Non-Legislative Paths to Fix Workers’ Comp
Workers’ compensation has long been a burden to nearly all parties involved in the process. Be it the employer, injured employee or insurance company, few feel like they’re getting the fair end of the deal. It’s no surprise states across the country are taking a stab at legislative changes to improve the workers’ compensation system.
Consider Tennessee. Not even a year after enacting workers’ comp reform, legislators are proposing to allow private employers to opt out of the traditional workers’ compensation plans in favor of writing their own rules.
While the driving force is to reduce the high costs typically associated with workers’ comp claims, it should be known that legislation is far from the only way to curb these costs. While there are multiple proactive back-end strategies, one of the most effective methods to significantly reduce claims costs is to enforce a well-defined modified duty program.
Beating Time, Saving Money, Reducing Risk With Modified Duty
Time is the main culprit behind the high cost of workers’ comp. When employees remain off the clock, the financial burden of a claim quickly snowballs. Consider that lost time alone accounts for about 94 percent of typical claim costs. Implementing a modified duty program to get injured employees back to work sooner – even in a limited physical capacity – is essential to addressing this costly problem.
Not only does indemnity increase with every day an injured employee remains at home, it also becomes more likely that other issues will arise that can compound costs. Injured employees who remain at home for long periods of time to heal are more likely to fall victim to depression, weight gain or prolonged healing from remaining inactive, which in turn, keeps medical expenses and lost time expenses accumulating.
Without modified duty, costly litigation is also more likely to happen because of secondary medical issues arising or the breakdown of employer communication that can occur when an employee is out of the office.
Yet, a pre-determined, stringent modified duty allows injured employees to heal in a manner that:
- is approved by a physician
- gets an injured employee physically active and socially stimulated
- keeps communication open with employers and
- demonstrates value to judicial and medical officials as permanent or temporary impairment ratings are delivered.
It’s important for a modified duty program to be in place before an employee gets injured to eliminate confusion and, ultimately, prevent additional lost time.
Work with employers to create modified job descriptions that accommodate a wide variety of injuries, including the inability to use one’s back, hands or legs, and keep them accountable to the program. Even if an injured employee does not live in the same area as the employer, as is often the case with truck drivers, for instance, he may be able to perform work for a local non-profit agency as a way to earn credit for modified duty.
While modified duty may be just one cog in the machine to reduce workers’ compensation claims costs, it can be the key to reducing significant expenses, removing the need for a legislative crutch.
Firm, Fair and Friendly
When we think of brand we tend to think of a company’s crafted image or marketing message. But it’s been my experience that a workers’ compensation program can have a brand.
Mine is “Firm, Fair and Friendly.” Do you know what yours is?
If your brand is Delay, Deny and Defend then perhaps you should read on!
Chances are your company has a mission statement. How does your program fit into that framework?
Most companies articulate their ethical business practices and respect for customers, vendors and employees. Are you following those statements?
Close your eyes for a minute and imagine how you would describe your workers’ compensation program. If you can’t find the words then you most likely do not have a brand.
I have always felt that workers’ compensation walks a tight rope.
I have seen every sort of program. Some fight everything, some accept everything and some ignore the whole thing.
At some point in the process we see employees becoming claimants and litigants and the employer the defendant.
At the root of it all, is the employer-employee relationship. Regardless of the claim’s details, the employment relationship is changed and needs to be managed.
I have always felt that workers’ compensation walks a tight rope. To maintain balance, about 10 years ago I began to work in an environment that I describe as FIRM, FAIR and FRIENDLY. Since that time, I have worked to maintain that brand.
That means being…
FIRM in the jurisdiction in which you do business, keeping to the local jurisdictional differences and not merging multiple jurisdictions into one program.
FAIR in the way everyone is treated. The same process applies regardless of who you are, what you do for the company or how long you have been an employee.
FRIENDLY in helping each employee manage their own recovery and return to work. That means providing all necessary information to help them navigate the process, including knowing the benefit programs that accompany workers’ compensation.
If FMLA is involved along with any other disability programs, help the injured worker coordinate what is needed. The fewer problems they have the fewer issues arise in the claim. The more information you give them the more comfortable they are.
The brand works for all decisions and each interaction. Before a task is done or letter is sent I can ask myself if I am being FIRM, FAIR and FRIENDLY.
If I am not, I re-write the letter or think about another way to do something. The last part of FRIENDLY that we have to think about is the language we use to talk about claims, employees, lawyers and adjusters.
Watch for negative language in everything you do. Employees should always be employees, lawyers should be legal counsel and the employer should be the employer.
If we start to refer to employees in negative terms then we have lost the respect that each of us deserves. If we remember that the claim is a life altering event for the employee, perhaps we will be more FRIENDLY, FAIR and FIRM.
RIMS Recap: Tech Trends that Could Change Everything
Last month, Gordon Clemons, CEO and Chairman of CorVel Corporation, presented at the RIMS Conference in New Orleans, La. about emerging technology and how it is impacting risk management and workers’ compensation. The discussion served as a springboard for new insights on how technology will change the industry, and reaffirmed the need for integrated systems and human interaction for the best results.
The presentation noted the future is here – and technology is constantly evolving in hopes of outpacing tomorrow’s needs. As these technology platforms become more inherent in daily life, the gap in translating their utilization to workers’ compensation will begin to close.
Technology in Healthcare
While many consumer-based technology advancements exist in other industries, perhaps most notably in the retail space helping vendors to reduce various delays in the sales experience, people may forget that healthcare, too, is a consumer industry. And as such, healthcare also experiences workflow lags, which can be collapsed.
While patients and claims may not lend themselves as freely to mobile applications and technology that subscribes to the “Internet of Things” philosophy, the rapid rate of development foretells the not-too-far-off arrival of the “a-ha,” “wow factor”-type application that consumers are seeking in the healthcare industry.
Once we get there, we can only expect that the Pangea of resources will yield better outcomes. The potential impact to medical management includes more affordable/accessible healthcare, patient convenience, personal assistance, automatic inputs to claims systems and less administration from both patients and injured workers.
“Healthcare is stubborn about change. There are more data points in healthcare and there is a greater need for high quality and accuracy,” Clemons said.
Tech Trends for the Next Digital Decade
As an industry advocate in all things innovation, CorVel has been keeping tabs on emerging tech trends. As they begin to influence in other industries, it sparks the question – will they eventually change workers’ compensation?
Here are some of the trends on CorVel’s radar:
Smart phones and tablets were the first mobile devices to really start to gain traction across people’s personal lives. Since then, wearables (like Fitbits and smart watches) have been part of the next digital generation to be taken up by consumers.
As these personal devices quickly advance, wearables could offer payors and employers added insight into the wellness of claimants through the extent of their retrievable data.
Beacons are devices that use low-energy Bluetooth connections to communicate messages or triggers directly to a smart device (such as a phone or tablet). Retailers have started using this technology, sending offers to near-by consumers’ phones. Now the concepts of smart mirrors and smart walls offer a one-stop-shop with recommendations related to the preferences of the shopper – making a hyper-efficient business model. It is possible that we could see these devices adapted to being a catalyst for healthcare’s business model by reducing the delays of administrative work.
Formally known as unmanned aerial vehicles (UAV), drones can be remote-controlled or flown autonomously through pre-defined flight plans within their internal systems. Some carriers are testing the use of drones to potentially be used to evaluate property damage and responding to natural disasters.
As most injuries reported in workers’ compensation are musculoskeletal injuries, the industry lends itself well to the benefits of telecommunications and telemedicine. With the rise of electronic capabilities, telemedicine becomes another option to help guide an injured worker through their entire episode of care, reducing time delays.
In order to get to that point in time, implementing these trends (and those that are yet to be launched) will only be as successful as the population willing to accept them. Buy-in will require a commitment to the long-standing pillars of the industry. According to Clemons, “While technology can truly move the needle in workers’ compensation, it will take more than bells and whistles to maximize its impact.”
“People’s feelings are valid. The skepticism surrounding new technology is not misplaced, but neither is the enthusiasm,” Clemons said.
New Trends, Same Priorities
Beyond the buzzwords and hype surrounding the latest apps and devices, for new technology to succeed within the workers’ compensation realm, it boils down to the two primary concepts that drive the industry to begin with – effective infrastructure and a people-first philosophy.
The power of applicable resources and the actionable data that results from them is in the foundation of the systems themselves; that primarily being through the influence of integration. It is not a new concept; however, as technology advances and the reach of analytic capabilities broadens, it is important to find a provider that can harness this data and channel it into effective workflows to increase efficiencies and promote better outcomes.
CorVel’s proprietary claims management system has been developed and supported by an in-house, full-time information systems division to be intuitive and user-friendly. Complex, proprietary algorithms link codified data across the system, facilitating collaboration between services, workflows, customers, and technology and eliminating the risk that a crucial piece of information will be missed. The result is an active “ecosystem” providing customers with actionable data to provide the most accurate, comprehensive picture at any time, while also collapsing inherent delays.
For the injured worker, the critical human touch connection in the workers’ compensation process can never be minimized. By cutting lag time throughout the various inefficiencies underlying the industry’s workflows, CorVel can connect injured workers with quality care sooner. As systems advance, claims and managed care associates do not have to spend as much time on administrative work and will instead be able to devote more time to the injured workers, reviving the human touch aspect that is just as impactful within the industry.
Regardless of the technology that lies ahead, CorVel looks to the future with investments in innovation, while not losing sight of their role and responsibility to clients and patients. Dedicated to constant improvement for the services they provide injured workers and industry payors, CorVel is committed to improving industry services one app, click, drone (or whatever is yet to come) at a time – perhaps something to discuss in San Diego at next year’s RIMS conference.
For more information, visit corvel.com.
This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with CorVel Corporation. The editorial staff of Risk & Insurance had no role in its preparation.