Suffering a workplace injury can be a very stressful experience. Going from fully functional to incapacitated in the blink of an eye, combined with angst and uncertainty about the future, makes for a very difficult time for an injured worker.
Adding more pressure to an already challenging situation is the complicated workers’ compensation system, which can be confusing to navigate. In the traditional model, many injured on the job were left feeling that their overall well-being was dismissed, while all that mattered was the operational impact. Today, employers and service providers are leaning into an advocacy-based approach, in which each employee is not just an asset but a human being deserving of empathy and assurance. This blog will highlight some of the ways we can provide injured workers with compassionate care focused on their individual needs.
A hallmark of quality care is ensuring that injured workers have access to the medical resources needed to maximize their recovery, optimize their experience, and produce the best outcome. Sometimes that means guiding them to top-performing physicians with experience in occupational medicine or specialty care; other times, it means advising those with minor injuries to pursue first aid or thoughtful self-care instead of unnecessary, unpleasant and costly trips to an emergency room. Clinical consultation and evaluation at the first notice of injury helps to ensure that appropriate care is delivered at the appropriate time. It also gives injured workers peace of mind they’re doing the right thing, will receive the right care, and won’t have to worry about out-of-pocket treatment costs. With nurses rated as America’s most honest and ethical professionals in Gallup’s survey for more than 20 years, this early engagement can bring added trust to the claim process from the outset.
Case management is another strategy for getting injured workers the care and support they need. Drawing on their clinical training, nurse case managers are ideally positioned to work with treating physicians, employers, claims examiners and others to coordinate proper medical care for injured workers. In case of a severe, complex or catastrophic injury, a field case manager can be on site at the hospital or medical appointment to advocate for the injured worker, help them navigate the health care system, and provide a sympathetic ear. Having a nurse case manager in their corner — whether in person or a phone call away — can make all the difference for an injured worker and their family, who are looking for a personal connection during a very overwhelming time.
Recognizing the need for holistic care following an injury, behavioral health support is a key element of the advocacy model. Behavioral health specialists offer clinical expertise and guidance for injured workers and can help in identifying other related issues that should be addressed to maximize physical and mental/emotional recovery. Behavioral health support is particularly important in claims involving trauma, violence, mass casualties and other catastrophes, or psychosocial concerns like substance abuse, financial difficulties or family/relationship challenges. All of these factors, as well as anxiety or fear about returning to work, can impede healing and negatively affect overall well-being if left unchecked. Behavioral health specialists serve as caring advocates for injured workers, imparting coping skills that promote resilience and providing supportive assistance to help them overcome any barriers on the road to recovery.
Advocacy and empathy
From the first notice of injury to the end of the claim, the tone of every interaction should be supportive rather than adversarial. Employees may come into the claims process with a perception that the workers’ compensation system is “out to get them”; each positive touchpoint can chip away at that negative view, instead replacing it with confidence that the claims team is there to help. Clear, empathetic and frequent communication with the injured worker conveys accountability for their role in the process and their commitment to providing every available support resource throughout the journey.
Claims professionals may touch dozens of workers’ comp cases a day, but it’s likely those injured workers are going through this experience for the first time in their lives. They are scared about their health, their livelihood and taking care of their families. They’re worried about who will pay their medical bills and what they need to do next. In the advocacy model, claims professionals are charged with building trust and rapport with injured workers and enlisting the right clinical resources to support their recovery. By showing they care, claims and clinical professionals have the capacity to allay injured workers’ fears and bring a hefty dose of sensitivity and understanding to an unexpectedly difficult period.
Treating injured workers with care and empathy is not only the right thing to do; it also affects how claims ultimately resolve and yields great results for employers. Data shows that taking a holistic approach to workers’ compensation reduces claim durations, medical and indemnity costs, litigation rates and lost productivity. The advocacy model cuts down on friction in the process and significantly improves employees’ post-injury experience.
Additionally, advocacy helps to prevent employees from never returning to their jobs. Getting employees back to work after they’ve recovered from injury has always been important in workers’ comp, but it’s taken on greater significance in today’s tight labor market. Many of the jobs that are hardest to fill involve potentially dangerous work. The people in those roles perform critical societal functions but are more susceptible to injury. With many employers and industries already scrounging, they cannot afford for skilled talent to unnecessarily depart from the workforce. They also cannot afford to risk further injuries to other employees, so modifications should be considered as part of the overall solution. If talented individuals in these short-handed industries do sustain injuries on the job, they must be treated in a way that reflects the true value they bring to the table — because caring counts.
There is much discussion today about the potential impact of artificial intelligence on workers’ compensation. We’re already discovering some of the ways AI can help us boost claims efficiency and leverage data for better outcomes. But however helpful the technology may be, it can never replace the value of human connection and empathy when it matters most.
Some of these concepts were previously shared in a session presented in conjunction with the State of Louisiana’s Office of Risk Management at the spring conference of the Louisiana Public Risk Management Association (PRIMA).