Rousmaniere: Predictions

This will be my final regular column writing in the workers’ compensation community. I began in 2003. I want to conclude this wonderful experience by making some predictions: two things which will happen and one thing which will not.

I recently defined workers’ compensation as a safety net which helps people after an injury at work. For many of us in the field, the story begins at the moment of injury and ends at the closure of the claim. For the worker herself, the employer, and the economy, there is a life of the worker before and after the injury.  We are, in fact, viewing the entire sweep of lives through the lens of a problematic and, for most, a seemingly temporary episode. 

I believe that when we look at the work injury system in a country, be it Sierra Leone or the United States, we see how a country expresses the values it places on work, accountability, and fairness. It matches these values with law and resources. In predicting workers’ comp, we are in this respect predicting our society, and vice versa.

Let’s start with what will not happen. There is no sign of any state investing in a project to envision and shepherd in a workers’ comp system that the 21^st Century deserves. The basic architecture has not changed since the 1910s.

Some questions need to be asked, such as who is working? Our workforce is heading towards more independent work, which is not covered by workers’ comp.

Where does workers’ comp fit in?  In a time of declining work injury risk and expanding absence and health benefits, no state is seeking to coordinate benefits. What does injury recovery entail for a more co-morbid and aging work force?  Who is accountable for treating co-morbid conditions?  No state is asking these questions.

Now I turn to what will happen. First, we are going to see more and more engagement with the injured worker. We will also see more engagement with the employer and the doctor, but attention will be most intense on the injured worker, three million of them each year.

A standard adjuster’s training manual for worker’s comp, published by the Institutes, ignores the worker -- her psychology, the disruption, the decision-making, the risk and impact of delays. Any intelligent claims leader today knows better. Some 3,000 workers’ comp professionals who have participated in Rising Medical Solutions’ on-going Claims Benchmarking Study confirm the need to address the psychosocial aspects of injury recovery.    

More engagement with the injured worker reflects the added value placed today on household convenience, self-management and what is referred to as “nudging.” That nudging is done by the school, employer, government, retailer and frankly the claims payer.

Engaging people today adapts to the exploding technology of communications. That has been profoundly affected by the smart phone. For instance, many injured workers today prefer to text message rather than to place a phone call.  A text message exchange can move instantly onto a digital platform. This platform can deliver information, motivation, advice, and, let’s be clear, surveillance.  Look ahead to, say, 2025. Why would any claims team then not want to engage their injured workers through text messaging upon a platform? Some claims teams today are piloting this future.

This kind of engagement technology is inevitable, much as the landline phone was generations ago.  A wise claims team will be sensitive to how this technology is viewed from all perspectives.

For my second prediction of what will happen, we are going to see a lot more use of artificial intelligence. AI can be most readily understood as machine learning. The computer draws continuously upon massive databases to accurately predict or recommend the next step in injury recovery and claims closure.

We are going to hear a lot of promises and push-back about AI in our field. This must be expected. AI technology is being introduced in society through a process of trial and error, and error, and error, until it works, probably not as the visionaries expect.

AI is unlike any other technology of the modern age, such as internal combustion engines, electricity and even the first generations of computers. That is because AI seeks to not only be a tool set, but also to create a practical replication of human thought.  AI takes into account human psychology in real time. Instead of depreciating like an engine, AI grows in prowess with use.

Engagement and AI, to be sure, are also useful in the market of workers’ comp insurance.  The insurance market has become very settled, thanks in part to better insurance leaders. Today, however, uncertainty, volatility, and economic stakes to all participants in injury response are high. That is why the success of workers’ comp so much depends on how we respond to injuries.

I am eternally grateful to editors and publishers who have coached and supported my writing – Jack Roberts, Cyril Touhy, Dan Reynolds, Dave DePaolo and Bob Wilson. I admire all those who seek to make our industry, and by extension our society, a better place.  A work injury triggers a cascade of human interactions that typically include medicine, law, insurance, human resources, work productivity, and, not least, observations on fairness.  Anyone who has spent some time in our field has spent her time well.

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