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

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 2^nd post in the series. The first focused on case managers.

Be prepared

• Apply policies consistently and fairly. Perceived unfairness breeds resentment that prolongs claims[i].
• Train supervisors in return to work management. The relationship between the injured worker and their supervisor has a huge impact on return to work. Poor relationships often lead to drawn-out claimsⁱ.
• Psychological factors impact physical claims. Don’t ignore social, emotional or relationship issues[ii].

When an injury happens: the immediate response

• If you have a return to work coordinator, contact them immediately[iii].
• Avoid treating an injured employee with suspicion. Give the employee clear, constructive advice on the process. Let them know their rights and responsibilitiesⁱⁱⁱ.
• Respond appropriately in the first 5 minutes and the first 24 hours. The first conversation you have with an injured worker creates a lasting impression. Be supportive and helpful. If you let blame and resentment color the initial interaction, you may be contributing to a prolonged time off – with less chance of returnⁱ.
• Be open to discuss the needs or desires of employees – don’t push them away for the sake of “how we’ve always done things.” If their request isn’t possible, offer a fair explanation of why and discuss other ways to help them get what they’re looking for[iv].

Supporting your employee throughout the process

• Be supportive and non-judgmentalⁱⁱⁱ.
• Allow the employee to feel as in control as possible. The more in control your employee feels, the more likely they are to return to work. Ask what they need and make accommodations as possible. When not possible, explain why and work towards a mutually agreeable compromise[v].
• Discuss issues to discover root causes. Don’t ignore non-physical issues that may exacerbate the injury or may be part of the root causeⁱⁱ.

While an employee is off work

• Maintain contact. This helps the injured worker feel they’re still connected to the workplaceⁱⁱⁱ, increasing likelihood of return to work and easing the transitionⁱ.
• Talk with the employee post-injury. Ask how recovery is going. Address any questions or concerns. Don’t pressure them to return to workⁱⁱⁱ. Ask how the organization can support themⁱ.
• The injured worker 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^v.
• Show appreciation for employees helping out in the absence of the injured worker. Provide compensation for extra work when appropriateⁱⁱⁱ.

Preparing for the employee’s return to work

• Avoid an adversarial approach. Work with coworkers, unions, and doctors. Perception impacts claim durationⁱ.
• Communication is important. Get everyone working together towards a common goal[vi]. Understand your role in the process. Be open about what parts you control^v.
• Be flexible. Though the goal is to return the employee to their original role, alternate duties or reduced hours are often necessary during recoveryⁱ.
• Encourage the worker to participate in developing their return to work plan. Injured workers don’t have to be 100% recovered to return to work. Participating in the workplace improves recovery timesⁱⁱⁱ.

Establishing modified duties

• Be open to a graduated return to work plan with identified goals initially[vii].
• Be open to modified duties and creative solutions when it comes to physical injuries and pain^vii. Provide a job description for the employee to use to create their modified duty with their doctor/counselor/adjuster[viii].
• Focus on what the worker can do rather than what they can’tⁱⁱⁱ. Injuries may require creative thinking to get the employee back to work. Keep in mind when a piece of equipment is required for an employee to return to work, it’s possible other employees could use the same equipment to prevent future injuries^vi.

The employee’s return to work

• Psychological issues may occur if an employee’s return isn’t handled appropriately. Make sure to check in with the employee and make accommodations as necessary. Communicate with other employees what is going on and why the employee has modified duties so no one cries “unfair”^iv.
• Have a plan for the employee’s first day and first week back. Create a supportive, positive working environment for the employee. Review their progress at the end of the first day. Make sure they don’t push too hard too early. Stay alert for signs of the injury recurring or flaring upⁱⁱⁱ.
• Watch for signs that worker restrictions may be too restrictive or not restrictive enough. Signs of being too restrictive may include: boredom, frustration, and lack of productivity. Help them try out tasks to create the right restrictions at that moment^viii.
• Communicate safety procedures clearly with returning employeesⁱⁱ.

Working with an employee who is on modified duties going forward

• Return to work duties are an ongoing discussion. Hold regular check-ins with everyone involved to make sure restrictions or duties are appropriate as the employee continues to re-integrate. See how the employee is coping and address their questions and concerns. As their condition improves, upgrade their duties accordinglyⁱⁱⁱ.
• If the employee is not making progress, try to identify contributing factors (unsuitable job, lack of co-worker support, fear of re-injury, blame, resentment, other psychosocial factors)ⁱⁱⁱ.

 

[i] Top ten tips for preventing long term claims

[ii] Manage people, not musculoskeletal symptoms

[iii] Role Summary: Supervisors

[iv] Workplace culture: what’s everyone talking about?

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

[vi] Returning to hard work

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

[viii] Let’s get loud

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.