Advocacy Model vs. Workers Comp Adjuster Goals – A Point Missed?
Did I miss The Point – Maybe?
I recently attended a webinar provided by the National Workers Comp and Disability Conference where some of the Workers Adjuster goals were compared to the expectations of claims management.
Two of my favorite workers comp people, Rachel Fikes of Medical Rising and Denise Zoe Algire of Albertsons Companies led the event. Those two ladies have always been kind and gracious to me at all times, especially in-person.
I had written multiple articles pleading with adjusters to fill out the surveys to voice the claims staffs’ opinions on what their goals were during the process of a claim.
You can sign up here to listen to the webinar – totally worth it if you are in a claims office or if you have any interactions with workers comp adjusters.
The Survey Says (thanks Richard Dawson)
The shocking part was the congruence (similarity) between claims management expectations and the workers comp adjuster goals. Slide #6 had the Top Competencies Alignment between management and the claims staff. You will need to register to listen to a recording of the conference and to obtain the slides, please do listen to it – take the time.
The conversation in the webinar focused on:
• Alignment of frontline staff perspectives with those of claims leaders surveyed in prior years
• Assessment of job meaningfulness
• Ranking of company benefits that frontline staff most value
• Adequacy of new hire and senior staff training
• Ranking of core competencies and key practices most critical to claim outcomes – the one I am covering today.
• Assessment of technology and data’s impact on job performance
• Understanding of advocacy-based claims models
Frontline Staff Rankings
- Compensability Investigations
- Disability / RTW Management
- Medical Management
- Claim Resolution / Settlement Strategy
As one can see, these are the steps to “getting the claim off my list”. I could possibly be too “old school” in my views, but this is what I always hear from any adjuster that I speak with presently.
If one opens up any workers comp claims manual, the above 4 are major headings in the manual. The survey was spot-on to ask those questions (good job).
Yes, we all want to make sure the injured worker receives every penny they are owed timely. Many states are now ratcheting up the investigations and fines for sloppy or late adjuster benefit actions (payment, filing forms, etc.). The prior link is behind a WorkCompCentral paywall so I cannot share passages from it.
Adjusters want to naturally provide benefits timely. Some of the state-enacted COVID-19 presumptions made adjusting staffs look like draconian claim deniers – very unfortunate. Occupational disease statutes have long taken care of claimants when a disease has been contracted on the job.
Did Claims Management And Workers Comp Adjuster Goals Align?
As with any survey, the opportunity to dig deeper exists. I hope to see the question of Workers Comp Claims management and adjuster goals have a further explanation to it.
Good job – the survey and results production required a ton of hard work.
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