Crystal Eastman chronicled the distress of injured workers before the sweeping reforms of the 1910s. Arthur Lawson created a national body of legal thought in the mid-20th century. Today, insurer medical director Gary Franklin tenaciously advocates for better controls over narcotics use.
Workers' comp goes through cycles of stability and upheaval and then returns to stability, or possibly, inertia. An injury risk appears to multiply, such as carpal tunnel, and medical entrepreneurs offer a satchel of cures. This season's epidemic is chronic pain.
A lesson from the past is that major socio-economic turning points have an effect on workers' comp. Today, we need to take into account the massive increase in healthcare costs and the hard right turn in political sentiment.
Employer costs of employer-sponsored health insurance have more than doubled in the past 10 years. Chronic conditions and personal health behaviors inextricably link all employee health-related risks.
The case for a unified employer approach to all employee benefits is strong. Employers will increasingly meld their workers' comp program with other benefit programs.
A valuable source of insight about this unified approach is the San Francisco-based Integrated Benefits Institute, which for years has collaborated with employers and top researchers to illuminate the path of integration.
Another turning point is the rise of political conservatism. I am waiting for conservatives to discover that workers' comp represents everything they loathe about public mandates. I would not be surprised to find proposals in other states modeled after Texas' opt-out law for workers' comp. Oklahoma is already considering such a move.
I don't know if I want to admire or knock the Texas opt-out law. On the one hand, employers say it benefits both worker and employer. On the other hand, some employers will intimidate workers by ignoring their injury. No one in Texas appears to have studied the impact of opt-out on injured workers.
How might your work change if every employer could opt out of the workers' comp system?
Studying history should be a process of looking more carefully at the world and at ourselves. We should try to distance ourselves from our assumptions. Predictive analysis in prevention and claims management is similar to studying history in that it gets us to think more carefully.
Predictive analytics for claims typically involves the design of complex software that subjects each claim to a battery of questions.
The fruitful part of the exercise is selecting the questions. How practical can you be? One recent study recommends asking just one question to predict delayed recovery. It is, "How do you feel you are recovering from your injury?"
Take a moment to jot down what questions you would ask. Then pick just one. Explain to yourself why you chose that one.
We often talk about workers' comp opaquely. My year of history has me thinking more clearly and comprehensively about workers' comp.
PETER ROUSMANIERE is an expert on the workers' compensation industry. He can be reached at firstname.lastname@example.org.
December 1, 2011
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