This was originally published on 9/24/20 on a different platform. An article in the June 2020 edition of CLM Magazine entitled “Be Kind and Keep It Simple” piqued my interest in the success of an advocacy program at Fidelity National Financial in Jacksonville, FL. Specifically, the nationwide director of safety and claims management who was responsible for envisioning and implementing the advocacy program, Kimberly Simmons. So I arranged a phone…
You've probably used the term "mañana" even if you don't speak Spanish. While many think it means tomorrow, Merriam-Webster defines it as "an indefinite time in the future." With either understanding, it definitely means deferral. What did you not do yesterday by deferring it until mañana? Even though you had the same 86,400 seconds yesterday that you had the day before and that you have today, was there at least one thing…
Everyone agrees that workers' compensation is too complicated. But one aspect of it rises above others on the complicated scale – permanent partial disability benefits. The difficulty of finding the right balance for permanent partial disability benefits is at the heart of the differences among approaches, and it started with the grand bargain itself. The grand bargain means that benefits for workers' compensation claims aren't determined like claims based on…
Have you ever thought about whether you could live on your state's temporary total disability (TTD) benefits if you had a workers' compensation injury? It's a scary thought. The benefits in most states have formulas that begin with an injured worker's average weekly wage based on the prior 52 weeks' wages and multiply it by 66 2/3%. Then the resulting amount cannot exceed the maximum weekly wage for TTD benefits…
A 2021 Harvard Business School newsletter encouraged business leaders to take the long -term view rather than concentrating on quick returns. This is sound advice for several aspects of the medical component of workers' compensation, three of which are discussed below. First. Medical care is a major component of the total cost of workers' compensation. Policymakers have accepted that medical fee schedules help reduce medical costs in workers' compensation and…
Comments from last week illustrated the substantial difference that the choices about physicians can make in workers' compensation. This point was also made in a presentation at the recent IAIABC Forum. Dr. James Talmage, a well-known authority on medical care for workers' compensation injuries, spoke about “Working with Physicians to Achieve Return to Work.” His talk included some of the complexities of medical care that plague workers' compensation. He also…
The first edition of the It's Complicated blog began an exchange of ideas about what workers' compensation is and what it could be. The dialogue started with four questions. The responses to the questions were thought-provoking and raised even more questions. The responses are summarized below. The Definition of “Injury” The first question was basic ? what is a workers' compensation injury? ? and it had four possible answers. The…
A day rarely goes by when emails, social media, blogs, and news articles don't discuss workers' compensation – what's wrong with it, or what can “fix” some part of it. But there is no universal agreement on what “it” should be. Equally troubling, no consistent platform has existed from which the workers' compensation community can have a dialogue about issues the industry faces. The purpose of this blog is to…
At the California Coalition of Workers' Compensation Conference in Anaheim a couple of weeks back, one of the presenters made a comment that resonated with me. The topic was related to innovative claims management practices and had shifted to discussions of return to work and the role of physicians. One of the panelists made an emphatic point of being tired of being given a list of restrictions related to the…
Accidents can happen in the blink of an eye, as can other mistakes in the workplace. A recent minor mishap reminded me that when an error or accident occurs, the best thing you can do is accept the reality and roll with it as best you can. Sometimes, literally. It is a maneuver based on something I call “the art of the tumble.” I traveled to Wisconsin this weekend to…
