Social Barriers to an Injured Worker’s Recovery

We know that health is determined by more than just access to quality medical care. Social factors such as poverty, housing, and education can significantly impact health outcomes. These factors are known as the social determinants of health (SDOH). At the 2022 WCR Conference, a group of panelists discussed these social barriers to recovery and how we can help injured workers overcome them. The speakers included:

• Rafael Gonzalez, Esq. – Cattie & Gonzalez, PLLC
• Debra Livingston – CEO, ReEmployability
• Chad Beinschroth – Claims Manager, ABM

Addressing Social Determinants of Health

Accounting for up to 80% of the overall health of an individual, SDOH can act as barriers to recovery from illness or injury, and they can also contribute to chronic conditions. In order to address SDOH, it is essential to take a whole-person approach to health. This means considering each individual’s physical, mental and social needs. Economic factors such as income and employment are key drivers of healthcare outcomes. The good news is that there are proven tools and techniques that can be used to improve health outcomes for individuals and communities. By using screening tools to identify SDOH and using first points of contact to assess critical indicators, we can make a real difference in the lives of those we serve.

SDOH Impact on Claims

A lost time workers’ compensation claim will result an immediate loss of income for an injured worker. Since wage replacement benefits are consistently less than what they earned while employed, it can cause a financial hardship. Economic stability is always a priority for an injured worker on a limited income, so they are typically focused on affording basic needs, like rent or groceries. With little understanding of the workers’ compensation system and stretched resources, a fearful injured worker’s claim may escalate to litigation.

Communication with injured workers is so important to the overall success of the claims process. There needs to be regular conversations with the injured worker from both the adjuster and the employer. Ask open-ended questions to encourage the worker to speak and listen carefully so they can express their thoughts, fears and concerns.

Higher-wage earners’ workers’ compensation benefits will be significantly less than their usual pay, but they may be eligible for additional benefits through their employer’s group benefits or qualify for various state or federal aid programs. Employers and carriers can investigate further sources of income supplementing to assist the worker and keep the claim out of litigation. Additionally, HR professionals should be knowledgeable of the social programs available in their community that may be helpful.