Daniel, an Injured Worker, Reminds Us of the Importance of Direct and Transparent Medical Communication
We are going to be focusing on real conversations that we’ve had with Injured Workers to bring the industry a front-row experience to what injured workers go through. Throughout this series we will hear differing opinions and cases and use that as a jumping point to discuss best practices for workers’ compensation professionals. We are using only their first names and not including identifying information like employer or industry to maintain their privacy.
Reflections on the Workers’ Compensation Experience
Daniel was recovering from a workplace injury to his right hand and was awaiting his second surgery. This was his first experience with a Workers’ Compensation Claim.
What has been the best and worst parts of the workers’ compensation experience so far?
Daniel:
“For the longest time, I didn’t know what to look forward to. I didn’t understand the process, or how long I would have to wait for direction. With this second surgery scheduled, I have a goal now. I have a surgery coming up, and then recovery.”
“My employer doesn’t always answer when I call. [My employer] is hard to get a hold of. Doctors, too. It can be really frustrating when you can’t get any answers, when you don’t know what’s going on.”
“You know, I thought those guys cared about me. I thought my employer valued me, but I don’t hear from them ever since I got hurt.”
“Approval is another big frustration – they will send a request for surgery or shots, but waiting for approval takes a long time. Sometimes I’ll have a follow-up scheduled, then when I get there, they’ll still tell me there’s no approval, or they’ll say they haven’t started on my case. They don’t cancel appointments or push them out when there are no updates. So, I go out of my way sometimes to get to these appointments only to be told there are no updates. There’s a long gap between request and approval. It’s a lot of waiting.”
What do you wish you knew about the workers’ compensation process before you were injured?
“You get assigned to one doctor. You don’t really get a say in the doctor you’re given. But I’ve found that there’s a whole network of doctors in workers’ comp, so it would have been good to have the option to choose your doctor. You feel like you are stuck with a doctor that might not be nice. They don’t tell you on the front end that maybe you can have a say in who your doctor could be. What if there was one closer to where I live? Or one who has better bedside manner?”
Lessons Learned from Daniel’s Experience
Daniel’s experience with his Workers’ Compensation claim highlights the frustration that can arise when there is a lack of timely communication from adjusters, medical professionals and employers. From the onset, Daniel is confused about the process and didn’t understand some nuances pertaining to his surgeries and medical appointments. This lack of transparency creates frustration and fear surrounding someone’s claim. These types of concerns can quickly escalate and derail a claim. Likewise, by appropriately addressing these concerns adjusters are able to calm any fears and work together to assure that the needs of the individual are met. The biggest frustration from Daniel was a lack of clarity, especially from his employer stating that “he thought those guys cared about me.” A lack of concern from an injured workers’ employer can cause resentment and lead to litigation. It is paramount that all stakeholders on a claim take the necessary steps to support an injured employee through their workers’ compensation claim. The necessity of timely, appropriate, clear, and direct communication cannot be understated when managing a claim. By understanding the fears and needs of the individual, workers’ compensation professionals can meet people where they most need support and make their workers’ compensation process smoother. Taking the small amount of time to communicate when needed makes the entire process easier for both the stakeholders and injured individual.
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