A few weeks ago, a thought-provoking thread occurred on LinkedIn about frustrations felt in the workers’ compensation process. This thread stemmed around people not exercising their power to help the injured worker. Injured workers should not need to obtain legal representation to recover from their injury timely, effectively, and efficiently. One common theme emerged: We need to do better in our industry.
While many components flow through the workers’ compensation system, we all have a part to play to help people recover effectively. We work with human beings, actual people who are mothers, fathers, friends, volleyball team members, golf buddies, and philanthropists… functional, contributing members of society. The overarching cloud of ‘work injury’ can cast a shadow not seen under personal health insurance when injuries occur outside of work. Why the bias? And what to do about it?
The first step is to recognize injury is injury. If you are working in the workers’ compensation industry, your goal is to help injured workers. Whether it be from a medical standpoint, return-to-work standpoint, administration of the claim, offering services to assist in the healing process, or understanding what jurisdictional benefits an injured worker qualifies.
The second step is to be human. It is time we make this industry human by being more purposeful and more meaningful to drive change effectively. Approaching every injured worker as if it was YOU is a significant first step. As someone who has been on both sides of the industry, the treatment and fear that immediately occurs once you are injured should not be typical. We should all take the Discover tag line: “We treat you like you treat you.” Or even more so, maybe we should revert to pre-school where we learned the golden rule.
The third step, build a recovery team. We all have a position to play with a common goal to achieve to win: Get the injured worker back to work and back to their LIFE. The work matters will fall into place if you focus on the life elements that are important to an injured worker. We tend to become so short-sighted of the focal points of return to work that we fail to acknowledge the outside factors that can improve recovery. Expand the lines of thinking to enhance overall outcomes by focusing on the life components, and the rest will work itself out. Being human, it matters.
For some reason, and with a lack of education on the parties in the workers’ compensation space, it has been thought that the medical providers in this space do not want the best outcomes for their patients. This concept floors me as I have treated with the people with whom I recommend injured workers’ to see. If we step back to the 20,000-foot view, how does sending someone to a medical provider who wants an unfortunate outcome benefit anyone? Medical providers want the best outcome for their patients. There are statistics, reviews, ethics, and a plethora of other metrics that showcase this, let alone unfavorable results yield a cost to everyone involved.
While every medical provider is certainly not perfect, sending injured workers to the ‘chop shop’ needs to be eliminated. The mindset that injured workers’ have with their medical providers can significantly impact the claim. Trust matters! Aiding in comfort versus confirming the fear can help this when speaking about the direction of medical care, suggesting reputable providers, and bedside manner of the treating physician.
Physical therapists have incredible insight to the injured worker. Not only do they get to see the physical process and assist in a very routine timeframe, but they also can build a stable relationship with the injured worker. The frequency in visits and trust established from working in the medical profession, as well as dialogue that occurs through this process, allows a connection not found within other avenues of this team. The goal of the physical therapist is not only to help the body with the retraining functions but also with the mind.
Through the connection and relationship established with the injured worker, the physical therapist can take a more in-depth look into avenues other members of the recovery team may not see. For example, if an injured worker struggles with the lack of a home support system or lacks connection with others in their daily life, and the physical therapist notices this, suggestions can be made to get out and meet a friend for coffee. It will get the injured worker out of the house, get them moving, and help with the personal connection if they feel isolated. The physical therapist, having a frequency in visits with the injured worker can then allow for follow up to follow through in-person and provide feedback to the adjuster for other areas needing focus that would not be within a standard telephonic relationship in this space.
The adjuster is the captain of the recovery team. They are the center point to make the plays for successful recovery and navigation of the workers’ compensation system. Everything centers on how the adjuster approaches the captaining of this group. Cutting through red tape is a necessity by doing what is right for the injured worker. Listening and setting the tone all fall on the shoulders of this imperative member. The better the adjuster is at communicating with the team, taking information and making it consumable to everyone involved, the better the team will be at coming together to make the recovery process win!
The adjuster also ensures accountability at all levels. If tasks of the team lack timeliness, the adjuster must follow up to keep things moving forward. This team member also helps glue the other members in cohesion by following up to see how things are going with the injured worker, the employer, checking in with the physical therapist, nurse case manager, and medical provider. Taking this to a holistic approach establishes transparency in the plan needed to achieve the recovery win.
Time, education, communication. These elements allow vendor partners to help accelerate the recovery process. Time matters so much in this space and justification as to why the timing of medical equipment, next appointments, scheduling, medical imaging, and transportation are not completed yesterday are of the utmost importance. We all want things done yesterday, not three weeks from Tuesday!
Vendor partners who take time to explain the “why” a delay has occurred to the adjuster, and the injured worker can help the recovery process by encouraging transparency. Doing everything in your power to make good things happen to move whatever process you impact forward MATTERS. Each piece matters to drive the overall success of the recovery team. Vendor partners are here to improve the customer experience across the board for the injured worker to have things work seamlessly, efficiently, and effectively with minimal check-in needed from the adjusting team to make it happen.
The employer is an active member of the recovery team and not merely by having a member of the human resources department involved, but having the direct leader invested in the recovery of their teammate. There is a gap that can exist when the injured worker’s direct leader is not checking in or following up because it allows for emotional hijacking. When an employer is not participating as an active member of the recovery team, the injured worker will begin to conclude on their own about why they are not hearing from their boss or teammates, regardless of what they believe is accurate. As an active member of the recovery team, the employer contact should involve the direct leader of the injured worker to facilitate open communication and dialogue. Simple text check-ins or phone calls can help alleviate the added stress and reduce emotional hijacking than can occur.
An example of emotional hijacking is an injured worker who sustains an injury that removes him from his employment for the next six weeks. He does not hear from his leader and thus begins to assume his leader does not care. He hears from human resources, which ensures the process is moving forward; however, he does not talk to his direct leader. The injured worker begins to think that his colleagues are upset with him due to their added workload and becomes fearful of returning to work because of how unhappy people are he sustained an injury.
Emotional hijacking is incredibly easy to rectify. Employer contacts should have the direct leader of an injured worker check in to say hi weekly. They are not inquiring as to the medical information or trying to pry. The leader is there to see how their teammate is doing and to let the injured worker know they are thinking of them. This communication can be done very quickly, with ease, and is one of the essential factors in the recovery team that goes overlooked regularly.
Nurse Case Manager
Nurses are the healing part of the team! They bring the pure recovery element to the functional contribution related to the recovery team’s success. Nurses are healers, trusted, and caring. Their role helps bring clarity to all of the team members involved to streamline processes involved with the medical care and facilitation of return to work. They collaborate plays with other members of the recovery team to assist in making them come to life.
NCMs are the translators in the medical arena. Often, what the physician says goes unheard of because of the lack of human ability to consume all information during one medical provider appointment. NCMs can help set the stage pre- and post-interview to prepare the injured worker for what is going to transpire and then follow up to make sure the injured worker understood what took place. Setting the stage and completing the follow-up communication helps the injured worker process what is taking place to help eliminate fear. The more the injured worker understands what is taking place and why, the less fear of the unknown comes into play.
The NCM is also influential in helping the employer with return-to-work, which is imperative in the ‘back to work, back to life’ strategy of the recovery team. Focusing on back to life is how we win! We work collectively to return the injured worker to work so they can get on with their life. NCMs also have a trusted mentality, which helps bridge the gaps in communication between the employer, the adjuster, and the injured worker. The more streamlined, open interface that can occur across the board, the greater trust among all team members. With increased trust comes increased accountability and focus, allowing this team to come together for a successful win.
The goal of everyone in the workers’ compensation system should be to help the injured worker recover. Recover, heal, and return to their LIFE. Each of us has a role we can play to help navigate this complicated and frustrating system. Shift your mindset and begin to help be a functioning, contributing member of the recovery team. We can do better in our industry, and each of us has the power to do so.