Family Matters: The Vital Role of Engaging Family Members in Workers’ Compensation

25 Mar, 2024 Shawn Deane

                               

Shawn Deane
General Counsel & Vice President of Claims Solutions | J29
Shawn.Deane@j29inc.com  

In workers’ compensation, most of our focus and attention is directed towards the injured worker – and understandably so. Ensuring prompt medical attention, coordinating care, developing a comprehensive treatment plan, providing supportive services, monitoring progress, and return to work planning are all crucial. There must be a focus on the injured worker to ensure delivery of benefits and the best possible outcomes.

However, a sometimes-overlooked area of focus in workers’ compensation is the injured worker’s family.  

Occupational injuries impact families – both spouses/significant others, children, and extended family members. “Injured parents are less able to do household work, and other family members are often called on to care for them. Family members cut back on their paid, school, and household work to fill in for the injured parent.” See Running on Empty: Families, Time, and Workplace Injuries. A 2021 Centers for Disease Control and Prevention (CDC) paper indicates, “…research suggests that [a] workplace injury may ripple through families to adversely affect the psychological well-being of children.”

A work injury may be one of the most difficult events in someone’s life and there will undoubtedly be impact – big and/or small – on their family. Where appropriate, there is an opportunity for claims professionals to engage family members of the injured worker. Not only can it help provide support and assistance, but it may also facilitate smoother communication, ensure a better understanding of the process, and potentially aid in the worker’s recovery. Family engagement is also an opportunity to exercise empathy, compassion, and kindness, and can be a chance to help in simple but powerful ways.

In my experience with Kids’ Chance of Massachusetts and the Kind Souls Foundation, I’ve seen first-hand the positive impact engaging family members of injured workers can have.

It’s important to note that a claims professional should ensure any such communication is permissible (legally or otherwise), appropriate, and respectful. The following are potential strategies and benefits associated with workers’ compensation professionals engaging family members of an injured worker.

Strategies & Benefits – The 3 C’s: Communication, Collaboration in Care & Cost-Reduction

Communication

Encouraging open channels of communication with family members can have a profound positive impact. Communication affords the claims professional an opportunity to build rapport and a relationship with the injured workers’ family. This in turn fosters trust and collaboration, which will help manage expectations, prevent misunderstanding, decrease the likelihood of confusion, and even reduce costs and mitigate against litigation.

Collaboration in Care

There’s a recognition that, “[i]nvolving patients and families in healthcare decisions about patient care… results in better health outcomes, higher quality of care, lower health system costs, and improved patient safety.” See Patient and Family Roles in Safety. I’m fortunate to have gotten to personally know Dave and Amanda Repsher. As a flight nurse, Dave was severely injured in a work-related helicopter crash. His subsequent journey to recovery was, in large part, led by his wife Amanda – who was an integral part of his care team. Amanda is a critical care nurse, but even those family members without a medical background can play a role in the care plan. “The loved ones of a patient may not have a medical license or healthcare background, but their voice and presence matters in the hospital room.” See The Critical Role of Family in Patient Experience.

Cost-Reduction

Poor communication can lead to inefficiencies, delays, and misunderstandings that increase the overall cost of workers' compensation claims. By fostering clear and open communication with family members of an injured worker, stakeholders can identify and address issues proactively, leading to more efficient claims management and cost savings. “There are many pillars and strategies for helping reduce workers’ compensation costs, which impact the total cost… [b]ut improved communication with injured employees [and their family] is key and effort should be placed on establishing a consistent best-practice framework for all stakeholders to follow.” See 8 Strategies for Reducing Workers’ Compensation Total Cost of Risk.

Conclusion

Where appropriate, actively engaging family members of injured workers can foster a supportive environment that conveys compassion and empathy, and which facilitates the injured worker’s recovery and improves claims outcomes.

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Author Bio

Shawn Deane
General Counsel & Vice President of Claims Solutions | J29
Shawn.Deane@j29inc.com  
(866) 529-6771
www.j29inc.com

As General Counsel & Vice President of Claims Solutions, Shawn Deane leads J29’s legal and Medicare Secondary Payer (MSP) services team. Shawn is a practicing attorney and has over 16 years of experience in Medicare compliance, workers’ compensation, and insurance claims. He was previously General Counsel & Senior Vice President of Risk Management & Compliance at the nation’s largest professional administrator of Medicare Set Asides. Prior to that he was Vice President of Medicare Compliance & Policy at one of the country’s largest Medicare Set Aside vendors. He’s an industry expert and thought leader in workers’ compensation, Medicare Set Asides (MSAs) and Medicare compliance.

About J29

J29 is a women-owned business that offers Medicare Secondary Payer (MSP) compliance services providing Medicare Set Asides (MSAs), conditional payment / lien services and related solutions to all workers’ compensation stakeholders – including carriers, self-insureds, third-party administrators, and attorneys.


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