By PETER ROUSMANIERE, an expert on the workers' compensation industry
What's a succinct way to describe the field of workers' compensation to laypeople, such as a neighbor or a fellow passenger on an airplane? Here are some tips from workers' comp experts who've had years of practice.
The first bit of advice is to be prepared to correct some basic misconceptions about workers' compensation, even among those who may have direct experience with the system.
Joe Mullens, a Portland, Ore., based owner of an eponymous comp consultancy, is particularly alert of wrong perceptions among employers.
"I still see some that still think the injured employee is not their responsibility. Agents should spend more time educating employers as to what the impact injuries will have on their business," he warned.
Cecil Rudd, being director of claims at New Mexico Mutual, knows how workers can get the wrong idea.
"The greatest misconception is that the doctor works for the insurance company and can't be trusted. The second greatest misconception is that the injury requires more time to heal because the employer or insurer is paying for it," he said.
When having conversations about workers' comp with people who are even less accustomed to it, misconceptions can range farther afield.
Many outside the field are puzzled about the lack of inclusion of workers' compensation's medical benefits within health insurance. This year the governor and state legislature of Vermont ordered a study of why these medical benefits should not be merged. They are looking for answers.
Richard Victor, executive director of the Cambridge, Mass.-based Workers' Compensation Research Institute (WCRI), had a response ready: "Divorcing the responsibility for medical care from that for return-to-work would be costly to both workers and employers. In other countries that have done so, the payer of disability income benefits has to find alternative arrangements to get workers needed care in a timely manner or return-to-work suffers."
Laypeople, not necessarily politicians, have told Julie Fortune, senior vice president and chief claims officer of Charlotte-based Arrowpoint Capital, that they thought that state agencies are in control and that workers' compensation benefits are funded through a payroll tax deduction. Others thought that a workers' compensation program is the same as their employer's disability insurance program and Social Security disability, or that the benefit is the result of union membership.
CLEARING UP MISCONCEPTIONS
At a cocktail party or children's birthday party, perhaps the best way for workers' comp professionals to enlighten others about their business is to use the analogy of no-fault auto insurance, in that "an accident happens, but who is at fault does not matter," as Rudd explains.
"If Joe gets hurt while at work, he can receive medical care and lost wage consideration while he recovers without fear of losing his job," Rudd said. "In like manner, the employer can help Joe receive proper medical attention and lost-wage consideration and not have to worry about Joe suing him for getting hurt on the employer's premises or at the employer's direction."
Mullens also likes the auto insurance analogy.
"If you have too many fender benders, your insurance goes up. If you have a couple of major car accidents, you may get cancelled and then have to pay extra fees just to get insurance," he put it.
"If you are an employer that could care less about injuries, then workers' comp is basically designed to put you out of business. But if you do an outstanding job in assuring that your employees are safe and free from accidents, you will be rewarded with low premiums," he continued.
The WCRI's Victor would educate laypeople using more scholarly terms.
"It provides medical care, income security and return-to-work assistance to millions of workers each year," he said. "The costs are paid by employers, affecting the competitiveness of American business in the global marketplace. The benefits and rules are set by statute and regulation. However, the delivery system is privatized. This is unique among social programs. "
And as for anyone who thinks the workers' comp system is stacked against the worker, take what Fortune might tell laypeople.
"The burden of proof is for the injured worker to demonstrate that the injury was work related. The proof threshold is relatively low, which makes it difficult for the employer to prove that the injury was not the result of work," she said.
Read more at the WorkersComp Forum homepage.
July 13, 2011
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