This 22nd edition CompScope™ Benchmarks study for North Carolina helps policymakers and other system stakeholders identify current cost drivers and emerging trends in total costs per claim and key components. The study compares the performance of state workers’ compensation systems in North Carolina and 17 other states, focusing on income benefits, costs, overall medical payments, use of benefits, duration of temporary disability, benefit delivery expenses, timeliness of payments, and other metrics. The study also examines how these system performance metrics have changed, mainly from 2015 to 2020, for claims at various maturities. We analyze claims with experience through 2021 for injuries up to and including 2020, and in some cases, we use a longer time frame to supply historical context. 

The study continues to monitor the effects of major legislation enacted over the past decade. A key provision of House Bill (HB) 709 in 2011 capped temporary total disability (TTD) benefits at 500 weeks (in most instances); previously, there was no duration limit on TTD benefits. This report includes claims occurring up to about nine years after the income benefit provisions of HB 709 became effective, so it provides a look at changes in patterns of some indemnity components that could be related to those provisions. New medical fee schedule rules became effective in 2015, with reimbursement based on a percentage of Medicare. The medical data we report reflect up to six years of experience following implementation of the new reimbursement rules. Taken together, the income benefit provisions in HB 709 and the hospital fee schedule reductions targeted historical key cost drivers in North Carolina—longer duration of temporary disability, larger lump-sum settlements, and higher payments for hospital outpatient care as compared with the typical study state. 

Note that the results we report reflect experience on claims through March 2021, including non-COVID-19 claims only from the early pandemic period (March–September 2020). The study, therefore, provides a look at how the pandemic impacted non-COVID-19 workers’ compensation claims in the early months of the pandemic.

CompScope™ Benchmarks for North Carolina, 22nd Edition. Carol A. Telles. April 2022. WC-22-10.

Copyright: WCRI