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Start with the Employee Experience for Better Workers Compensation Claims Management

Written by Jodi Mathy | Thu, Sep 10,2015 @ 12:49 PM

JODI MATHY
Senior Claims Consultant at HNI 

Let’s face it, work injuries are going to happen. Medical costs are going to continue to increase. Lawyers are going to continue to knock insurance companies in order to snatch up clients.

So how are you going to mitigate your losses? The time has come for employers to shake their cynicism about work injuries and injured workers.

Yes, there will always be those who want to “work the system.”  But the fact is, the majority of workers compensation claims are legitimate.

When Your Valued Employee Needs You Most

You’ve attracted, recruited and hired a great employee. You’re excited about the prospect of them contributing to your organization.

Several months or possibly years may go by and they are performing well. Then one day they are injured. It could be that they became complacent and the injury was preventable, or perhaps the injury could have been caused by a third party.

In either case, your valued employee is hurt.  Now is the time that they need you most.  And here’s where most workers compensation claims management processes come up short.

Workers Compensation Claims Management Is Stressful – But it Can Be a Chance to Shine

A recent study published in JAMA Psychiatry, “Relationship Between Stressfulness of Claiming Injury Compensation and Long-term Recovery”, identified high stress levels associated with a claimant’s understanding of what to do for their claims, claim delays, the number of medical assessments made and the amount of compensation received.

Six years following their initial injuries, these same claimants identified with higher levels of disability, anxiety and depression and a lower quality of life.

It is at this fork in the road that your organization can stand out. Your employee’s experience following a work injury is crucial to their healing and maintaining employment with your company.

4 Areas to Focus on to Achieve the Best Possible Experience and Results

There are four key areas that you should focus on in order to create the best experience and most influence on your employee’s work injury.

1) Build trusted provider relationships – before you need them

First, your employee may have an immediate need for medical attention. Every jurisdiction is different and in some the employer will direct the employee where to go and in others they may only suggest options.

The key here is to have established relationships with key medical providers near your physical locations. If this is properly vetted ahead of time, it will provide your employee with the appropriate level of care and there will be a better experience for them.

They will have less questions to answer about who the insurer is, where to send bills and records, etc. This will take a substantial amount of stress off your employee during a time when they are in pain.

2) Proactively let employees know how the workers compensation claims management process works

Second, your employee needs to understand the benefits that are available to them and how those benefits will be coordinated.

Consider having a conference call that includes the employee, a company representative and the claims representative. The purpose of the call would be specifically to make sure that your employee knows the “rules”.

They will know how to access medical care, and if they are unable to work, they will learn about how their lost wages will be replaced. It is best for you to help facilitate the discussion to make sure that you and your employee both have a clear understanding of the process.  

3) Help them stay at work while they heal

Third, your employee shouldn’t be off of work completely. By now you have likely heard all of the advantages for keeping injured workers in transitional jobs during a period of healing. So why do we struggle getting them to participate?

For one thing, we are always telling them how their participation benefits the company. It may take a substantial paradigm shift within your organization, but the focus should be on the commitment your company is making to its employees and how your program benefits THEM.

The focus here is not on return to work at some point in their healing process, but on the benefit to the employee to continue working during a period of temporary disability. We don’t want an employee to lose any time from work. Losing time from work can cause a substantial financial hardship, it can affect their benefits and it can delay the healing process.

4) Remember that they’re hurting – and a little compassion goes a long way

Last, the focus should always remain on positive interactions and communication with your employee. They are important to the organization and they are in pain, suffering financial hardships and may have a permanent impairment.

Don’t turn your back on them or expect the insurance adjuster to show the care and concern that your company should demonstrate. When an employee breaks a leg falling down the stairs at home or is diagnosed with a disease or condition that keeps them from working, do you cut off communication?

No, what we usually see are get well cards and continuous encouragement for a quick painless recovery from the company. Why should a work injury be treated any differently? Think about it.

Need to make a change to your process?

If any of this has struck a chord, it may be worth taking a closer look at your workers compensation claims handling process and the employee experience throughout the life of the claim.  Ensuring this is as smooth as possible for the employee (instead of reverting to a combative mindset) and showing them that you care often leads to better outcomes of all parties involved.

HNI is ready to assist if your organization is ready to make some positive changes to develop a more employee focused injury recovery program. You will certainly see the financial impact that these changes will have.

 

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