Report to the San Francisco Workers Compensation Council Peggy - - PowerPoint PPT Presentation
Report to the San Francisco Workers Compensation Council Peggy Sugarman Workers Compensation Director March 4, 2019 Agenda Accomplishments & Initiatives Performance Quick Facts Claim Analytics Financials Workers'
Peggy Sugarman Workers’ Compensation Director
March 4, 2019
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Workers' Compensation Council Meeting March 4, 2019 3
Carve Out / “Alternative Dispute Resolution”
Firefighters Local 798 signed 12/17/2018
Administrative Director on 1/31/2019
established, 2 meetings have occurred
and ongoing
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Awareness Training Program completed and ready for roll-out
– Development of clear workflows established – Staff Training scheduled – Examining potential for external organizations to partner with us to improve compliance by integrating with iVOS claims system
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performance and identifying new physicians for inclusion
based on working in or around Building 606
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FY19 Q2 Performance Quick Facts
FY19 Q2: 109.3% FY19 Q1: 92.3%
Benchmark: 95%
403 Indemnity Claims 273 Medical Claims
Benchmark: 401 Indemnity Claims/Quarter 275 Medical Claims/Quarter
Indemnity: $13,887 Medical: $782
Benchmark: Indemnity: $15,637 Medical: $611
249 Days
Benchmark: 324 Days
Fiscal Health Ratio of Actuals to Budget Claim Volume Count of New Claims in Period Duration
Average Days Open of Claims Closed in Period
Claim Cost
Average Cost of Claims Closed in Period
Notes: All benchmarks based on rolling four-year averages (FY15-18.) Fiscal health metric includes overhead and claim expenditures and is based on revised budget, excluding any carryforward. Duration excludes disability retirement and future medical claims.
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FY15-18 FY19 Q2 FY19 Q2 Increase / Decrease Department Average Indemnity Claims Per Quarter Average Medical Claims Per Quarter Average Indemnity + Medical Claims Per Quarter Total Indemnity Claims Total Medical Claims Total Indemnity + Medical Claims Indemnity Medical Indemnity + Medical Public Health 88 106 194 70 130 200
24 or 22% 6 or 3% Police 79 44 123 84 40 124 5 or 6%
1 or 1% Fire 61 17 78 69 19 88 8 or 13% 2 or 13% 10 or 13% Sheriff 36 8 44 38 11 49 2 or 7% 3 or 31% 5 or 11% Public Works 15 15 30 24 16 40 9 or 59% 1 or 7% 10 or 33% Human Services 22 14 35 24 7 31 2 or 11%
Airport 19 14 33 22 9 31 3 or 16%
Recreation & Parks 18 21 39 18 9 27 0 or 2%
Public Library 6 4 10 9 4 13 3 or 57% 0 or 3% 3 or 35% Water Pollution Control 7 4 11 9 4 13 2 or 30% 0 or 8% 2 or 22% Citywide 401 275 676 403 273 676 2 or 0%
0 or 0%
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Department 2015 2016 2017 2018 2019 Est. Fire 21 19 19 23 23 Sheriff 21 23 20 20 20 Police 20 23 23 21 20 Public Health 12 12 11 13 12 Citywide 11 11 11 12 11 Public Works 10 11 9 10 11 Recreation & Parks 9 9 9 9 8 Airport 10 10 10 10 8 Human Services 7 6 6 8 7 Water Pollution Control 2 2 2 3 3 PUC-Water 3 3 3 4 3
Notes:
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Notes:
5 10 15 20 25 2015 2016 2017 2018 2019 Est.
Top 10 Departments
Fire Sheriff Police Public Health Citywide Public Works Recreation & Parks Airport Human Services Water Pollution Control PUC-Water Workers' Compensation Council Meeting March 4, 2019 12
Notes:
50 100 150 200 Bodily Motion Exposure Cumulative Trauma Fall, Slip or Trip Physcial Assault Abrasion Struck By/Against Misc Caught In, Under, Between Stress
Top 10 Claim Cause Groups by Frequency - New Claims in FY2019 Q2
Public Works Fire Sheriff Police All Other Departments Public Health Workers' Compensation Council Meeting March 4, 2019 13
Notes:
100K- 150K 150K- 200K 200K- 250K 250K- 300K 300K- 350K 350K- 400K 400K- 450K 450K- 500K 500K- 550K 550K- 600K 600K- 650K 650K- 700K 700K- 750K 750K- 800K 800K- 850K 850K- 900K 900K- 950K 950K- 1M Over 1M Recreation & Parks 11 13 4 5 1 2 3 1 1 2 Sheriff 61 52 20 10 6 3 3 1 1 1 2 Public Health 66 43 14 11 6 7 4 1 2 4 2 2 1 1 1 1 Fire 83 81 45 11 13 8 4 1 1 2 1 3 All Other Departments 113 59 39 19 12 7 6 5 3 2 2 1 2 1 4 4 Police 133 94 74 36 16 15 11 6 2 1 1 1 1 2 3 1 1 2 7 50 100 150 200 250 300 350 400 450 500 Workers' Compensation Council Meeting March 4, 2019 14
1,308 Claims >=$100k $308.8 Million
Data as of 2/25/2019
Note: Dollar figures in millions
$101.0, 33% $56.7, 18% $39.0, 13% $32.7, 10% $11.2, 4% $68.1, 22% Police Fire Public Health Sheriff Recreation & Parks All Other Departments
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16
Department Open Indemnity Claims Added from FY15-FY19Q2 Represented Claims Represented % Litigated Claims Litigated %
Police 375 209 56% 186 50% Fire 291 126 43% 121 42% Public Health 260 101 39% 104 40% Sheriff 202 96 48% 87 43% Human Services 99 46 46% 42 42% Airport 97 32 33% 26 27% Public Works 89 41 46% 39 44% Recreation & Parks 60 35 58% 31 52% PUC-Water 40 12 30% 10 25% Water Pollution Control 34 22 65% 22 65% Citywide 1763 826 47% 764 43%
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Department FY18 Budget FY18 Actuals FY19 Orig. Budget FY19 Rev. Budget FY19 Estimated YE Actuals FY19 Surplus/ (Deficit)
Police 15,691,689 20,898,127 17,270,551 18,238,494 22,120,096
Public Health 12,026,726 10,831,216 12,001,726 12,545,259 11,996,259 549,001 Fire 9,354,940 8,817,237 9,154,940 9,623,463 10,990,286
Sheriff 5,630,186 5,387,756 5,630,186 5,630,186 5,600,338 29,848 Public Works 3,598,881 2,362,963 3,709,007 4,259,007 3,883,670 375,337 Recreation & Parks 3,569,246 2,637,724 3,569,246 4,920,001 3,545,808 1,374,193 Human Services 2,901,364 2,629,920 2,876,364 2,876,364 3,262,581
PUC-Water 2,504,098 2,138,127 2,580,723 2,580,723 2,436,107 144,616 SF Airport 2,494,467 2,344,896 2,570,798 2,720,369 2,896,450
Juvenile Probation 1,079,467 929,729 1,029,467 1,029,467 496,997 532,470 Total Top Ten Departments 58,851,064 58,977,692 60,393,008 64,423,333 67,228,594
Total of All City Departments 69,378,135 67,615,222 71,991,903 77,571,049 77,862,793
Notes:
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FY17-18 Actuals FY18-19 Actuals YTD FY19 Est. YE Actuals YOY Change (%)
INDEMNITY Temporary Disability 8,220,280 4,081,508 8,163,016
Permanent Disability 15,776,104 8,842,701 17,685,401 10.8% INDEMNITY SUBTOTAL 23,996,384 12,924,209 25,848,417 7.2% VOCATIONAL REHABILITATION 226,139 81,259 162,517
MEDICAL 26,044,350 14,922,583 29,845,165 12.7% EXPENSE 3,040,483 1,611,799 3,223,598 5.7% RECOVERY (692,535) (268,122) (536,244)
GRAND TOTAL 52,614,822 29,271,727 58,543,454 10.1%
Notes:
benefits.
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Hospital Inpatient Hospital Outpatient Special Facility (incl ASC) Skilled Nursing Home Health Hospital Other 2017 1H 63 1,786 211 1 58 1 2017 2H 91 1,689 155 2 15 2018 1H 92 2,497 183 6 35 9 500 1,000 1,500 2,000 2,500 3,000 Bill Count
however the quantity of hospitalizations has increased. Data Source: EK Health Services, Inc.
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Hospital Inpatient Hospital Outpatient Special Facility (incl ASC) Skilled Nursing Home Health Hospital Other 2017 1H $35,157 $492 $2,997 $175 $500 $59 2017 2H $44,470 $799 $3,105 $5,466 $494 2018 1H $36,549 $724 $2,895 $12,268 $442 $690 $0 $5,000 $10,000 $15,000 $20,000 $25,000 $30,000 $35,000 $40,000 $45,000 $50,000 Average Allowance per Bill
to June, 2017). Data Source: EK Health Services, Inc.
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Hospital Inpatient Hospital Outpatient Special Facility (incl ASC) Skilled Nursing Home Health Hospital Other 2017 1H $2,214,913 $878,066 $632,384 $175 $28,978 $59 2017 2H $4,046,796 $1,350,250 $481,343 $10,932 $7,415 2018 1H $3,362,514 $1,808,405 $529,722 $73,609 $15,485 $6,213 $0 $500,000 $1,000,000 $1,500,000 $2,000,000 $2,500,000 $3,000,000 $3,500,000 $4,000,000 $4,500,000 Allowance
expenditure growth. Data Source: EK Health Services, Inc.
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50 100 150 200 250 300 350 400 450 500
FY08-09 FY09-10 FY10-11 FY11-12 FY12-13 FY13-14 FY14-15 FY15-16 FY16-17
Millions
CCSF Workers' Compensation Future Liability
an average 3.3% year-over-year, over the last five years. Efforts to reduce tail exposure include an increase in Compromise & Releases.
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whereas Ultimate Frequency, defined by claim incidence per $1M of payroll has declined. Source: Willis Towers Watson
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Upward Cost Pressures
increases incidence of claims and aggregate costs; 6.8% growth from 7/1/13 to 7/1/17
exposure and catastrophic claims within public safety departments
medium to high exposure claims, increasing near-term expenditures but providing long-term cost savings
has increased by 10% annually in recent years
Downward Cost Pressures
("Carveout") will lower claim and litigation costs based on reported savings by other programs
pre-authorization programs deliver benefits faster with less administrative review/expense
service contracts took effect in October 2018
and printing fees in transformation of existing check-issuance framework
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Appendix 1: Claim Cause Group Definitions
Claim Cause Group Definition Type(s) of Injury
Abrasion
Injuries sustained as a result of rubbing against a rough surface/wall Skin
Bodily Motion Injuries sustained due to physical motion, such as bending, lifting, reaching, pulling/pulling, twisting/turning, etc.
Primarily orthopedic injuries.
Caught In, Under, Between Injuries that have occurred due to being pinned by, under or between objects, furniture, or equipment. This includes injuries occurring as a result of a cave-in.
Orthopedic injuries, lacerations, crush injuries.
Cumulative Trauma Use for repetitive stress injuries due to repeated exposure over time.
Single or multiple body parts used in repeated exposure over a period of time – e.g. Carpal Tunnel, prolonged standing, psyche stress.
Explosion Used for injuries sustained as a result of an explosion.
Orthopedic, burns, internal, catastrophic injuries, etc.
Exposure Used for various internal injuries, such as repeated exposure to carcinogens, stressful work situation, or hard physical work leading to a negative bodily
Cancer, heart trouble, internal injuries or exposure to poison oak, MRSA, or heat stroke. Also may include foreign substance into eyes or body, or blood borne pathogen exposure.
Fall, Slip or Trip Injuries sustained from a slip and fall, or trips and slips. This includes falls from elevation, from stairs, ladders,
Single or multiple body parts, resulting in sprains, strains, contusions, lacerations, fractures, etc.
Ingestion Injury sustained due to ingesting harmful substance.
Internal/exposure.
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Appendix 1: Claim Cause Group Definitions, Cont.
Claim Cause Group Definition Type(s) of Injury
Misc Miscellaneous injury not covered in other areas or rarely filed
Misc
Personal Injury/Illness Injury that is non-occupational in nature, but aggravated or exacerbated by work.
Personal injury of a orthopedic or internal nature.
Physical Assault Injuries sustained due to physical altercations (being struck or striking person or people).
Single or multiple body parts involved. Results in lacerations, sprains, strains, fractures, abrasions, even internal injuries.
Stress Injuries sustained due to work related stress.
Primarily psychological/psychiatric injuries, including any resulting physical symptoms.
Struck By/Against Injuries when objects are thrown at employees, when an employee is hit by a random moving machine part
piece of furniture.
Orthopedic or head injuries
Suffocated Injuries sustained due to suffocation, such as during a fire.
Respiratory injuries, smoke inhalation. May
Vehicle Accident Injuries sustained due to a vehicle, including vehicle/pedestrian accident or incident. This may be car or truck, motorcycle, bicycle, scooter, etc.
Orthopedic, single or multiple body parts, head, internal
Vibration Injuries sustained due to vibration or seismic event, such as an earthquake.
Orthopedic, internal, head, etc.
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Claim Cause Group Claim Cause When Used
Abrasion ABRASION/RUBBED Injuries sustained as a result of rubbing against a rough surface/wall Bodily Motion BENDING/STOOPING Bending down to tie shoes, etc. Bodily Motion LIFTING Injuries from lifting weights, desks, tables, equipment, etc. Bodily Motion PUSHING/PULLING Pushing or pulling of furniture, equipment or patients. Bodily Motion REACHING Reaching for equipment resulting in hyperextension of extremities, etc. Bodily Motion RUNNING/WALKING Injuries while running (during exercise or running after suspects), stepping off a curb the wrong way, injuries while walking. Bodily Motion THROWING/WIELDING Injury sustained during baton-use exercise or other use of equipment in a throwing or maneuvering type motion. Bodily Motion TWISTING/TURNING Injuries resulting from exiting vehicle, maneuvering in small spaces, etc. Caught In, Under, Between CAUGHT IN, UNDER, BETWEEN Injuries as a result of being pinned under, or between objects, furniture, or equipment. Caught In, Under, Between CAVE IN Injuries sustained due to being crushed by collapsing debris, such as in a tunnel or collapsing building in a fire. Cumulative Trauma CONTINUOUS TRAUMA For repetitive stress injury due to repeated exposure over time. Cumulative Trauma REPEATED MOTION Repetitive stress injury due to continued motion (typing, etc.). May be used interchangeably with CONTINUOUS TRAUMA Cumulative Trauma REPEATED TRAUMA same as CONTINUOUS TRAUMA Explosion EXPLOSION Injuries when bombs are set off during demonstrations and protest or fireworks during celebrations. Also may be a gas/fire explosion. Workers' Compensation Council Meeting March 4, 2019 29
Appendix 2: Claim Cause Definitions, Cont.
Claim Cause Group Claim Cause When Used
Exposure ADVERSE REACTION Dizziness/Fatigue/Headaches due to heat exposure, intense exercise, dehydration, etc. Also could be an allergic reaction or exposure to poisonous substance. Exposure BODILY REACTION The body's reaction to repeated exposures to carcinogens, stressful work situations, hard physical work. This could also be an allergic reaction to a poisonous substance or toxic substance. Exposure CONTACT INFECTIOUS AGENT Needle Sticks, Exposure to blood borne pathogens (blood, saliva, urine, etc.) Exposure CONTACT WITH CHEMICALS Exposure to Toxin, chemicals Exposure CONTACT WITH ELECTRICITY Electrocution Exposure CONTACT WITH EXTREME TEMPERATURE Injuries sustained during firefighting or working in extreme heat. Exposure Contact with Radiation Exposure DERMAL Dermatitis due to contact with poison oak, poison ivy, etc. Exposure FOREIGN SUBSTANCE Object/s getting into the eyes Exposure INHALATION Injuries from smoke inhalation during firefighting, or inhaling chemical vapors. Exposure SPLASHED Refers to when liquid splashes onto eyes or body. Overlaps with CONTACT INFECTIOUS AGENT. Fall, Slip or Trip FALL FROM CHAIR Sitting and falling off chair. Chair might have slid from underneath claimant. Fall, Slip or Trip FALL FROM ELEVATION Fall from a height, such as from a roof. Fall, Slip or Trip FALL FROM LADDER Injuries while falling off ladder. Workers' Compensation Council Meeting March 4, 2019 30
Appendix 2: Claim Cause Definitions, Cont.
Claim Cause Group Claim Cause When Used
Fall, Slip or Trip FALL FROM STAIRS Injuries resulting from falling down stairs or steps. Fall, Slip or Trip FALL FROM VEHICLE Injuries due to an officer falling off a police motorcycle or bicycle. Fall, Slip or Trip FALL ONTO AGAINST OBJECTS Filed if someone fell onto a certain object or machine, or against an object or machine such as gurneys and side tables Fall, Slip or Trip FALL SAME LEVEL Slip and Fall due to wet floor,slippery floo. Also used for an employee falling onto the ground (similar to Slip/Trip) Fall, Slip or Trip FALL SCAFFOLD/WALKWAY Fall from scaffolding/walkway Fall, Slip or Trip SLIP / TRIP Slipping on wet surface or tripping over object on the floor. Ingestion INGESTION Sustained due to drinking/eating harmful substance such as chemicals Misc EVENT TYPE (NEC) Misc FAULTY EQUIPMENT Injuries from defective chairs, tables and other equipment Misc FAULTY ROADWAY MTA Injury sustained due to road/street defect such as sinkhole or large pothole. Track/Track issues Misc UNASSIGNED Personal Injury/Illness PERSONAL INJURY/ILLNESS Injury or illness of a nonindustrial nature but filed as EE was at work (or aggravated by work). Physical Assault ASSAULT, PHYSICAL Used for physical assaults by the public, by patients/detainees, or between employees in a Workplace Violence setting Stress ASSAULT, MENTAL/VERBAL Altercation between co-workers, with the public, patients, etc. Overlaps with STRESS, RELATIONAL CONFLICT Workers' Compensation Council Meeting March 4, 2019 31
Appendix 2: Claim Cause Definitions, Cont.
Claim Cause Group Claim Cause When Used
Stress RELATIONAL CONFLICT Stress as a result of interpersonal conflicts at work (with Supervisor and/or co-workers) Stress STRESS MTA MTA uses this for all stress claims Struck By/Against COLLISION Running into another person at the office, striking a body part (e.g., nose) against another object, Hallway and door collisions Struck By/Against STRUCK BY FALLING OBJECT Injuries resulting from fighting fires or being hit by an object. Struck By/Against STRUCK BY MOVING OBJECT Injuries when objects are thrown at employees. May overlap with PHYSICAL ASSAULT. Also if EE is hit by a random moving machine part or object. Suffocated SUFFOCATED Fighting fires Vehicle Accident VEHICLE ACCIDENT Motor Vehicle Accidents (City Vehicles, motorcycles), rear-enders, collision with other vehicles Vehicle Accident VEHICLE OVERTURNED Use VEHICLE ACCIDENT Vehicle Accident VEHICLE RAN OFF ROADWAY Use VEHICLE ACCIDENT Vehicle Accident VEHICLE SUDDEN START/STOP Use VEHICLE ACCIDENT Vibration VIBRATION Earthquake Workers' Compensation Council Meeting March 4, 2019 32
Munic icip ipal l Transpo porta tati tion Agency
Worker’s Compensation 12 Month Loss Summary Workers’ Compensation Council March 4th 2019
NEW CLAIMS BY TYPE CLAIM TYPE FY 18-19 July August September October November December January February March April May June FY Total Monthly Average INDEMNITY # 39 38 46 62 44 54 50 333 48 MEDICAL ONLY # 4 7 6 9 4 4 1 35 5 OTHER # 1 4 2 8 11 2 5 33 5 INDEMNITY % 88.64% 77.55% 85.19% 78.48% 74.58% 90.00% 89.29% 83.04% 84.21% MEDICAL ONLY % 9.09% 14.29% 11.11% 11.39% 6.78% 6.67% 1.79% 8.73% 8.77% OTHER % 2.27% 8.16% 3.70% 10.13% 18.64% 3.33% 8.93% 8.23% 7.02% CLAIM TYPE FY 17-18 July August September October November December January February March April May June FY Total Monthly Average INDEMNITY # 51 54 40 45 57 32 44 52 40 44 45 41 545 45 MEDICAL ONLY # 3 6 5 11 13 7 12 10 6 13 9 2 97 8 OTHER # 2 1 3 3 3 3 2 1 5 3 7 2 35 3 INDEMNITY % 91.07% 88.52% 83.33% 76.27% 78.08% 76.19% 75.86% 82.53% 78.43% 73.33% 73.77% 91.11% 79.75% 80.70% MEDICAL ONLY % 5.35% 9.83% 10.41% 18.64% 17.80% 16.66% 20.68% 15.87% 11.76% 21.66% 14.75% 4.44% 15.03% 15.79% OTHER % 3.58% 1.65% 6.26% 5.09% 4.12% 7.15% 3.46% 1.60% 9.81% 5.01% 11.48% 4.45% 5.22% 3.51% CLAIM TYPE FY 16-17 July August September October November December January February March April May June FY Total Monthly Average INDEMNITY # 46 41 38 46 36 41 40 36 47 53 60 63 547 46 MEDICAL ONLY # 6 9 8 4 5 4 4 8 13 9 5 6 81 7 OTHER # 5 5 1 1 1 1 5 3 22 2 INDEMNITY % 88.46% 74.54% 74.50% 90.19% 85.71% 91.11% 90.90% 80% 78% 84% 86% 87% 83% 85% MEDICAL ONLY % 11.54% 16.36% 15.68% 7.84% 11.90% 8.89% 9.10% 17.77% 22% 14% 7% 8% 14% 13% OTHER % 0.00% 9.10% 9.82% 1.97% 2.39% 0.00% 0.00% 2.33% 0% 2% 7% 5% 3% 2% CLAIM TYPE FY 15-16 July August September October November December January February March April May June FY Total Monthly Average INDEMNITY # 40 51 44 56 32 58 45 52 59 50 39 39 565 47 MEDICAL ONLY # 6 9 3 7 8 7 2 12 6 9 7 8 84 7 OTHER # 3 2 1 2 1 2 1 2 3 17 1 INDEMNITY % 81.63% 85.00% 93.62% 86.15% 80% 87.87% 91.84% 80% 88% 83% 81% 78% 85% 84% MEDICAL ONLY % 12.24% 15.00% 6.38% 10.77% 20% 10.60% 4.08% 18.46% 9% 15% 15% 16% 13% 12% OTHER % 6.12% 0.00% 0.00% 3.08% 0.00% 1.53% 4.08% 1.54% 3% 2% 4% 6% 2% 4% CLAIM TYPE FY 14-15 July August September October November December January February March April May June FY Total Monthly Average INDEMNITY # 31 32 43 42 35 42 40 34 31 36 32 45 443 36.92 MEDICAL ONLY # 3 4 5 9 4 6 7 5 9 7 8 7 74 6.17 OTHER # 1 1 3 1 3 1 1 2 2 1 16 1.33 INDEMNITY % 91.18% 86.49% 87.76% 77.78% 89.74% 85.71% 80.00% 85.00% 75.61% 80.00% 76.19% 84.91% n/a 83.36% MEDICAL ONLY % 8.82% 10.81% 10.20% 16.67% 10.26% 12.24% 14.00% 12.50% 21.95% 15.56% 19.05% 13.21% n/a 13.77% OTHER % 0.00% 2.70% 2.04% 5.56% 0.00% 2.04% 6.00% 2.50% 2.44% 4.44% 4.76% 1.89% n/a 2.86% Data prior to March 2013 is drawn from Sedgwick data as reported in HR Monthly Reports Other # = First Aid, Future Medical, Reported
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CLAIMS REOPENED FISCAL YEAR July August September October November December January February March April May June FY Total Monthly Average FY 2018-2019 2 12 6 11 6 3 5 45 6 FY 2017-2018 3 3 8 7 11 4 9 6 13 3 7 6 80 7 FY 2016-2017 11 12 8 3 6 7 2 8 4 9 13 9 92 8 FY 2015-2016 8 7 4 7 4 6 6 6 18 8 7 11 92 8 FY 2014-2015 8 14 5 15 5 3 10 12 7 6 5 7 97 8 FY 2013-2014 8 15 13 13 10 10 16 12 6 7 9 4 123 10 CLAIMS CLOSED FISCAL YEAR July August September October November December January February March April May June FY Total Monthly Average FY 2018-2019 45 60 56 71 34 68 74 408 58 FY 2017-2018 52 69 51 53 50 98 58 70 70 69 42 73 755 63 FY 2016-2017 48 67 59 61 68 75 47 60 67 70 62 73 757 63 FY 2015-2016 46 53 45 82 41 99 35 62 72 82 75 69 761 63 FY 2014-2015 41 57 54 69 67 81 54 47 46 54 57 44 671 56 FY 2013-2014 110 88 61 254 74 71 50 52 41 64 57 48 970 81 CLOSING RATIO FISCAL YEAR July August September October November December January February March April May June FY Total Monthly Average FY 2018-2019 98% 98% 93% 79% 52% 108% 121% 94% 93% FY 2016-2017 76% 100% 100% 113% 136% 144% 102% 113% 105% 97% 75% 90% 102% 104% FY 2015-2016 80.70% 79.10% 88.24% 113.89% 93.18% 137.50% 63.63% 87.32% 84.70% 120.58% 136.36% 113.11% 100% 100% FY 2014-2015 97.62% 111.76% 100.00% 100.00% 152.27% 155.77% 90.00% 90.38% 95.83% 105.88% 121.28% 73.33% 107% 108% FY 2013-2014 183.33% 107.32% 107.02% 416.39% 129.82% 165.12% 98.04% 108.33% 89.13% 100.00% 114.00% 96.00% 145% 143% CLAIMS PENDING EOM FISCAL YEAR July August September October November December January February March April May June FY Total Monthly Average FY 2018-2019 1,616 1,617 1,621 1,640 1,671 1,666 1,653 1,653 1,641 FY 2017-2018 1,620 1,615 1,620 1,633 1,667 1,615 1,624 1,623 1,617 1,611 1,637 1,615 1,615 1,625 FY 2016-2017 1,643 1,643 1,643 1,636 1,616 1,593 1,592 1,585 1,582 1,584 1,605 1,613 1,613 1,611 FY 2015-2016 1,642 1,656 1,662 1,652 1,655 1,628 1,648 1,657 1,670 1,656 1,636 1,628 n/a 1,649 FY 2014-2015 1,673 1,667 1,667 1,667 1,644 1,615 1,621 1,626 1,628 1,625 1,615 1,631 n/a 1,640 FY 2013-2014 1,923 1,917 1,913 1,720 1,703 1,675 1,676 1,672 1,677 1,677 1,670 1,672 n/a 1,741 Data prior to March 2013 is drawn from Sedgwick data as reported in HR Monthly Reports Other # = First Aid, Future Medical, Reported
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ROLLING 12 REPORTING MONTHS - INJURIES BY DIVISION DIVISION NAME CLAIM FREQUENCY Days Between Employer Knowledge and Reported to TPA Days Between DOI and Received by TPA ADMIN., TAXIS & ACCESIBLE SERV. 4
1.25 ADMINISTRATION 2 56.00 56.00 Administration & Finance 2 4.50 12.00 CABLE CAR & RAIL SYSTEMS 5 160.80 161.60 CHIEF MECHANICAL OFFICER (BUS SECTION) 2 0.00 0.00 CHIEF MECHANICAL OFFICER (RAIL SECTION) 3 4.33 11.67 CITATION DIVISION 0.00 0.00 COMMUNICATIONS MAINTENANCE SECTION 1 0.00 2.00 DIESEL MAINTENANCE 3 5.67 5.67 DIRECTOR OF TRANSIT OPS 1 6.00 6.00 DIVISION OF SUSTAINABLE STREETS 23 44.91 46.48 ELECTRICAL MAINTENANCE 19 19.63 29.68 ENFORCEMENT SERVICES 46 19.11 23.33 EXECUTIVE DIRECTOR/CEO 1 13.00 13.00 FINANCE, ADMIN., INFORMATION TECH. 5 0.40 5.00 Islais Creek 3 4.00 4.00 LEGISLATIVE AFFAIRS 0.00 0.00 MAINTENANCE / UNASSIGNED 5 7.80 18.00 MAINTENANCE DIVISION 20 3.55 6.25 Muni Metro East 3 9.33 9.33 OPERATIONS / UNASSIGNED 36 51.36 69.97 Parking Authority 8 108.50 154.75 SAFETY, SECURITY & ENFORCEMENT 23 4.30 19.61 STRUCTURE & WAYS 4 10.25 10.75 TAXI COMMISSION 2 15.00 37.50 TECHNICAL SERVICES 0.00 0.00 TRANSPORTATION DIVISION (TRAN) 406 20.93 24.94 Not yet assigned 54 6.78 14.41 Grand Total 681 22.26 26.54
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FY 2017/2018 Seven Month Expenditures FY 2018/2019 Seven Month Expenditures Increase/Decrease % of Change
INDEMNITY Temporary Disability $5,168,363 $5,573,277 $404,914 7.83% Permanent Disability $3,592,388 $2,620,020 ($972,368)
Total Indemnity $8,760,751 $8,193,298 ($567,453)
Total Vocational Rehabilitation $60,359 $52,544 ($7,815)
Total Medical $4,016,190 $5,408,454 $1,392,264 34.67% Total Expense $646,629 $919,857 $273,227 42.25% RECOVERY Total Recovery Processed ($92,066) ($518,642) ($426,575) 463.33% GRAND TOTAL $13,391,864 $14,055,511 $663,648 4.96% MEDICAL EXPENSE Vocational Rehabilitation
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Open Claims Stratification: $100K+ Total Incurred = 666
50 100 150 200 250 100k- 150K 150k- 200K 200k- 250K 250k- 300K 300K- 350K 350K- 400K 400k- 450K 450k- 500K 500k- 550K 550k- 600K 600k- 650K 650k- 700K 700k- 750K 750k- 800K 800k- 850K 850k- 900K 900k- 950K 950K- 1M 1M+ Total 229 136 115 50 33 17 14 14 8 2 3 5 9 3 3 1 4 3 17 229 136 115 50 33 17 14 14 8 2 3 5 9 3 3 1 4 3 17
Open Claims Stratification by Severity All Policy Years $100K+ Incurred Claims
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LITIGATION RATIO FISCAL YEAR 2018-2019 July August September October November December January February March April May June Open Litigated Claims* 412 418 411 410 417 415 421 Open Indemnity Claims* 1,075 1,076 1,076 1,098 1,120 1,119 1,128 Litigated Ratio 38.33% 38.85% 38.20% 37.34% 37.23% 37.09% 37.32% #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! FISCAL YEAR 2017-2018 July August September October November December January February March April May June Open Litigated Claims* 399 409 429 429 428 418 423 423 429 428 433 417 Open Indemnity Claims* 1,077 1,085 1,081 1,094 1,117 1,082 1,079 1,084 1,073 1,079 1,098 1,075 Litigated Ratio 37.05% 37.70% 39.69% 39.21% 38.32% 38.63% 39.20% 39.02% 39.98% 39.67% 39.44% 38.79% FISCAL YEAR 2016-2017 July August September October November December January February March April May June Open Litigated Claims* 358 393 383 387 388 386 385 389 391 377 389 391 Open Indemnity Claims* 1080 1129 1106 1096 1076 1058 1045 1042 1037 1038 1,052 1,065 Litigated Ratio 33.15% 34.81% 34.63% 35.31% 36.06% 36.48% 36.84% 37.33% 37.70% 36.32% 36.98% 36.71% FISCAL YEAR 2015-2016 July August September October November December January February March April May June Open Litigated Claims* 412 406 403 397 384 385 384 378 371 366 377 364 Open Indemnity Claims* 1113 1121 1128 1129 1046 1098 1127 1130 1135 1114 1105 1076 Litigated Ratio 37.02% 36.22% 35.73% 35.16% 36.71% 35.06% 34.07% 33.45% 32.69% 32.85% 34.12% 33.83% FISCAL YEAR 2014-2015 July August September October November December January February March April May June Open Litigated Claims* 490 477 468 464 460 455 445 440 441 437 427 422 Open Indemnity Claims* 1116 1100 1112 1119 1127 1108 1119 1122 1113 1122 1106 1121 Litigated Ratio 43.91% 43.36% 42.09% 41.47% 40.82% 41.06% 39.77% 39.22% 39.62% 38.95% 38.61% 37.64% FISCAL YEAR 2013-2014 July August September October November December January February March April May June Open Litigated Claims* 653 636 619 612 607 600 592 571 559 525 514 507 Open Indemnity Claims* 1250 1219 1194 1190 1209 1176 1162 1149 1138 1110 1108 1126 Litigated Ratio 52.24% 52.17% 51.84% 51.43% 50.21% 51.02% 50.95% 49.70% 49.12% 47.30% 46.39% 45.03% *Does not include Future Medical Claims Data prior to March 2013 is unreliable and is excluded
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CLAIM CAUSE ANALYSIS
BY FREQUENCY
10 20 30 40 50 60 70 80 Repeated Motion Assault/ Physical Vehicle Accident Twisting/ Turning Collision Pulling/ Pushing Fall Same Level (NEC) Stress- MTA Continuou s Trauma Struck By Moving Object Total 54 72 49 33 18 58 19 20 35 25 54 72 49 33 18 58 19 20 35 25
Top 10 Claim Causes by Frequency Rolling 12 Reporting Months
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CLAIM CAUSE ANALYSIS
BY SEVERITY
$0 $200,000 $400,000 $600,000 $800,000 $1,000,000 $1,200,000 $1,400,000 $1,600,000 $1,800,000 Repeated Motion Assault/ Physical Vehicle Accident Twisting/ Turning Collision Pulling/ Pushing Fall Same Level (NEC) Stress- MTA Continuou s Trauma Struck By Moving Object Total $1,035,932 $1,761,841 $1,184,103 $449,451 $313,927 $966,683 $316,062 $387,586 $657,057 $1,264,429 $1,035,932 $1,761,841 $1,184,103 $449,451 $313,927 $966,683 $316,062 $387,586 $657,057 $1,264,429
Top 10 Claim Causes by Severity Rolling 12 Reporting Months
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CLAIMS CLOSED - ROLLING 12 REPORTING MONTHS ENDING 1/31/2019 CLAIM CAUSE DESCRIPTION CLOSED CLAIMS TOTAL COST OF CLOSED CLAIMS AVERAGE TOTAL COST PER CLAIM AVERAGE DURATION OF CLAIM (MONTHS) AVERAGE COST PER CLAIM PER MONTH CLAIM CAUSE DESCRIPTION CLOSED CLAIMS TOTAL COST OF CLOSED CLAIMS AVERAGE TOTAL COST PER CLAIM AVERAGE DURATION OF CLAIM (MONTHS) AVERAGE COST PER CLAIM PER MONTH ABRASION/RUBBED 8 $11,220 $1,403 2.21 $116.88 FAULTY ROADWAY- MTA $0 $0 $0.00 ADVERSE REACTION 7 $784,827 $112,118 100.20 $9,343.18 Foreign Substance 18 $35,448 $1,969 5.19 $164.11 ASSAULT, MENTAL/VERBAL 23 $287,447 $12,498 9.29 $1,041.47 INGESTION $0 #DIV/0! #DIV/0! ASSAULT, PHYSICAL 72 $2,456,206 $34,114 26.11 $2,842.83 INHALATION 15 $49,323 $3,288 27.69 $274.02 BENDING, STOOPING 5 $16,113 $3,223 5.88 $268.55 LIFTING 17 $470,391 $27,670 21.56 $2,305.84 BODILY REACTION 20 $1,731,344 $86,567 55.32 $7,213.93 Personal Injury/Illness 10 $1,083 $108 1.90 $9.03 CAUGHT IN, UNDER, BETWEEN 21 $167,038 $7,954 8.18 $662.85 PULLING/PUSHING 75 $3,734,280 $49,790 40.18 $4,149.20 COLLISION 15 $830,303 $55,354 8.91 $4,612.79 REACHING 9 $735,311 $81,701 35.90 $6,808.44 CONTACT INFECTIOUS AGENT 2 $10,815 $5,408 2.49 $450.63 REPEATED MOTION 48 $2,331,214 $48,567 28.58 $4,047.25 Contact W/temp Extremes 2 $16,483 $8,242 5.44 $686.79 RUNNING/WALKING 15 $105,147 $7,010 8.06 $584.15 CONTACT WITH CHEMICALS 1 $8,398 $8,398 5.95 $699.83 SLIP/TRIP 26 $2,151,281 $82,742 107.72 $6,895.13 Contact With Electricity 2 $1,430 $715 3.48 $59.58 Splashed 1 $0 $0 1.68 $0.00 CONTINUOUS TRAUMA 58 $3,456,272 $59,591 80.17 $4,965.91 STRESS - MTA 15 $179,201 $11,947 14.17 $995.56 Dermal 3 $4,728 $1,576 4.27 $131.33 STRUCK BY FALLING OBJECT 12 $193,144 $16,095 8.86 $1,341.28 EVENT TYPE (NEC) 8 $8,136 $1,017 3.47 $84.75 STRUCK BY MOVING OBJECT 31 $1,151,581 $37,148 32.30 $3,095.65 Explosion 2 $16,771 $8,386 7.98 $698.79 Throwing/Wielding 2 $3,844 $1,922 7.00 $160.17 FALL FROM CHAIR 4 $11,749 $2,937 13.90 $244.77 TWISTING/TURNING 30 $411,950 $13,732 9.28 $1,144.31 FALL FROM ELEVATION (NEC) 4 $9,523 $2,381 9.51 $198.40 Unassigned 22 $430,205 $19,555 22.04 $1,629.56 Fall From Ladder 1 $34,800 $34,800 43.19 $2,900.00 Vehicle Accident 52 $2,236,757 $43,015 52.81 $3,584.55 FALL FROM STAIRS 5 $1,491 $298 3.25 $24.85 Vehicle Off Roadway 1 $1,607 $1,607 3.75 $0.00 FALL ONTO AGAINST OBJECTS 1 $165,051 $165,051 41.88 $13,754.25 Vehicle Overturned 1 $134,921 $134,921 29.25 $11,243.42 FALL SAME LEVEL (NEC) 26 $330,950 $12,729 14.06 $1,060.74 VEHICLE SUDDEN STOP/START 17 $153,300 $9,018 13.67 $751.47 Fall/Scaffold,Walkway 1 $155 $155 3.15 $12.92 VIBRATION $0 #DIV/0! 0.00 #DIV/0! Fall From Vehicle 4 $63,731 $15,933 4.76 $1,327.73 TOTAL CLAIMS, TOTAL COST, AVERAGE COST 713 $25,012,524 $35,081 32.73 $2,923.39 FAULTY EQUIPMENT - MTA 1 $77,553 $77,553 129.25 $6,462.75
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4790 4856 5,729 5,723 5,885 5,919 5,962 5,749 5,918 5,917 5,898 562 539 654 657 693 707 716 679 655 670 667 11.73 9.55 10.64 9.71 10.51 4400 4600 4800 5000 5200 5400 5600 5800 6000 100 200 300 400 500 600 700 800 Nov-13 Jan-14 Mar-14 May-14 Jul-14 Sep-14 Nov-14 Jan-15 Mar-15 May-15 Jul-15 Sep-15 Nov-15 Jan-16 Mar-16 May-16 Jul-16 Sep-16 Nov-16 Jan-17 Mar-17 May-17 Jul-17 Sep-17 Nov-17 Jan-18 Mar-18 May-18 Jul-18 Sep-18 Nov-18 Jan-19
Agency Injury Rate Claims Incurred During Prior 12 Months per 100 Employees
Active Employees Rolling 12 Month Aggregate Injury Rate per 100 Employees
11.32
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9 26 8 17 12 12 17 9 15 9 11 18 9 17 12 17 8 8 6 18 10 17 6 14 20 12 10 15 10 14 6 12 20 31 13 15 17 25 14 14 15 16 12 14 21 17 10 9 12 18 14 19 15 5 10 15 20 25 30 35 Workers' Compensation Council Meeting March 4, 2019 44
ROLLING 12 REPORTING MONTHS - INJURIES BY DIVISION DIVISION NAME CLAIM FREQUENCY PERCENT OF ALL CLAIMS IN PERIOD CLAIM SEVERITY PERCENT OF TOTAL INCURRED FOR PERIOD ADMIN., TAXIS & ACCESIBLE SERV. 4 0.59% $34,000 0.26% ADMINISTRATION 2 0.29% $63,000 0.47% ADMINISTRATION & FINANCE 2 3.77% $3,120 0.47% CABLE CAR & RAIL SYSTEMS 7 1.03% $100,362 0.75% CHIEF MECHANICAL OFFICER (BUS SECTION) 2 0.29% $925 0.01% CHIEF MECHANICAL OFFICER (RAIL SECTION) 3 0.44% $1,363 0.01% CITATION DIVISION 0.00% $0 0.00% COMMUNICATIONS MAINTENANCE SECTION 1 0.15% $17,000 0.13% DIESEL MAINTENANCE 3 0.44% $35,849 0.27% Director of Transit 1 1.89% $17,000 2.54% DIVISION OF SUSTAINABLE STREETS 23 3.38% $452,368 3.39% ELECTRICAL MAINTENANCE 19 2.79% $352,531 2.65% ENFORCEMENT SERVICES 46 6.75% $871,274 6.54% EXECUTIVE DIRECTOR/CEO 1 0.15% $0 0.00% FINANCE, ADMIN., INFORMATION TECH. 5 0.73% $4,424 0.03% Islais Creek 3 0.44% $54,872 0.41% LEGISLATIVE AFFAIRS 0.00% $0 0.00% MAINTENANCE / UNASSIGNED 5 0.73% $35,487 0.27% MAINTENANCE DIVISION 20 2.94% $695,130 5.22% Muni Metro East 3 0.44% $17,000 0.13% OPERATIONS / UNASSIGNED 36 5.29% $381,485 2.86% Parking Authority 8 1.17% $22,537 0.17% SAFETY, SECURITY & ENFORCEMENT 23 3.38% $506,981 3.80% STRUCTURE & WAYS 4 0.59% $44,804 0.34% TAXI COMMISSION 2 0.29% $27,679 0.21% TECHNICAL SERVICES 0.00% $0 0.00% TRANSPORTATION DIVISION (TRAN) 405 59.47% $8,916,248 66.91% Not yet assigned 53 7.78% $669,771 5.03% Grand Total 681 100.00% $13,325,208 100.00%
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ROLLING 12 REPORTING MONTHS - INJURIES BY LOCATION FOR TRANSPORTATION DIVISION TRANSPORTATION DIVISION - LOCATION NAME CLAIM FREQUENCY PERCENT OF ALL CLAIMS IN PERIOD CLAIM SEVERITY PERCENT OF TOTAL INCURRED FOR PERIOD BUS TRANSPORATION SECTION 29 7.16% $1,498,508 16.81% CABLE CAR CABLE TRANSPORTATION UNIT 39 9.63% $1,081,230 12.13% CENTRAL CONTROL 0.00% $0 0.00% DATA COLLECTION UNIT 1 0.25% $17,000 0.19% DISPATCH UNIT RAIL & BUS 0.00% $0 0.00% DIVISION OPERATIONS 0.00% $0 0.00% FLYNN MOTOR COACH TRANSPORTATION UNIT 42
10.37%
$848,757 9.52% GREEN METRO RAIL TRANSPORTATION UNIT 34 8.40% $609,028 6.83% KIRKLAND MOTOR COACH TRANSPORTATION UNIT 40 9.88% $749,499 8.41% METRO RAIL TRANSPORTATION UNIT 4 0.99% $181,088 2.03% POTRERO ELECTRIC TROLLEY TRANSPORTATION 65 16.05% $1,024,015 11.48% PRESIDIO 0.00% $0 0.00% PRESIDIO ELECTRIC TROLLEY TRANSPORTATION 10 2.47% $197,602 2.22% PRESIDIO TROLLEY COACH 19 4.69% $580,022 6.51% RAIL TRANSPORTATION SECTION 1 0.25% $101 0.00% SAFETY/TRAINING 0.00% $0 0.00% SCHEDULES SECTION 1 0.25% $83,462 0.94% STATION OPERATIONS 6 1.48% $123,676 1.39% STREET SUPERVISION 2 0.49% $39,600 0.44% TRANSPORTATION DIVISION II (TRAN) 40 9.88% $618,245 6.93% WOODS MOTOR COACH TRANSPORTATION UNIT 68 16.79% $1,167,945 13.10% Null 4 0.99% $96,470 1.08% Grand Total 405 100.00% $8,916,248 100.00%
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CLAIM VOLUMES Category Method Notes Claims Opened iVOS - Claim_Log (Main) Add Date (claim) = each month; Format = PDF; data prior to March 2013 is unreliable in iVOS, and is drawn from Sedgwick data as reported in HR Monthly Report New Claims by Type iVOS - Claim_Log (Main) Add Date (claim) = each month; Format = PDF Claims Re-Opened iVOS - SFMTAClaimStatusMain (Main) Reporting History Period by each month; Format = PDF; data prior to March 2013 is unreliable in iVOS, and is drawn from Sedgwick data as reported in HR Monthly Report Claims Closed iVOS - SFMTAClaimStatusMain (Main) Reporting History Period by each month; Format = PDF; data prior to March 2013 is unreliable in iVOS, and is drawn from Sedgwick data as reported in HR Monthly Report Closing Ratio Calculation % "Claims Closed"/("Claims Opened" + "Claims Reopened") Claims Pending EOM iVOS - SFMTAClaimStatusMain (Main) Reporting History Period by month; Format = PDF; data prior to March 2013 is based on formula calculated backwards from March 2013 FINANCIALS Category Method Notes Payments Issued iVOS - LossRunMTA (Main) Reporting History Period by each month; Format = PDF; Reporting History Period = FY2013-2014; Reporting History Period = FY2012-2013 Open Claims Financials iVOS - LossRunMTA (Main) Reporting History Period = Last Month; Period Claimant Status = Open; Format = PDF; Data from Paid, Outstanding and Incurred columns Open Claims Stratification iVOS - LossRunMTA (Main) Reporting History Period = Last Month; Format = Excel Data Only; Pivot table filtered for "Open" and grouped by $50K LITIGATION STATISTICS Category Method Notes Open Litigated iVOS - SFMTAClaimStatusMain (Main) Reporting History Period by each month; Litigated (claimant) = checked; Format = PDF; Data from Ending Open column (Indemnity row); data prior to March 2013 is unreliable in iVOS and is excluded Open Indemnity iVOS - SFMTAClaimStatusMain (Main) Reporting History Period by each month; Format = PDF; Data from Ending Open column (Indemnity row); data prior to March 2013 is unreliable in iVOS and is excluded CAUSE ANALYSIS Category Method Notes Cause by Frequency iVOS - LossRunMTA (Main) Reporting History Period = Last Month; Add Date (Claim) = last 12-month period; Format = Excel Data Only; Pivot Table filtered for top-10 Causes by count of Claim Numbers Cause by Severity iVOS - LossRunMTA (Main) Reporting History Period = Last Month; Add Date (Claim) = last 12-month period; Format = Excel Data Only; Pivot Table filtered for top-10 Causes by sum Payment Amounts Closed Claims iVOS - LossRunMTA (Main) Reporting History Period = Last Month; Closed Date (claimant) = last 12-month period; Period Claimant Type (claimant_reporting_history) = First Aid, Medical, Indemnity, Future Medical, Disability Retirement (excludes Reported, Pending); Format = Excel Data Only, calculate Duration (Months), calculate Average Monthly Cost; Pivot Table with Totals and Averages, calculate Average Cost per Claim per Month Cause Determination Department and Adjuster Verification Cause codes are provided utilizing the NCCI mandated codes for State reporting purposes. The cause is determined by the department reporting the claim within SFMTA, our new set-up staff importing the claim to the system and the final review by the claims adjuster when managing the claim. DIVISION STATISTICS Category Method Notes Injuries by Division iVOS - LossRunMTA (Main) Reporting History Period = Last Month; Incident Date = last 12-month period; Format = Excel Data Only; Pivot Table filtered for top-10 Divisions by count of Claim Numbers and sum of Payment Amounts INJURY RATE Category Method Notes Injury Rate Per Month iVOS - LossRunMTA (Main) Reporting History Period = Last Month; Incident Date = last 12-month period; Format = PDF No Detail/ FTE # from SFMTA LAG TIME REPORT Category Method Notes Lag Time Information iVOS- LagTime Report Reporting History Period = Last Month; Add Date =last 12-month period; Sort by Division, Format = PDF No Detail
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rn o
r Scald d — Heat o
r Cold ld E Exposure res — Conta tact W t With
Includes Hydrochloric Acid, Sulfuric Acid, Battery Acid, Methanol, Antifreeze
Non-Impact Injuries Resulting in a Burn Due to Hot or Cold Temperature Extremes, includes Freezing or Frostbite
Includes Inhalation of Carbon Dioxide, Carbon Monoxide, Propane, Methane, Silica (Quartz), Asbestos Dust and Smoke
Includes Welder’s Flash (Burns to Skin or Eyes as a Result of Exposure to Intense Light from Welding
Includes Effects of Ionizing Radiation Found in X-Rays, Microwaves, Nuclear Reactor Waste, and Radiating Substances and Equipment. Includes Non-Ionizing Radiation Such as Sunburn
Includes Electric Shock, Electrocution and Lightning
Not Otherwise Classified in Any Other Code. Includes Cleaning Agents and Fertilizers
Caught I In, U Under er o
een
Running or Meshing Objects, a Moving and a Stationary Object, Two or More Moving Objects
Includes Medical Hospital Bed and Parts, Wheelchair, Clothespin Vise
Slides of Earth
Either Man-Made or Natural, Not Otherwise Classified in Any Other Code III III. Cut, Puncture re, S Scra rape Injure red by by
Includes Needle, Pencil, Knife, Hammer, Saw, Axe, Screwdriver
Includes Being Cut, Punctured or Scraped by a Person or Object Being Lifted or Handled
Includes Drill, Grinder, Sander, Iron, Blender, Welding Tools, Nail Gun
Not Otherwise Classified in Any Other Code. Includes Power Actuated Tools IV
Fall, ll, Slip o lip or r Trip I rip Injury ry
Includes Collapsing Chairs, Falling from Piled Materials, Off Wall, Catwalk, Bridge
Includes Mining Shafts, Excavations, Floor Openings, Elevator Shafts
Slip or Trip and Did Not Come in Contact with the Floor or Ground
Not Otherwise Classified in Any Other Code. Includes Tripping Over Object, Slipping or Organic Materials V.
Moto
Vehicle
Vehicle Collision, Both Vehicles in Motion
Collision Occurring with Standing Vehicle or Stationary Object
Includes Overturned or Jackknifed
Not Otherwise Classified in Any Other Code. Includes Injuries Due to Sudden Stop or Start, Being Thrown against Interior Parts of the Vehicle and Vehicle Contents Being Thrown against
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VI
rain o
r Injury ry by by 52. Continual Noise: Injury to Ears or Hearing Due to the Cumulative Effects of Constant or Repetitive Noise 53. Noise:
: Free Bodily Motion That Imposes Stress or Strain on Some Part of Body. Includes Assumption of Unnatural Position, Involuntary Motions Induced by Sudden Noise, Fright , loss of balance
Applies to Objects or People. Includes Restraining a Person
Includes Objects or People
Includes Objects or People
Physical Effort or Overexertion from Attempts to Resist a Force Applied by an Object Being Handled
Cumulative Injury or Condition Caused by Continual, Repeated Motions; Strain by Excessive Use, Carpel Tunnel
Not Otherwise Classified in Any Other Code
Strik rikin ing A Against o
r Stepp ppin ing o
NOT OTE: App pplie lies t to Cases in in Whic ich t the Injury ry W Was Pro rodu duced by d by th the I Imp mpact Cre reated by by the P Pers rson, R Rather t r than by by the S Sourc rce
Includes Scratches or Abrasions Caused by Sanding, Scraping, Cleaning Operations, Not Otherwise Classified in Any Other Code VIII
ruck or r Injure red d by by NOT OTE: App pplie lies t to Cases in in Whic ich t the Injury ry W Was Pro rodu duced by d by the Impa pact C Cre reated by by the Sourc rce o
ry, Rather r than by by the I Injure red Pe Person
Struck by Co-Worker, Either on Purpose or Accidentally. Includes Being Struck by a Patient While Lifting or Moving Them Not in Act of a Crime
Applies When a Person is Struck by a Motor Vehicle, Including Rail Vehicles, Water Vehicles, Airplanes
Includes Dropping Object on Body Part
Includes Another Person Dropping Object on Injured Person’s Body Part
Includes Bite, Sting or Allergic Reaction
Rapid Expansion, Outbreak, Bursting, or Upheaval. Includes Explosion of Cars, Bottles, Aerosol Cans, or Buildings. “Flare back” Involves Superheated Air and Combustible Gases
Not Otherwise Classified in Any Other Code. Includes Kicked, Stabbed, Bitten
Rubb bbed o
r Abra brade ded by by
Caused by Repeated Rubbing or Abrading; Applies to Non-Impact Cases in Which the Injury Was Produced by Pressure, Vibration or Friction between the Person and the Source of Injury.
Not Otherwise Classified in Any Other Code. Includes Foreign Body in Ears
Miscellane neous us C Caus uses
Not Otherwise Classified in Any Other Code. Applies Only to Non- Impact Cases in Which the Injury Resulted from Inhalation, Absorption (Skin Contact), or Ingestion of Harmful Substance
Injury to Eyes Resulting from Foreign Matter That is Not Otherwise Classified in Any Other Code
Injury Resulting from Natural Disaster. Includes Hurricane, Earthquake, Tornado, Flood, Forest Fire
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