Performance Details
Department of Labor and Workforce Development - Workers" Compensation
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 |
||||||||
|
| ||||||||
Mission Results |
Core Services |
||||||||
|
| ||||||||
Mission Results |
Core Services |
||||||||
|
|
Performance Detail
A: Result -All employers comply with AS 23.30, the Alaska Workers" Compensation Act. |
Target #2: All uninsured employers take responsibility for uninsured injuries..
Target Last Modified: 11/14/2023 |
A1: Core Service - Ensure compliance with the Workers" Compensation Act. |
Target #1: Investigate all alleged uninsured employers..
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 493 active formal investigations, SIU closed 386 in FY2023. Of the 386 investigations closed, 205 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 182 remaining closed investigations, 118 cases resulted in penalties assessed to employers via stipulated settlement (115) or formal decision and order issued by the Alaska Workers" Compensation Board (3). A total of 114 employers were petitioned for failure to insure in FY2023. 19 petitions were withdrawn due to either POC found or business closure. Target Last Modified: 11/14/2023 |
Target #2: Investigate all alleged Workers" Compensation Act fraud..
Target Last Modified: 11/14/2023 |
Target #3: 75% of investigations are completed within six months..
Target Last Modified: 11/14/2023 |
Target #4: Educate employers about the Workers" Compensation Act requirements..
Target Last Modified: 11/14/2023 |
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..
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 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 provide increased training opportunities to help self-represented claimants and non-attorney representatives more effectively and efficiently navigate the process. Target Last Modified: 11/14/2023 |
Target #2: Process open cases at the Appeals Commission within 250 days..
In addition to continuing a high level of compliance with the statute, the Commission has been able to close 44 percent of cases filed with the Commission within 250 days of receiving the case. Target Last Modified: 11/14/2023 |
B1: Core Service - Conduct timely Workers" Compensation hearings. |
Target #1: All written decisions will be issued within 30 days of record closure..
The division in FY2023 did not meet this target of 100 percent. While the average number of days after record closure to decision issuance was 23 days, more difficult cases with typically enormous factual records in some instances took significantly longer for a variety of reasons. Training for hearing officers is also needed and is being pursued to cut down on unnecessary factual finds that slow down the decision-writing process. The division will continue to work toward the goal of issuing all decisions within 30 days of record closure. Target Last Modified: 11/14/2023 |
Target #2: Hearings will be scheduled within an average of 90 days from receipt of readiness for hearings..
Target Last Modified: 11/14/2023 |
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..
In FY2023, the Commission issued 60 unpublished orders in addition to the 9 published decisions. Target Last Modified: 11/14/2023 |
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..
The Fund processed benefit payments for 208 claims (includes new and existing claims). A total of 604 bill payments were issued by the Fund. The Fund has been diligent in improving processing of first payments on claims under $10,000. The Fund has actively worked with injured fishermen and providers to ensure that submitted claims contain all required documentation upon initial presentation through the first 90 days via phone call or email. For FY2023, of the 241 claims submitted, 18 claims were filed and approved for benefits by P&I carriers. 4 vessel owners received reimbursement from the fund. Claims filed by fisherman are cyclical with the fishing season. The Fund receives 50 percent of its claims between July and October. The fund administration approved 175 claims of which 120 claims were approved within 30 days of receipt and 55 claims were approved for benefits past 30 days. Delayed decisions and payments were issued on 55 claims for the following reasons: 1. The Fund did not receive required medical bills, chart notes, and explanation of benefits with the claim. 2. The Fund was unable to verify a valid license or permit. 3. The Fund requested additional information and the information was not provided. In FY2021, regulation change under 8 AAC 55.010 was approved to extend initial treatment from 90 days to 120 days. In FY2010, the Fishermen"s Fund benefit limit was raised from $2,500 to $10,000 by the legislature and provided vessel owners` reimbursement of a portion of their Protection & Indemnity (P&I) insurance deductible if the injured fishermen filed a claim with the P&I insurer. In FY2019, the Legislature agreed to increase the reimbursable portion of the P&I deductible payment to $5,000 and this change became effective in FY2020. Target Last Modified: 11/14/2023 |
Target #2: 20 percent of injured workers eligible for reemployment benefits complete a viable retraining plan..
Target Last Modified: 11/14/2023 |
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..
The Council meets twice a year. The Council may deny a claim with conditions. These conditions could be a request for more information or documentation from the fisherman, especially if the request is a substantial dollar amount or extension of care beyond statutory limits. For FY2023, the Council reviewed 68 claims, of which 13 were appeals. The Council approved 11 of the appealed claims and denied 2. The Council also reviewed 55 claims denied by the Fund Administration. For FY2023, the average number of days from filed petition for benefits to approval on claims approved by the Fishermen"s Fund Council was 110 days. Target Last Modified: 11/14/2023 |
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..
Target Last Modified: 11/14/2023 |
Target #2: Review of all pending retraining plans will be performed quarterly..
Target Last Modified: 11/14/2023 |
Last refreshed: 04/24/2024 05:00 pm