One of the biggest misconceptions in workers’ compensation is that injured workers lose trust when something goes wrong.
- A claim is denied
- A treatment request is delayed
- A utilization review doesn’t go their way
- An independent medical examination reaches an unexpected conclusion
Those events certainly can damage trust. But in my experience, distrust usually begins much earlier. It often begins before the first potentially negative decision is ever made.
An employee who has just been injured enters unfamiliar territory almost immediately. They’re in pain. They’re uncertain about their health, their job, their income, and their future. They’ve never navigated workers’ compensation before. They’re hearing different opinions from coworkers, family members, social media, and maybe even an attorney’s commercial on TV.
In the absence of understanding, people create their own explanations, and those explanations are not always accurate.
That’s an important psychological principle that extends far beyond workers’ compensation. Human beings are remarkably uncomfortable with uncertainty. When we don’t understand what’s happening, our brains instinctively begin filling in the blanks. Sometimes those conclusions are correct. Often, they’re not.
That is where distrust quietly begins to take root.
An unanswered phone call becomes, “They’re ignoring me.”
A delayed authorization becomes, “They don’t want me to get better.”
A complicated process becomes, “The system is working against me.”
The conclusion may not match reality, but it becomes reality to the person experiencing it.
For years, I’ve heard people describe difficult claims by saying, “That injured worker just doesn’t trust the system.”
Why?
Why does distrust develop in one claim but not another?
The answer is rarely found in a single interaction. Distrust is usually cumulative.
It grows through uncertainty, inconsistent communication, unmet expectations, conflicting information, and a gradual loss of confidence that someone is guiding the process.
That distinction matters because it changes how we respond. If distrust is viewed as an attitude problem, our instinct is often to defend the system. If distrust is viewed as a human response to uncertainty, our instinct becomes education. Those are very different approaches.
One of the lessons we’ve incorporated throughout our educational programs is that communication should not begin with an explanation of the rules. It should begin with an explanation of the journey.
People tolerate uncertainty far better when they understand what to expect.
Think about boarding an airplane. Most passengers aren’t aviation experts. They don’t understand the mechanics of flight, weather systems, or air traffic control. Yet they remain remarkably calm because they understand the process. They know what happens before takeoff, during the flight, and upon landing. Even turbulence becomes less frightening when the pilot explains what’s happening (and when the flight attendants stay calm, always my personal barometer).
Workers’ compensation rarely offers the same clarity. Instead, injured workers often experience a series of disconnected events that make perfect sense to experienced professionals but appear confusing to someone encountering the system for the first time.
- Forms arrive with aggressive timelines
- Appointments are scheduled
- Medical opinions differ
- Phone calls come from unfamiliar people using unknown numbers
- New terminology appears
- Timeframes change
- Decisions are made
Each event may be entirely appropriate. Collectively, they can feel overwhelming.
Education helps transform confusion into understanding.
Notice that I didn’t say education eliminates disagreement. Sometimes claims will still be denied. Treatment recommendations will still differ. Independent medical examinations will still produce conflicting opinions.
Education doesn’t guarantee agreement. It increases understanding. And understanding often reduces unnecessary distrust.
That principle extends beyond injured workers. Employer supervisors, claims professionals, and physicians need education. Even experienced professionals benefit from understanding how the other stakeholders experience the process. That’s one reason we took a liberal arts approach to our curriculum. Rather than focusing solely on the technical mechanics of adjudicating a claim, we built a 360-degree view that covers the stakeholders as much as the process, and treats interpersonal skills as core content, not an afterthought.
One of the unintended consequences of specialization is that each participant becomes exceptionally knowledgeable about their own role while knowing relatively little about everyone else’s. The adjuster understands claim administration. The physician understands medicine. The employer understands the workplace. The injured worker understands the injury. Unfortunately, each often assumes the others understand the same things. They don’t, and that gap creates misunderstanding. Misunderstanding creates assumptions. Assumptions create distrust.
Which is why I’ve become increasingly convinced that one of education’s primary purposes isn’t simply transferring knowledge. Instead, it is building shared understanding between people who are looking at the exact same event through entirely different lenses.
When people begin to understand why others make the decisions they make, conversations change. Expectations become more realistic. Frustration decreases. Collaboration becomes more likely. Education becomes a bridge rather than a transaction.
Over the years, I’ve also come to appreciate that trust isn’t built through grand gestures. It is built through consistency. Whether at your job or at home, building (or destroying) trust is a journey. In the case of a claim, it means:
- Returning the phone call when you said you would
- Explaining the next step before someone must ask
- Using language people can actually understand
- Acknowledging uncertainty instead of pretending to have every answer
- Following through
None of those actions require extraordinary technical expertise. They require intentionality.
The irony is that most organizations invest heavily in teaching technical processes while spending relatively little time teaching professionals how uncertainty affects human behavior. Yet those psychological realities influence nearly every claim decision we make.
Fear changes communication. Stress changes perception. Pain changes decision-making. Loss of control changes expectations. None of those reactions are unique to workers’ compensation. They’re human.
As Provost, I’ve become increasingly interested in designing educational experiences that recognize those realities rather than ignoring them. Technical competence will always matter. Our industry depends on professionals who understand medicine, law, regulations, benefits, and claim administration.
But expertise alone is not enough.
Professionals also need to understand the people experiencing those systems. Claims are never managed in a vacuum. They are managed one conversation, one explanation, one expectation, one relationship at a time.
Perhaps that’s the biggest lesson I’ve learned after years in this unique ecosystem. Distrust is rarely the disease. It’s usually the symptom. The real challenge lies underneath. Uncertainty, misunderstanding, fear, and unmet expectations create distrust over time.
When we recognize that, education takes on an entirely different purpose. It isn’t simply about teaching people how workers’ compensation works. It’s about helping everyone involved understand each other a little better.
And sometimes, that’s where recovery truly begins.
