Tips on Managing Worker’s Compensation Claims Effectively – for Claims Adjusters

Tips on Managing Worker’s Compensation Claims Effectively – for Claims Adjusters

The goal of worker’s compensation is to assist the injured worker during recovery and ultimately see them return to work at some capacity. This series is designed to give those involved in a worker’s compensation claim direction on how to handle a claim from the beginning. This is the 4^th and final post in the series. The first focused on case managers.

Interacting with an injured worker

• It is normal for recovery to be affected by things that don’t have anything to do with work or the injury[i]. Therefore, it is important to build a positive relationship with the claimant, help them understand how the claims process works, and be available for their questions.
• The first conversation you have with an injured worker creates a lasting impression. If you allow the claimant to feel blamed for their injury or illness, you may be contributing to a prolonged claim or paving the way for future litigation[ii].
• The more in control the claimant feels, the more likely they are to return to work. Find things the claimant can control and share options with them. Make sure they understand their rights and options in the process of their claim[iii].
• Be aware that the claimant needs to heal mentally, even if the injury is physical. Encourage the claimant to ask for advice about psychological treatment and mind-body therapies such as yoga. Exercise, healthy relationships and hobbies can also improve their well-beingⁱⁱⁱ.

Preparing for return to work

• It is important for the claimant to understand the process of returning to work early in the life of the claim, so they can prepare for itⁱⁱⁱ.
• During the claim, a plan should be in place for the claimant to prepare for their return to work. Not everyone is able to return to work at full duty. Because of this, a graduated return to work plan with identified goals should be set up early in the claim and be updated as they get closer to returning to work[iv].
• Once the claimant is ready to return to work, a plan with modified work duties should be set up with the input of the claimant, their doctor, and their employer^iv.

[i] Let’s get loud

[ii] Top ten tips for preventing long term claims

[iii] Case Study: Cool, calm and in control

[iv] The importance of early return to productive and full time duties

About the Author: Jessica Stogsdill has been working in the mental health field for the past 2 years. She earned her Bachelor of science degree in Psychology in 2011 and her Masters of Social Work degree in 2015 both from Grand Valley State University. She completed her internship with Ottawa County Community Mental Health’s Assertive Community Treatment Team in her final year of graduate school. As an intern, Jessica was able to participate in a wide range of experiences with the severely mentally ill population related to improving function, education, assessment, and building rapport in the community. Upon graduating she began working as a telephonic clinician in the Productivity Assurance Call Center (PACC) at R3 Continuum, where she has been since 2015. Jessica has been trained in critical incident response (CIR) and provides telephonic support daily to individuals as well as to groups. She coordinates with other professionals and builds relationships with employees to facilitate their improvement in functioning so the employees can return to work and to their lives.