WCRI’s Newest Study on Psychosocial Factors – My Take On Claims Management
WCRI (Workers Compensation Research Institute) recently released the results of their newest study on how psychosocial factors have a direct correlation to the outcome of Workers Comp claims. They interviewed stakeholders in the Workers Comp claim process. I decided to take a different angle – with the same conclusions.
I have written many times about the cost/benefit of using Field Case Managers (Rehab Nurses) on new Workers’ Compensation claims. See the end of this article for a list of links to those articles and the link to the WCRI Study.
My rule was always-
If the injured employee was going to be out long enough to make the waiting period payable – usually 14 or 21 calendar days, I recommended a limited Rehab Nurse assignment at a minimum.
Assessing Psychosocial Factors Is Not Spying
When reading over the initial Rehab Nurse reports, I always read what was going on with the injured worker’s life before the injury. The Rehab Nurse would often meet the injured employee at their home.
Even if they met outside the home, the initial interviews almost always seemed to be a precursor to how the claim would progress when trying to return them to gainful employment. The psychosocial factors caused me to modify my claims handling procedures away from the “one size fits all” approach.
An initial adjuster call and mailing the injured employee a claims packet does little to establish trust with their future claim developments. WCRI’s groundbreaking studies where they interviewed injured employees after their return to work established one huge concept – TRUST.
If the injured employees TRUSTED their employer before the claim occurred, then the outcomes were much more positive. I added that link to the list at the end of this article.
We all know that being injured at work turns an employee’s life upside down at the beginning of the claim.
The injured worker’s attorney would seldom interject their concern about retaining their client’s privacy. I found an explanatory phone call to the attorney with a guarantee to cc: the attorney on all reports worked well. Many states now require filing a form to apprise all parties that a Rehab Nurse was being assigned to the file.