Strategic Alignment in Workers' Compensation?

Strategic alignment: To ensure consistency in the initiatives implemented from the executive leadership to the operational level of the organization.

Does this exist in workers’ compensation?

Looking back on the history of workers’ compensation over the past 100+ years, not a lot has changed. It is far beyond time that it does. With over 400,000 open positions in the insurance space, is it a wonder why people do not want to buy in to an industry who has made people’s lives miserable for over a century?

The intent of insurance is to restore the livelihood of people. The livelihood. Workers’ compensation is to restore the human, a human being who happens to have been injured working. It is fascinating we call people who are injured at work, “injured workers” yet those who are injured in a car accident are not labeled as “car accident person.” Food for thought.

The ‘advocacy-model’ has been swimming around as buzz words for a decade and what has been done? So much lip service and not a lot of execution. Is there strategic alignment in the workers’ compensation industry? The 2016 Rising Benchmarking Study surveyed organizations about their feelings toward the ‘advocacy-model’ of which 62% of organizations shared they were executing or soon-to-be implementing aspects. The 2019 Rising Benchmarking Study surveyed the ‘doers’ of the workers’ compensation industry: the people who hold the most power in this industry, the people, who every time they pick-up a phone call, have the ability to change the trajectory of someone’s life… the amazing humans we call adjusters. The front-line adjusters of the workers’ compensation industry reported that 72% did not know what the advocacy model is.

Strategic alignment… does it exist?

Let us look at this from a different angle. Adjusters hold the highest amount of power in the workers’ compensation space. They can authorize medical treatment at the drop of a hat, assist in providing injured humans the care they need, navigate the resources injured humans need to heal, and issue benefits for injured humans to continue their life, all at the touch of the adjuster’s fingertips. Adjusters are tasked with communicating statutes in a consumable manner; explaining resolution to the fears that surround the ‘unknown’ of what is yet to come for an injured worker; they need to showcase empathy, compassion and understanding needed to work with an injured human in a vulnerable space…and ultimately, adjusters are responsible for the recovery of an injured worker. The recovery of injured humans is of enormous impact to the cost of workers’ compensation claims.

How often do we ask for adjuster input in organizations who say they have an ‘advocacy-model’? When is the last time the C-suite of these organizations met with anyone who does the day-to-day operations to simply understand the landscape of the current space? The decision makers who showcase advocacy, do they understand what it means at the root core? If we as an industry truly understood this model, we would wake up and realize it is called humanity. It is not an advocacy-based model but the foundational components of humanity we simply operate.

We have de-empowered leaders and adjusters across the board in this industry. We promoted people based on their technical knowledge of workers’ compensation versus their ability to lead people; and not just any people, people who are working with injured humans in vulnerably places of life. This leads to a substantial emotional impact on the people in which these leaders are leading. This is somewhat comical.

We promote people based upon their statutory knowledge of the workers’ compensation industry to lead people, people who need to think outside the box to look for solutions because restoring injured workers is multi-dimensional, multi-faceted, and multi-emotional. Interesting. And yet we wonder why adjusters feel a lack of support. Where did the leadership go!? Where is the emotional intelligence needed to understand behavior and what helps humans thrive? I feel like Maslow addressed this long ago and for some reason, there is a stagnate leadership group in workers’ compensation that failed to read the memo. Maybe we can send it over in a TPS report from the 1990s.

Workers’ compensation statutes and regulations are the baseline. The bare minimum for how this system should operate. There are not the chains we tell leaders to enforce on adjusters. THEY ARE THE BARE MINIMUM FOR HOW TO TREAT HUMANS IN THIS SPACE. The statutes are the foundation we should be building our workers’ compensation culture upon to provide the best experience for the injured worker. Why? Because the statutes were there as a base, yet we have chosen as an industry, for over a century, to operate as if those are concrete walls of doing business in this space. Add into this black and white space, adjusters are told by organizations to not offer mileage and to use strategic partnerships that do not make sense. Just like that, we are off to the races for why we have failed the alignment of purpose through this space.

We can make the industry better by tearing down the concrete walls and using them as a foundation to build a new day. I have yet to meet an adjuster who does not want to do the right thing. In my past few years of traveling to speak on the topic of Humanity in Workers’ Compensation, I repeatedly hear how leadership will not support doing the right thing… not allow the sending of cards… not override ‘vendor’ partnerships when it will shave six weeks off the MRI wait time to save money even if it gives peace of mind through a diagnosis…

In all fairness of playing devil’s advocate, I do hear the ‘I’m too busy’ far too often in these vicinities as well. Leaders, you are not too busy to develop your people and your teams. Adjusters, you are not too busy to be nice to people. All of us can look at how we structure our days to determine what personal boundaries we need to make this a successful environment resulting in people who THRIVE. I believe this can be done and it can start with YOU. You reading this. It does not matter what seat you sit, you can make a difference.

Strategic Alignment, huh? Interesting.

Let me share my strategic alignment for the entire workers’ compensation industry.

The mission for the workers’ compensation is to make good things happen for people by helping injured workers restore their lives so they can be functional contributing members of society. The vision is to do so in a team environment where all parties are working towards the successful restoration and well-being of this injured worker. It is done in a manner filled with compassion, emotional intelligence, empathy, and ACCOUNTABILITY.

We must hold one another accountable. Adjusters, I see you, I hear you, you matter. Now meet me at the table. Issue your payments on time, call people back, and be nice to all with whom you encounter. It is really that easy. Start being proactive and I guarantee the lens in which you operate will shift. You would never want to be without a paycheck, would you? I know I would not, let alone when I am injured, vulnerable, and have a family to support. Put yourself in their shoes. Again, I see you, I hear you, I was one of you and the missed payments, unreturned phone calls, and rudeness do not exist in this world.

To our employers, please educate your leaders within your organizations on the power of simply checking in with their injured workers’ post-injury. There is so much power in acknowledging someone was injured. Check in. Do it timely. Then do it again. And again. Teach your employees and your leaders to check in on one another. Build the sense of community and comradery so that people WANT to come back to your work environment. “Joe” is a terrible employee cannot be a phrase echoed regularly. Take care of your people. Once they are back working for you, handle the HR issues because if they truly were a poor hiring decision, you should hold yourself accountable. This should have been handled before they became an injured worker. Workers’ compensation is not a means to correct poor hiring decisions.

Leaders, expect more of one another. Develop your people and invest in them! Culture is not an organizational influence. It is the collective result of individual leadership. Bring people along with you to show there is a fabulous world of leading in workers’ compensation. It is done through focus on humans, being. Find ways to empower your team. The red tape has existed for far too long and it is up to each one of us to cut through it.

The MRI example I gave earlier is one of my own. When I sustained a work injury, I went to our occupational medical provider on a Friday at 8:30 am. The physician needed an MRI to complete their diagnosis. The MRI machine was open at their facility at 9:40 am. The facility was instructed they could not allow me to have my MRI at that time because it needed to be scheduled through their third-party vendor. My MRI was scheduled for six-weeks out. I later learned the difference of the provider bill and the third-party bill saved the insurance company $50. Let that sink in.

Do the math. If an injured worker would happen to be off work and need diagnostic testing to confirm diagnosis, why do we delay? The diagnosis not only helps the medical provider decide the appropriate treatment plan, but the diagnosis also puts the injured worker at ease for what they can and cannot do in their LIFE. Workers’ compensation is not simply an 8 – 5pm time period. It is 24 hours per day, impacting everyone in the injured worker’s circle.

Six weeks of temporary total disability or temporary partial disability? Or $50 “savings” $250? Even $1,000?  Savings of $1,000 versus six weeks of TTD/TPD? That is simply indemnity cost. What about the mental factors that come into play? Without the confirmed diagnosis, what could I do during this time period? I did not want to injure myself in a more debilitating manner and I also did not want to be sedentary in the middle of summer with a life I had with friends, family, kids… LIFE. We force injured workers into these situations without thinking of the bigger cost at hand.

What happens when we put at injured worker at home for six weeks with no answers, no diagnosis, and no confirmed direction? Absent from work, friends, family… LIFE. Ahh, there are those lovely commercials that come across television and now the streaming services! Is it really any wonder we have so much misalignment in the workers’ compensation industry?

Strategic alignment in workers’ compensation? Let us start by empowering the true decision makers, the game-changers, the people who want to make a positive difference in this space. Take time to empower adjusters. It WILL make all the difference.

Repair begins with accountability. – Brené Brown

By Claire Muselman

Dr. Claire Muselman is a workers’ compensation enthusiast (and Vice President at North American Risk Services).

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