Workers’ compensation began as a system for injured workers in the early 1900s. Since that time we have seen numerous changes within each state system evolving to where we are today; however, the basic construct of workers’ compensation has remained the same. The last several years have ushered in many new practices within the workers’ compensation systems, some significant with others merely inconvenient, yet all have forced change in some fashion. At the 2022 Workers’ Compensation Institute Conference in Orlando, a panel of claims experts discussed how employers can prepare for these changes to ensure that their programs are achieving positive outcomes for all involved. Speakers included:
- Moderator: K. Max Koonce – Chief Claims Officer, Sedgwick
- Teresa Gunter – Senior Claims Manager, The Adecco Group
- Debra Howie – Systems Director, Workers’ Compensation Claim Operations, CommonSpirit Health
Significant Pandemic-Related Impacts to Workers’ Compensation
1. Workforce Changes
At its peak, unemployment reached over 13%, but it is now back below 4%. Some studies showed over three million people left the workforce during the pandemic, and now there are more job openings than job seeking candidates. One of the results of these changes was a less experienced workforce. Historically, accident frequency is higher for newer employees and this matches current trends.
2. Healthcare Industry
Positive perceptions of the healthcare industry have been diminished as the public dealt with constantly changing COVID-19 guidelines. However, utilization of telehealth increased significantly during the pandemic, which was an outcome of the industry pivoting. While telehealth usage has dropped, current user figures are still more than double what they were pre-pandemic.
Eighteen states passed some form of workers’ compensation presumptions related to COVID-19 claims with some of these presumptions extending into this year and beyond. It is unprecedented to have a widely spreading infectious disease be mandated as compensable under workers’ compensation.
Technology use in workers’ compensation has been growing for some time, but usage has increased significantly over the last two years. This includes greater use of modeling to assist in making informed claims handling decisions.
Q: Your companies were considered essential businesses. How did you work through COVID-19 changes?
A: As a staffing agency we were not just dealing with the COVID guidelines we required, but the requirements of our clients. We had to make sure our clients were following CDC guidelines and meeting our expectations for our employees. The pandemic created a temporary spike in the need for temp employees to perform healthcare tasks like taking temperatures at building entrances and assisting in vaccine clinics. Their overall claims counts dropped because of business closures which allowed them to focus on getting their older legacy claims closed down.
A: Even though healthcare workers were essential employees, most healthcare systems had to furlough workers early in the pandemic because patients were not coming in for routine care or other services. It was not until late 2021 that their patient volume returned to pre-pandemic levels. One job that dramatically changed during the pandemic was employee health nurses. They had to do all the screening and contract tracing for COVID. They operate in 21 states and are still seeing a significant number of COVID claims, especially in the western states that have COVID presumptions for healthcare workers.
Q: How have employee expectations changed after the pandemic?
A: Employees expect to be safe in their work environment. This is not new, but there is a heightened awareness of this new. The average age of our nurses is 52 years old. That means we have a lot of employees nearing retirement age. Because of this, staffing challenges in the healthcare industry are going to continue. There also seems to be an expectation that the workplace is responsible for degenerative conditions with more people filing claims for “repetitive trauma”.
A: With a shortage of workers, there is more of a focus on employee experience and work/life balance. Workers have much more power than ever before. Workers who were out of the workforce for a period of time are often deconditioned, which is leading to more injuries. Mental health is a much bigger issue than ever before. Employers need to pay more attention to the mental health resources they are providing.
Q: What changes are you seeing in regards to healthcare?
A: Telehealth adoption is still lower than expected. Patient safety and employee safety are closely tied together. Finding medical providers to treat injured workers is very challenging especially in some rural areas. Healthcare works better when the patient has an advocate to assist them. This is true on the workers’ compensation side and the group health side.
A: Our telehealth usage increased by 10%. That was very significant for us. We established a centralized reporting procedure using nurse triage to ensure they get the correct care at the correct place initially after the claim occurs.
Q: Why are physicians reluctant to treat workers’ compensation patients?
A: Many physicians do not like to deal with the paperwork and billing issues associated with workers’ compensation. Also, many are concerned that the workers’ compensation claim may end up with litigation and they don’t want to be involved in things like depositions.