Press Release  Audit Reveals 68 Percent of Workers’ Compensation Cases Delayed by Department of Industrial Accidents

Boston — Today, an audit released by State Auditor Suzanne M. Bump’s office found the Department of Industrial Accidents (DIA), which is responsible for reviewing workers’ compensation disputes, has not met required timeframes for settling cases. Bump’s audit determined that during the period examined, (July 1, 2017 through June 30, 2019) 68 percent of cases processed by DIA were not completed in the mandated timeframes for initial case conference, hearing, and decision.

“The statute sets timeframes not just to hold judges accountable for the timely resolution of these disputes, but also to give attorneys, insurers, medical examiners, and all other participants a heightened sensitivity to the needs of injured workers and their employers, because delays penalize them both,” Bump said of the audit. “If there are systemic reasons for delays, such as a shortage of impartial medical examiners, I urge the DIA to take whatever steps it can to resolve these issues.”

The audit reviewed 10,695 claims, and found on average, that conferences between the worker’s attorney, insurance company, and judge were completed 89 days past the mandated timeframe of 28 days. Hearings and case decisions were 159 and 134 days late, respectively. The audit recommends DIA implement a formal procedure to make sure these deadlines are met.

The audit also found DIA did not report attorney fees and insurer penalties to the Workers’ Compensation Advisory Council (WCAC), which monitors and makes updates to the state’s workers’ compensation system. In its case management system, DIA listed insurer penalties of $60,430 and attorney fees of $157,694,993, but did not report this information to WCAC. The audit notes this underreporting can harm the Council’s ability to accurately monitor fees and penalties paid to the Commonwealth.

Further, DIA did not have proper IT security controls over its case management system. The audit revealed the agency did not always revoke terminated employees’ access rights to the system, did not ensure employees completed security awareness training, and did not have documentation of certain employee access rights. DIA also did not have a disaster recovery plan in place to ensure essential business functions continue and staff are properly trained.

Finally, the audit found no deficiencies in DIA’s administration of the Opioid Alternative Treatment Pathway Program, and its employee flex time and parking benefits programs.

DIA, which serves as the state’s court system for workers’ compensation cases, operates within the Executive Office of Labor and Workforce Development. It is responsible for reporting fees and penalties to WCAC, and ensures employers in the state have workers’ compensation insurance. The agency administers the Workers’ Compensation Trust Fund and the Workers’ Compensation Special Fund. In fiscal year 2019, DIA received $20 million in state appropriations.

The audit of the Department of Industrial Accidents is available here.

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