET #1: Issue final Workers" Compensation Appeals Commission decisions within an average of 90 days of record closure.
Mission Results	Core Services
C: More Alaskans available for jobs. Details > TARGET #1: Requests for reimbursement from the Fishermen"s Fund will be paid within 30 days of receipt. TARGET #2: 20 percent of injured workers eligible for reemployment benefits complete a viable retraining plan.	C1: Process Fishermen"s Fund claims timely. Details > TARGET #1: Keep the number of days it takes to get the Fishermen"s Fund Advisory & Appeals Council"s approval to within 90 days. C2: Administer a vocational rehabilitation benefits and training program for injured workers. Details > TARGET #1: Reduce the percentage of retraining plans that are returned to the rehabilitation specialists by 20 percent per year until no plans need to be returned. TARGET #2: Review of all pending retraining plans will be performed quarterly.

Performance Detail

A: Result -All employers comply with AS 23.30, the Alaska Workers" Compensation Act.

Target #1: Maintain ratio of uninsured injuries at .01% or less of Alaska"s Workforce. Methodology: Number of injuries is based on claims made to the Workers" Compensation Board. Workforce is the "Labor Force" determined by the Division of Research & Analysis. Percentage of Employee Injuries Uninsured Under Workers" Compensation Fiscal Year Injuries Workforce % of Workforce FY 2024 24 357,637 .007% FY 2023 11 356,167 .003% FY 2022 9 359,618 .003% FY 2021 21 348,043 .006% FY 2020 20 344,159 .006% FY 2019 38 354,141 0.01% Analysis of results and challenges: During FY2024, the Special Investigations Unit (SIU) received 32 allegations of uninsured injury and fully investigated each one. Out of the 32 alleged uninsured injuries, 24 were confirmed to have occurred and were uninsured. This could be due to unpaid premiums, failure to renew their policy, or failure to become insured in the first place. Eight of the alleged uninsured injured workers filed a report of injury and/or workers` compensation claim with the division against the Benefits Guaranty Fund. Two withdrew their claim due to alternate insurance coverage. Of the other allegations, 11 had insurance coverage, the employer took responsibility for two injured workers, ten injured workers did not file a claim, and one injured worker withdrew their claim. Target Last Modified: 11/14/2024

Target #2: All uninsured employers take responsibility for uninsured injuries. Methodology: Percentage of uninsured employers that are participating in board proceedings in the uninsured injury case, paying the compensable claim costs direct or by reimbursement to the Benefits Guaranty Fund. Also includes uninsured employers that are not doing either only because the uninsured injured worker did not file or pursue a workers" compensation claim. Analysis of results and challenges: During FY2024, out of the 24 confirmed uninsured injuries, a total of eight uninsured injured workers filed workers" compensation claims against their uninsured employers and the Benefits Guaranty Fund. Two of the eight were closed due to alternate coverage. Of the six remaining confirmed uninsured injuries with filed claims, two of their employers are actively participating in the uninsured injury case. Target Last Modified: 11/14/2024

A1: Core Service - Ensure compliance with the Workers" Compensation Act.

Target #1: Investigate all alleged uninsured employers. Alleged Workers" Compensation Act Failure to Insure Investigated Year Total Alleged uninsured Percentage investigated 2024 4620 +70.35% 100% 2023 2712 +674.86% 100% 2022 350 -4.89% 100% 2021 368 -10.68% 100% 2020 412 -30.52% 100% 2019 593 +11.05% 100% Analysis of results and challenges: The Special Investigations Unit (SIU) conducted 4,620 compliance checks and found 4,240 of those alleged uninsured employers in compliance. The remaining 380 alleged uninsured employers were referred for further investigation. SIU began FY2024 with 107 pending failure to insure investigations and opened or reopened another 380 cases for a total of 487 active formal investigations worked during FY2024. These investigations typically begin within a day or two and range from conducting simple compliance checks that do not result in opening a formal failure to insure investigation to completing the more complex investigations that result in issuance of warning letters, penalties agreed upon via the settlement process, and formal hearings. Out of 487 active formal investigations, SIU closed 313 in FY2024. Of the 313 investigations closed, 197 were resolved as investigations only (meaning that either (1) proof of coverage (POC) was found, (2) proof of coverage was no longer necessary due to business closure/no longer operating with employees, or (3) the employers coverage reinstatement resulted in a small enough lapse that pursuing a penalty would not be cost effective). Out of 116 remaining closed investigations, 66 cases resulted in penalties assessed to employers via stipulated settlement (61) or formal decision and order issued by the Alaska Workers" Compensation Board (5). A total of 95 employers were petitioned for failure to insure in FY2024. 13 petitions were withdrawn due to either POC found or business closure. There were 175 remaining investigations actively pending at the close of FY2024. Target Last Modified: 11/14/2024

Target #2: Investigate all alleged Workers" Compensation Act fraud. Methodology: The number of Workers" Compensation Act fraud allegations is calculated by adding the total number of calls received from the public alleging criminal fraud perpetrated by a claimant, employer, care provider, insurer/claims administrator, or attorney to the total number of requests for assistance received from other law enforcement agencies. Analysis of results and challenges: The Special Investigations Unit received 105 fraud allegations in FY2024. Of the 105 fraud allegations, 16 were alleged claimant fraud, 25 were alleged employer fraud, 2 were alleged care provider fraud, 1 was alleged attorney/non-attorney rep fraud, 6 were alleged insurance company/agent fraud, 57 were other agency assist requests, and 0 were not related to workers" compensation fraud. Target Last Modified: 11/14/2024

Target #3: 75% of investigations are completed within six months. Methodology: The percentage of investigations completed within six months is generated by comparing the total number of cases investigated within the fiscal year against the total number of cases investigated within the fiscal year that are closed for any reason within 180 days. Analysis of results and challenges: The Special Investigations Unit (SIU) investigated a total of 487 formal failure to insure matters, including those carried over from FY2023 and new matters opened in FY2024. Of the 313 failure to insure investigations closed, 242 were closed within 180 days from the actual date opened to the actual date closed. Target Last Modified: 11/14/2024

Target #4: Educate employers about the Workers" Compensation Act requirements. Methodology: The number of employers educated is generated by adding the total number of attendees at formal employer education presentations, to the total number of documented public inquiries received, to the total number of onsite visits conducted. Analysis of results and challenges: During FY2024, the Special Investigations Unit (SIU) conducted four formal educations presentation with 178 attendees, responded to 332 documented public inquiries, and conducted a total of 190 onsite visits for a total of 700 educated employers. Limited ability to travel to communities outside the regional areas continues to have impact SIU"s ability to increase its proactive public education activity during FY2024. Target Last Modified: 11/14/2024

B: Result -Improved delivery of efficient, low cost and legal informal and formal dispute resolution.

Target #1: Resolve at least 90 percent of disputed issues without a formal hearing. Methodology: Total number of claims and petitions filed, compared to the number of decisions and orders issued. Analysis of results and challenges: The Division of Workers` Compensation continues to achieve the goal to resolve at least 90 percent of all claims and petitions without a formal hearing. Many less complex issues are resolved at prehearing conferences by Workers` Compensation Officers and Hearing Officers. Many of the more contentious cases with difficult parties are resolved through mediation, which saves the parties and the division hours of hearings and weeks of work for a Hearing Officer and board panel. For example, in FY2024, the division`s mediation program mediated 56 complex and contentious cases and 54 were resolved. The division is challenged by non-attorney representatives who attempt to assist injured workers and provide incorrect advice, miss deadlines or complicate simple cases. The division recommends a statutory amendment that forbids persons who are not licensed attorneys from representing claimants. The division is also challenged by self-represented claimants with mental health concerns that interfere with their ability to effectively utilize advice given on how to pursue their rights under the Workers` Compensation Act. The division will selectively seek guardianship for claimants with mental illness that renders them incompetent to protect and pursue their rights under the Act. The division will continue to advise self-represented claimants and non-attorney representatives of injured workers` right and how to pursue them under the Act. Target Last Modified: 11/14/2024

Target #2: Process open cases at the Appeals Commission within 250 days. Methodology: The average number of days from the filing of an appeal or petition for review to the issuance of a final order or decision. Analysis of results and challenges: The Commission"s FY2024 docket contained cases filed in FY2024 and cases filed in previous fiscal years, as well as cases remanded from the Alaska Supreme Court. The average time period from the filing of an appeal or petition for review to the issuance of a final order or decision in cases closed on the FY2024 docket was 141 days, with 88 percent of those cases being closed in less than 360 days from the filing of the appeal or petition for review. In addition to continuing a high level of compliance with the statute, the Commission has been able to close 75 percent of cases filed with the Commission within 250 days of receiving the case. Target Last Modified: 11/14/2024

B1: Core Service - Conduct timely Workers" Compensation hearings.

Target #1: All written decisions will be issued within 30 days of record closure. Analysis of results and challenges: The Alaska Workers" Compensation Board hears claims regarding disputes of entitlement to benefits under the Alaska Workers" Compensation Act. After the hearing record closes, the division has 30 days to complete its work and write a formal decision and order based on the board"s determination. Those determinations will either allow or disallow an injured worker various benefits under the Alaska Workers" Compensation Act. The division in FY2024 did not meet this target of 100 percent. The average number of days after record closure to decision issuance was 24 days, more difficult cases with typically enormous factual records in some instances took significantly longer for a variety of reasons. The Alaska Supreme Court requires decisions to include extensive factual findings, which increases the time required to write legally and factually complex the decisions. The division will continue to work toward the goal of issuing all decisions within 30 days of record closure. Target Last Modified: 11/14/2024

Target #2: Hearings will be scheduled within an average of 90 days from receipt of readiness for hearings. Average Number of Days between Request for Workers" Compensation Hearing and Hearing Date Fiscal Year Average FY 2024 86 FY 2023 73 FY 2022 96 FY 2021 124 FY 2020 92 FY 2019 81 Analysis of results and challenges: The division met this target in FY2024. Once parties are ready to go to a hearing, the division offers parties requesting a hearing the first available hearing date. In most instances, it is up to the parties or their representatives whether they accept that earliest hearing date. Frequently, one or both parties do not accept the earliest available hearing date, due to other commitments and innumerable other reasons. To delay hearings on the merits of injured workers` cases, the second independent medical evaluation (SIME) process was used as a litigation strategy. This increased the average days between a hearing request and hearing date. A recent regulatory change eliminates the unnecessary delay in SIME disputes hearings. This should bring this gap down more going forward. Target Last Modified: 11/14/2024

B2: Core Service - Operate a timely and efficient appeals program.

Target #1: Issue final Workers" Compensation Appeals Commission decisions within an average of 90 days of record closure. Methodology: The average number of days from record closure to issuance of a final decision is for published final decisions only, and is not adjusted for cases with decisions on reconsideration, decisions on remand from the Alaska Supreme Court, or unpublished orders. Analysis of results and challenges: In FY2024, the Commission issued no published written final decisions. The Commission believes this was due to the much lower number of appeals filed during FY 2022 and FY 2023 due to the COVID-19 pandemic. The number of new cases filed since January 1, 2024, has since increased to almost pre-pandemic levels. In FY2024, the Commission issued 42 unpublished orders. Target Last Modified: 11/14/2024

C: Result -More Alaskans available for jobs.

Target #1: Requests for reimbursement from the Fishermen"s Fund will be paid within 30 days of receipt. Methodology: Includes new and existing claims that have been found eligible for Fish Fund benefits and were processed. Average Number of Days to Process a Fishermen"s Fund Claim Fiscal Year # of claims paid FY 2024 145 FY 2023 208 FY 2022 150 FY 2021 143 FY 2020 197 FY 2019 230 Analysis of results and challenges: In FY2024, the number of claims received by the Fishermen"s Fund totaled 183. Of the 183 claims, 148 were approved for benefits (145 by fund administration and 3 by the Fishermen"s Fund Council). The Fund paid benefits for 105 claims within 30 days and 40 claims were paid beyond 30 days. There were 40 claims paid 30 days or more after receipt. The average number of days from filed petition for benefits to approval on claims approved by the fund administration was 35 days. Target Last Modified: 11/14/2024

Target #2: 20 percent of injured workers eligible for reemployment benefits complete a viable retraining plan. Percent of Eligible Injured Workers Who Completed a Retraining Plan Fiscal Year # Eligible # Completing Plan % Completing FY 2024 73 3 4.11% FY 2023 76 9 11.8% FY 2022 71 9 12.7% FY 2021 90 7 7.7% FY 2020 96 10 10.4% FY 2019 136 11 8.1% Analysis of results and challenges: The number of employees eligible for reemployment plans remained consistent in FY2024, while the number of completed plans decreased. As a result, the percentage of completed plans decreased. In FY2024, 29 injured workers determined eligible for reemployment benefits exited the reemployment benefits system by selecting the job dislocation benefit under AS 23.30.041(g)(2); an additional 30 injured workers found eligible settled reemployment benefits in a Compromise and Release agreement at some point after eligibility and prior to plan completion. These two factors significantly limit the number of injured workers available to participate in a retraining plan. Also, as training costs continue to rise it becomes more difficult for rehabilitation specialists to develop retraining plans within the $13,300 statutory limit under AS 23.30.041(l). Finally, for workers that have been in the workforce for a number of years, the statutory two-year time limit on retraining plans is not always sufficient and time expires prior to plan completion for an additional subset of workers. Target Last Modified: 11/14/2024

C1: Core Service - Process Fishermen"s Fund claims timely.

Target #1: Keep the number of days it takes to get the Fishermen"s Fund Advisory & Appeals Council"s approval to within 90 days. Average Number of Days to get Fishermen"s Fund Council"s Approval Fiscal Year Target YTD Total FY 2024 90 0 FY 2023 90 110 FY 2022 90 142 FY 2021 90 83 FY 2020 90 53 FY 2019 90 83 Analysis of results and challenges: The Fishermen"s Fund Council reviews all claims denied by the Fund Administrator, all applications for benefits that exceed the Fund Administrator"s statutory limit, and all requests to extend duration of care. The council meets twice a year. For FY2024, the Council reviewed 60 claims. Of the 60 claims, 13 were appeals (some appeals were submitted in FY 2023 for review in FY 2024). The Council approved 13 of the appealed claims and denied 0. The Council also reviewed and concurred with 47 denied by the Fund Administration. For FY2024, the average number of days from filed petition for benefits to approval on claims approved by the Fishermen"s Fund Council was 210 days. Target Last Modified: 11/14/2024

C2: Core Service - Administer a vocational rehabilitation benefits and training program for injured workers.

Target #1: Reduce the percentage of retraining plans that are returned to the rehabilitation specialists by 20 percent per year until no plans need to be returned. Percent of Retraining Plans Returned to Rehabilitation Specialists Fiscal Year # Plans Submitted # of Plans Returned Percent Returned FY 2024 24 3 12.5% FY 2023 36 3 8.3% FY 2022 30 4 13.3% FY 2021 40 7 17.5% FY 2020 45 5 15% FY 2019 58 4 6.9% Analysis of results and challenges: In FY2024, there were less plans submitted, and the same number of plans returned to rehabilitation specialists. This is primarily a function of the number of disputed plans that require Reemployment Benefits Administrator (RBA) review. Nearly all plans submitted for review by the RBA are suspended or denied because they do not meet statutory requirements; plans about which neither party has concerns are agreed to without RBA review. For high wage earners it can be impossible to meet the requirements of the law that the plan meet the remunerative wage (60 percent of the wage prior to injury). Even if there is theoretically a means (occupational goal) to meet the wage, statutory time (two years) and more so cost ($13,300) limitations can be the barrier. Of course, the mental and physical capacities of the injured worker can also provide barriers to developing a plan that meets the requirements of the law. Rehabilitation specialists are left more and more with the option of submitting a plan they know would not pass RBA review, hoping the parties will agree to it anyway. Target Last Modified: 11/14/2024

Target #2: Review of all pending retraining plans will be performed quarterly. Analysis of results and challenges: The Reemployment Benefits Administrator reviewed 100 percent of all pending retraining plans quarterly in FY2024. Except for two quarters when the position was vacant in FY2019 and FY2020 the Reemployment Benefits Administrator has reviewed all pending training plans on a quarterly basis for the past seven fiscal years. Target Last Modified: 11/14/2024

Last refreshed: 05/22/2025 12:00 pm