This study helps policymakers and other system stakeholders in North Carolina identify current cost drivers and emerging trends in total costs per claim and key components. It compares the performance of state workers’ compensation systems in North Carolina and 16 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 2017 to 2022, for claims at various maturities.

We analyze claims with experience through 2023 for injuries up to and including 2022, and in some cases, we use a longer time frame to supply historical context. For example, we examined major legislation enacted in 2011 focused on indemnity benefits, and the fee schedule changes enacted in 2015 that impacted medical payments. 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. New medical fee schedule rules became effective in 2015, with reimbursement based on a percentage of Medicare. Using longer time frames, we can observe how components of indemnity benefits and medical payments changed following implementation of that legislation.

Note that the results we report reflect experience on claims through March 2023, including non-COVID-19 claims from the three years since the COVID-19 pandemic began (March 2020 through September 2022). The study, therefore, provides a look at how the pandemic impacted non-COVID-19 workers’ compensation claims in the first three years of the pandemic.

CompScope™ Benchmarks for North Carolina, 24th Edition. Carol A. Telles. April 2024. WC-24-10.

Copyright: WCRI