Why Workers'Recovery?

                               

The workers’ compensation industry needs a serious pep talk. Many have lost sight of the original intent of workers’ compensation: to take care of the injured worker. When messaging is added in from the outside world, it appears that everyone is against the injured worker or out to get them, especially the ‘big bad’ insurance companies. While many of us know this is not the reality, messaging has substantial impact. People see the insurance world as a contractual and somewhat dark place. The workers’ compensation industry is well established and is thought of as a dreary, difficult, and undesirable system. This cultivates feelings of distrust and overall skepticism when parties collaborate after an injury occurs.  

In reality, insurance was created to restore the livelihoods of people, and workers’ compensation to restore the livelihood of injured workers … getting them back to life. But insurance companies are not the only part of the system. There are many players that have an ability to impact this space: TPAs, employers, friends and family, medical providers, attorneys, nurse case managers, etc.

What can someone do to change this space? From my perspective, it takes someone who cares and believes that you can change the system. It is my goal to share this vision with others to cultivate change through execution, implementation, and simply making it happen!

The industry. There is a need in this industry for a recovery unit mindset – taking this black and while type of workers’ compensation and changing it into a colorful outlet to restore the livelihoods of those who have been injured. Being in the business of workers’ compensation not only involves state-mandated benefits pertaining to medical treatment and lost time, but we work with people, emotions, and their daily lives. Our job is to indemnify people and restore them through the road to recovery, making them as whole as we can. This differs from other lines of insurance because of the nature of the human body and the impact this has on an injured worker’s purpose or contribution to life. When someone is injured at work and is removed from his employment, temporarily or permanently, he can lose his sense of purpose and feelings of accomplishment through task-based work. Where do you begin? How can we assist in these barriers? What else can we do? How can we make the process better? How can we take the laws and direction given through jurisdictional mandates to improve overall experience?

The ‘why’ has always been an important aspect of change management. At Continental Western Group, a Berkley Company, we founded, executed, and implemented the first ever Workers’ Recovery Unit (WRU). The WRU was founded with a new mindset based upon the belief that we (as individual contributors) have the power to positively impact people’s lives each and every time we interact with an injured worker. The WRU focuses on recovery, taking the dreary and changing it to positive, and helping people learn to help themselves. Some may call this the advocacy model which has been talked about for the last few years; we chose to add more flair focusing on the support system mentality, then executed and followed through with doing what we said we were going to do.

There is a need for this, not only at one insurance company but with all of those companies that touch workers’ compensation. This includes the employer level. Open your eyes and take a look at the industry … even personal healthcare is becoming grey and unhelpful to those who need it. It is time to change insurance for people and the impact within our own scope of control is how we do it. Treating people with kindness, respect, and through education is how we can make injured workers’ recoveries smoother, more effective, and more efficient.

Insurance Carriers/TPAs. Attitude is felt on the phone through tone! Insurance Companies and TPAs have an impactful power starting at the adjusting desk. The initial contact made by an adjuster holds much power as this is going to set the tone for the claim. Speaking with kindness, providing no more than three bullet points with a check for understanding, and explaining a lot of the unknown factors ahead can lay the foundation for a successful relationship on the road to recovery. Simply starting conversations with ‘How are you?’ and waiting to actively listen can have substantial benefits in forming a bond with the injured worker. Working kindly is so important in this industry and can have a substantial ripple effect.

Set realistic time frames and expectations. The more you can explain the claims process along the way, the better understanding the injured worker will have because you are walking her through the experience.

Do what you say you are going to do. Simple enough … execution and follow-through are where adjusters find themselves in trouble. If you inform Joe you are going to call him at 3pm on Wednesday, call Joe at 3pm on Wednesday. This establishes credibility through accountability and ownership of your word. It builds trust!

Cultivate a vision at the very first call. What does a successful recovery look like for the injured worker? Focus on the ultimate outcome and assist the injured worker with focusing on that recovery aspect rather than the painful situation in which they find themselves presently situated. If the injured worker is off work, start the conversation of returning-to-work with the first contact focusing on the aspect of recovery.

Explain benefits in a multitude of ways, and then follow up in writing. Having a couple of different avenues of communication available helps reiterate the information you are communicating, as well as providing follow up references. Transparency is key!

Employers. Care about your employees, and let them know you care. Workers’ compensation was not designed to be an opportunity to correct poor hiring decisions. Regardless of your opinion of this person, this is an injured worker now in the workers’ compensation system. Our collective goal is to get this person back to work, and back to their life. Try to leave all opinions at the door and approach this as if it were a family member. Be genuine and authentic. No one likes to be injured. Being sincere is important when expressing care and compassion. It is important to remember that workers’ compensation injuries do not go from 8 – 5pm, or stop at second shift. The impact is 24 hours a day and can be felt through a family.

Establish accountability at the onset of the claim. Lay out expectations for the injured worker such as having him check in with you after his doctor’s appointments so you are aware of his work status/restrictions. This also presents an opportunity for you to sincerely ask how he is doing.

Follow Up, especially if they are off of work. Send a quick text to simply check in and see how they are doing. Send a card and if that is not your style, make sure to send a text or call to check in. The absence of having an employer reach out to their injured workers can result in a plethora of ideas surrounding how much an employer does not care about someone. Bridging this gap with effort will aid in the injured worker feeling supported during this time of insecurity. Keep the injured worker in mind. If there is another company event going on during the injury, is this an opportunity for inclusion? Possible upcoming meeting? Bring them in as they still want to be included.

Communicate. There is power in communication. Work with your insurance carrier/TPA to ensure transparency for the most up-to-date information. Let the injured worker know that you are working in tandem and want to be included to ensure the road to recovery is optimal for the injured worker. This will assist in working towards the vision of returning to work and to life. Be warm and welcoming.

How do you game-change an industry? Care … and believing you can. We should … and all of us can effectively change the workers’ compensation space to a positive light. Get ready, the time is now. We can change this space by each of us changing one element of the manner in which we work and interact in this space.

Here is what you can do to make a difference:

  • Target your power of influence. Who can you help? Why are they important? Are you working directly with injured workers? Do you have influence at the employer level? Be specific and work with intent on who you can work with to bring effective change.
  • Influence them to help you. This is a great exercise to help injured workers focus on their recovery as well as an opportunity for an employer to improve their system through small changes. Think outside the box. What does success look like from their standpoint?
  • Teach people how to think. Verbiage is important. This is workers’ recovery; the goal is to restore the injured worker and focus on their abilities on the road to recovery. Remember these are injured humans, not claim numbers.
  • Challenge growth. Ask the right questions. What are you able to do? How can we work together to achieve recovery? What does recovery look like to you? How do we collectively get there? You will not be penalized for being gracious.
  • Role model the way and be the change. The world is changed by your example, not your opinion. Treat others the way you want to be treated. What example do you want to leave, and what will you do with your time here in the workers’ compensation space?

Claire Muselman is the director of the Workers' Compensation Recovery Unit at Continental Western Group, a Berkley Company.

 


  • AI arising out of california case management case management focus claims compensability compliance courts covid do you know the rule exclusive remedy florida FMLA glossary check Healthcare health care iowa leadership medical medicare minnesota NCCI new jersey new york ohio opioids osha pennsylvania Safety state info technology tennessee texas violence virginia WDYT west virginia what do you think women's history month workers' comp 101 workers' recovery workers' compensation contact information Workplace Safety Workplace Violence


  • Read Also

    About The Author

    • WorkersCompensation.com

    Read More

    Request a Demo

    To request a free demo of one of our products, please fill in this form. Our sales team will get back to you shortly.