It’s refreshing to hear the term, “patient advocacy” used in the workers’ compensation industry. There was a time when the workers’ compensation system seemed more adversarial than supportive toward injured workers.
Getting injured at work and beginning down the workers’ compensation path can be a scary and intimidating journey. Most injured workers don’t know what to expect. They are contacted by strangers asking all kinds of questions about the injury. They may be told that their choice of physician is limited or that their treatment must be approved before they can proceed. Their employer may express suspicion about the injury instead of offering compassion. The injured worker can easily feel alone and unsupported. History has demonstrated that when an injured worker feels this way, many will turn to attorneys for support. Medical and indemnity costs, therefore, rise accordingly.
So, what does patient advocacy in workers’ compensation actually mean? In literal terms it means “injured worker supporter.” When the workers’ compensation system supports the injured worker, he or she is far less likely to seek an attorney and more likely to return to work. That helps to keep claim costs lower.
Three steps need to be taken if patient advocacy is to occur. First, everyone involved in the claim process (employer, physician, claim representative, case manager, etc.) must have an unwavering focus on return to work. Second, trust must be developed with the injured worker. And third, all parties involved– especially the employer–must keep the injured worker engaged throughout the return-to-work process.
All medical and rehabilitative aspects of the post injury process must occur with one end game in mind: keeping return to work clearly in the injured workers’ sights.
In most cases, it’s not a question of “if” they are going back to work, it’s “when. Injured workers might be afraid their employer may not want them back at work and wonder how they will provide for themselves and their loved ones. They may also worry about the injury keeping them from doing the activities they enjoy. Recent headlines underscore those fears:
“40% of Americans (are) only one missed paycheck away from poverty”- CBS News Money Watch 1/27/19
“Most Americans don’t have savings to cover a $1000 emergency”- CNBC 1/23/19
Most injured workers don’t want to lose time from work. Therefore, a system that demonstrates that recovery and returning to work are the primary focus is a system that addresses and overcomes the injured worker’s greatest concerns.
Building trust is paramount. Navigating the workers’ compensation system is most certainly unfamiliar territory for most injured workers.
Employers can earn trust immediately by reacting with compassion to a worker who reports an injury. When an employer believes the injury is real and reassures an injured worker that he or she is a valued member of the workforce, the employee is more likely to remain motivated to get back to work as soon as possible.
At the claim level, trust is developed when the claim representative clearly establishes the expectations, including injured worker rights and responsibilities, and then follows through. Trust is reinforced when indemnity checks arrive on time and the claim representative is responsive to questions or concerns.
At the case management level, trust is earned when the case manager offers an empathetic ear, clarifies medical treatment options and coordinates travel arrangements or accelerates appointments. Trust is further solidified when nurse case managers attend medical appointments and remind the treating physician that transitional work is available.
Helping to make injured workers feel valued and an integral part of their recovery and return-to-work process is critically important. A weekly phone call, text message, or handwritten note from the employer showing concern and the desire to have the injured worker back to work as soon as he or she is able makes all the difference. It is essential that injured workers feel connected to their employer in a positive way from the time of injury until they return to work.
The late Bertram J. Black made the best argument for advocacy when he wrote, “To work is to be needed and to be needed is essential for life.” That philosophy is the essence of workers’ compensation insurance today.
This article, written by our CEO Sebastian Grasso, can also be found in the Spring Edition of The Connection Magazine. Navigate to the article here and explore some of the most intuitive perspectives from experts in the workers’ comp industry.