The AMA Guidelines and South Carolina Governor Mark Sanford

I had posted quite a few times on Governor Mark Sanford's push to have the Permanent Partial Disability ratings based on the AMA Guidelines and not an arbitrary figure synthesized by a Deputy Commissioner.  The ratings that were given at "viewings" were so inconsistent that it made reserving the Workers Compensation files as difficult as any state.  

To be on the safe side, Workers Comp adjusters would have to reserve the files at a very high level on the permanency ratings.  The reserves were sometimes excessive.  This situation has cost South Carolina employers a large amount of premium dollars as the Experience Mods (E-Mods) were sometimes artificially high.  Even though all of the funds reserved for permanency were not spent, employers were paying premiums based of the reserved amounts, not the amount spent. As I have said before, what a company pays in premiums is based on the files reserves and NOT the amount spent.  Please search for my prior posts on Total Incurred. You may use the search box at the top of the page. 

I would often see South Carolina Workers Comp adjusters set the reserves on the file as 4 to 5 times the permanency rating. For example, say that an injured worker received a 10% permanency rating the arm.  This 10% rating would result in $6,000 being paid to the injured worker. The way that South Carolina handles the permanency rating is to have a viewing, where the Deputy Commissioner may award the injured worker 50% to the arm instead of the 10% rating given by the treating physician. 

I will post tomorrow on the status of the push for fair permanency ratings in Workers Comp by Governor Sanford.