Bulletin 98-06
November 19, 1998


   The following article, describing the reorganization of the Division of Workers' Compensation currently underway, was prepared by Chief Deputy Administrative Director Peggy Sugarman for publication in an upcoming issue of the California Workers' Compensation Enquirer.  Organizations, newsletters and others in the workers' compensation community are invited to reprint this material in their own publications or otherwise distribute it to their memberships.
 

The Restructuring of the Division of Workers' Compensation

By Peggy Sugarman,
Chief Deputy Administrative Director, DWC
 
 
     The Division of Workers' Compensation has made major structural changes to its organization effective November 2, 1998.  A great deal of research went into the process, beginning with our initial contract for a business process reengineering study in 1995.  This study pointed out many problems that have been evident to the administration and the community for many years and which have contributed to DWC's inability to promptly and efficiently perform the work despite the best efforts of our employees.

Background

     The basic organizational structure prior to this reorganization is better understood when you take an historical perspective.  Prior to the enactment of the mandatory vocational rehabilitation laws in 1975, the Division of Industrial Accidents as it was then known consisted mainly of judges and raters. The Rehabilitation Unit was then added to that structure, along with the Information and Assistance Unit in 1976.

     The separate staffing and management of these units created a great deal of redundancy in the common business processes, such as handling incoming phone calls, mail, file processing, and data entry.  Similarly, some parts of the organization were (properly) focused on different and sometimes competing missions.  The information & assistance officers deal with litigated and non-litigated cases by helping to informally resolve disputes without the need for litigation, while also assisting the judges with pro per workers during the litigation process.  Similarly, disability evaluators perform summary ratings to help resolve claims while also providing formal and consultative ratings on litigated cases.  The best illustration of this classic "push and pull" was during the tremendous backlog of summary ratings when raters were not available to resolve litigated cases.  This was as frustrating for raters, judges, and attorneys as it was for the claims community.

The New Structure

     The new structure supports what we have identified as our two main business processes: Claims Resolution  and Dispute Resolution  services.

     Dispute Resolution encompasses all of the judicial staff, all of the Rehabilitation Unit staff, and some of the disability evaluators and information & assistance officers.  These staff members will remain in the district offices under the supervision of the Presiding Judge and Regional Manager for the adjudication system.

     Claims Resolution services will be provided out of what will be one of three Regional Centers, starting with San Bernardino.  These centers will be staffed with technicians and consultants to absorb incoming telephone calls from each district office in that region, perform summary ratings, and provide community outreach and training services. These centers will also be under the supervision of the Regional Managers, who are Robert Kutz, Mark Kahn, and Bill Whiteley. The three Regional Managers report to Assistant Chief Rich Younkin.

     A separate Policy, Program Evaluation and Training Unit (PPET) was created as an integral part of the restructuring plan, and will be staffed with the division's highest-ranking technical experts.  This unit will continue the quality assurance programs that have been implemented over the last year to insure adherence to policies and guidelines.  This unit will also preserve the Division's expertise in the areas of disability evaluation and vocational rehabilitation, and develop and/or maintain policies and regulations in these areas as well as all medically related regulations and fee schedules. The current Rehabilitation Unit and Disability Evaluation Unit managers and supervisors are assigned to this unit and will continue to oversee these two functions.  PPET is part of the headquarters office.

Impact on the Workers' Compensation Community

     At this point, the changes should not be readily apparent to the community, nor should the community make any changes to existing practices or filings. Practitioners will be notified of any changes.

     Once the Regional Center in San Bernardino is fully functional, community members and injured workers in the Southern Region should experience a major improvement in our ability to answer the phone and provide accurate information to callers.  The latest in computer equipment draws information from three separate systems to provide technicians with the ability to provide information on the status of a rehabilitation case, the WCAB case, or a rating request.  An automatic call distribution system will siphon the general incoming calls from the district offices to the Regional Center, freeing the district office staff to concentrate on the resolution of disputes.

     We will be issuing new venue lists to align rehabilitation venues with WCAB venue, eliminating the need for practitioners to travel to different district offices on the same case.  We have already moved rehabilitation consultants to Anaheim, Riverside, and Salinas previously been serviced by consultants in other offices.  Again, practitioners will be notified if their files have been moved.

     A centralized clerical pool will be processing all incoming mail to the district office, including rating requests, declarations of readiness, and rehabilitation unit requests.  To help identify and properly route the mail, we have created a new cover sheet for all filings.  This new form should be available by the first of the year.  While not mandatory, we will be asking for the cooperation of the community in using this form to help insure that your requests are properly and promptly processed.

     Summary ratings will ultimately be handled out of the regional centers, but not yet.  We want to make sure that the phone systems are working properly prior to shifting this workload to the regional centers.  We will keep you informed.

A Bright Future for DWC

     Most of you know that changes of this magnitude are fraught with turmoil. People tend to associate "change" or "reorganization" with "downsizing".  This is not the case in DWC.  We need every available staff member in order to meet the challenge of making this system work without encumbrance.

     With these structural changes, we hope to achieve our vision of promoting the prompt, voluntary delivery of benefits to injured employees, providing clear and consistent direction to the workers' compensation community, and efficiently resolving disputes.
 

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