A guilty pleasure of mine is scrolling through my Facebook feed. While doing this yesterday, I saw one posting that all workers’ compensation was evil. As an individual who’s been providing cost containment services to the workers’ compensation world for 33 years, I took exception. I was thinking about how is this person perceiving workers compensation as being evil?
The first thought that came to mind is that this individual either had expectations of the workers’ compensation system that weren’t met or was trying to substitute healthcare insurance for workers’ comp insurance. They had a clinical issue that was not addressed and in their mind thought there was a function of their compensable injury or these individuals did not understand the limitations of the workers’ compensation system in the delivery of healthcare.
Then I thought this was a perfect example of how the delivery of benefits in a worker’s compensation scenario has to change. If that individual adjuster or whoever is handling adjudicating the file was skilled at whole personal recovery and understood that the perception of that individual is their own – how they see things, how they understand things, how they believe things to be true is not quite accurate- then, of course, they believe the system is failing them.
In my 30 years of providing these services, we’ve seen fraud, we’ve seen errors, we’ve seen candidly, and have seen adjusters who were intentionally not doing the things they should have been doing for some misguided reason. But the reality is everyone has their own perceptions. Everyone needs to be evaluated and each scenario needs to be appropriately handled so that that injured workers understand that the workers’ compensation system is there to help them, but only limited to the compensable injury alone.
Workers’ compensation is not health insurance. It’s not Blue Cross Blue Shield. Workers’ compensation deals with health issues and provides benefits, but there are statutory limitations to all those benefits. Therefore, everyone involved in workers’ compensation has to look at that injured employee and understand that the communication has to be successful in terms of what the system delivers, how it delivers it, and what it addresses. I do not believe the system to be evil.
In the 10’s of thousands of cases I’ve been involved in over the last three decades, I didn’t see but one exception that was maybe evil. The reality is, it’s good people doing good things as best they can under the limitations of the system. That’s the message that needs to be delivered.
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