Results in Brief

The Hearings Division has fully implemented some prior audit recommendations and partially implemented others. Because of these changes and other changes made by management, the Division's performance has improved since the last audit. For example, despite an increasing number of requests for hearings and appeals, the Division schedules hearings and renders decisions more timely than before. In addition, the Division has access to more information about the hearings and appeals process than was previously available.

Further improvement can be achieved, however. In fiscal year 1995, only half of appeals officers' decisions were rendered within the 30 days required by statute. Also, compiling information about the Division's performance from its management information system is very cumbersome and time-consuming. An improved management information system will help the Division achieve greater compliance with statutory time frames by providing management with information to help identify and monitor causes of noncompliance. Because of the Division's important role in the workers' compensation program, continuously striving to improve its effectiveness is critical.

Principal Findings

1. Despite an increasing number of requests for hearings and appeals, the Division has increased its compliance with statutory time frames for scheduling hearings. In fiscal year 1995, hearings were scheduled timely 84% of the time, and appeals were scheduled timely 95% of the time. Many of the hearings not scheduled within statutory time frames were delayed at the appellant's request or to accommodate the parties by grouping hearing requests together. (page 10)

2. The Division complied with statutory time frames for rendering hearings decisions in almost all cases. However, appeals decisions are often not rendered timely. Decisions were rendered timely in only 49% of the appeals in 1995. The statutory time frames are intended to minimize the time needed to resolve disputes of contested workers' compensation claims. This guarantees that if an insurer denies benefits to which a claimant is entitled, the benefits will be provided as quickly as possible. (page 12)

3. The prior audit found the Division did not maintain adequate information about the hearings and appeals process; therefore, it recommended a management information system be developed. Although the Division has taken steps to set up a system, it still cannot regularly and efficiently compile program data from its computer system. The Legislature authorized the Division to spend $77,270 in fiscal year 1996 for its information system. It is currently working with the Department of Information Services to address the system's inadequacies. (page 13)

4. The prior audit recommended staffing requirements be analyzed periodically because of significant differences in caseloads between the two offices. However, the analyses performed by the Division have been on a Division-wide basis, not by office. An improved management information system would enable the Division to perform more thorough staffing analysis with little effort, which in turn, could help the Division achieve greater compliance with statutory time frames by enabling management to identify and monitor potential causes of noncompliance. (page 16)