At the 2018 CLM / Business Insurance Workers’ Compensation Conference a panel discussed advocacy and employee engagement in your workers’ compensation program. The panel included:
- Kimberly George – SVP, Corporate Development, M&A and Healthcare, Sedgwick
- Laurie Frey – Manager of Workers’ Compensation, Kohl’s
- Jim Roach – Attorney, Hennessy & Roach PC
- Nancy Strubler – Director of Workers’ Compensation, National Express Company
What does advocacy mean to you and why it is important?
- This is about having your associates fully engaged in the claim process. We want to give our associates all the resources we would want available to us in the same situation.
- This is a seismic shift when have seen in our industry where the focus has changed from simply costs to outcomes. I like the term engagement better than advocacy. The data shows better engaged employees perform better, whether that is at work or as part of the claims management process. Treating people the right way gives better outcomes on claims, which ultimately leads to lower cost.
- Engaged employees have a better attitude about their claims. This can lead to less litigation, and studies show litigated claims have much higher costs including duration of disability.
- The indirect costs of workers’ compensation claims in terms of lost productivity, morale, etc are much higher than the direct claims costs. Anything you can do to lower claims costs is going to have an even larger impact on your organization.
- We have evolved from an “us vs. them” approach on claims to one where we try to emphasize taking care of our employees and getting them back to work as soon as possible.
- Traditional claims management programs were designed around the small percentage of claims looking to abuse the system rather than the vast majority of injured workers just looking to get better and go back to work. Advocacy means trying to focus on the positive things and the majority of your claims. Focusing on paying claims rather than denying them.
- Advocacy programs not only help in terms of claims costs, but also with lowering the turnover of adjusters and them having higher job satisfaction. Employees want to do meaningful work, be part of a team, and help people.
How did you implement this?
- This started with our return to work program. We wanted to make sure our workers’ compensation return to work program completely aligned with our ADA/FMLA and leave of absence programs on the non-occupational side. We try to get the injured workers back to work as soon as possible and the risk management department subsidies the workers’ payroll in the store while they are working a temporary modified duty position.
- We are in 37 states with over 200 locations. The first step we needed to take was a standardized approach on how claims were handled from the start. We are using a telephonic nurse triage program on all claims which gives all our employees the opportunity to speak to a medical professional. About 25% of the cases resolve fully with self-care as instructed by the nurse. Our employees like that they get to speak to a nurse immediately and they feel cared for. They have seen a significant reduction in their claims since starting this program.
- Some employers have implemented self-reporting programs for their workers’ compensation claims. We self-report our group health and group disability claims, why does it take a supervisor to report a workers’ compensation claim. The self reporting makes the claim less adversarial from the beginning and engages the employee in the claims process.
- Providing onsite physical therapy at manufacturing locations is a way to engage more with your workforce as these programs can work with associates on a daily basis to aid in injury prevention.
- Telemedicine can be a very helpful tool when your facility is not located near appropriate medical care.
- This tends to be a reflection of your overall workplace culture. If your employees do not feel respected and that the company cares about them, then it will have an impact on your claims and your claims handling program.
- Most of our employees are part-time and do not have health insurance provided by us. Because of this, managing co-morbidities can be a big challenge on our claims. Implementing a wellness program in the workplace can assist with this, and also show your employees that you care about their overall health and wellbeing. If you have health insurance, most of these programs will cover the costs of these wellness programs as they are a great tool to improve overall employee health in your workplace.
- We are partnering very closely with our Human Resources team on the health and wellness side. For example, you may have access to free programs on back injury prevention on the group health side that can benefit your workers’ compensation program. Take advantage of the programs that are already available to your associates which they may not be utilizing.
- We saw a 40% reduction in our workers’ compensation costs after implementing our program partnering with our HR side on leave of absence and taking advantage of group health resources. At the same time our group health costs remained flat.
- You need to make sure you find a way to fully engage your employees in the field in your efforts, especially management personnel. It can help to have a dedicated workers’ compensation champion at each site to help facility things. That is the key to making the advocacy/engagement program work well.
A great resource on this topic is on the Alliance of Women in Workers’ Compensation web site. On their home page is a white paper on the topic of creating an advocacy based claims model.