You can catch more flies with honey

You Catch More Flies With Honey Than You Do With Vinegar:
Creating a Front-Line Defense for Managing Workers’ Compensation
Claims

by Gary Lavoie

There is a significant driver of rising workers’ compensation costs in New Hampshire that has nothing to do with experience mod split-point changes or medical cost inflation. It falls into a category that I like to refer to as benefit preservation, which has a very specific cause, a simple remedy and almost every employer that we speak to has experienced. They key to managing benefit preservation, which is often mistakenly referred to as “malingering” is first identifying the WHY.

The culture surrounding workers’ compensation has changed in our communities. There was a day when bumps, bruises, sprains and strains where simply the rewards for a hard day’s work. Today, claim volumes are inundated with musculoskeletal type injuries that are caused by the job itself, they are not accidents. This is a key point that is worth honing in on – acute or traumatic injuries are typically caused by accidents that fall outside of a person’s job description. An example would be your worker who might be working too fast, but is working hard nonetheless and falls from a ladder causing multiple fractures. Think of your emotional response as an employer in that circumstance. It is about what we CAN DO to support this person. Because this was an accident.

Musculoskeletal injuries are different.Eric’s job is to lift the boxes from over there to over there. Multiple other people perform this same job, but Eric is the only one that is complaining of back pain. This means that Eric can’t do the job, and we can’t accommodate because that IS the job. This is a natural and quite logical response, but it is having a MAJOR impact on the psychosocial component of your resulting workers’ compensation claim.

The reason is that Eric now feels as though his job is at risk and therefore his livelihood is at stake. And this perception is being created with as little as an eye roll from his supervisor. That one quick moment, where Eric feels like he is a problem.

So what is Eric’s response? Pain, restrictions, treatment and anything else that will create a certainty that weekly checks will arrive and arrive on time because there is a mortgage to be paid, and groceries to be bought. I would argue that this simple dynamic is also the driver of the over-utilization and rising medical costs per claim that the industry is experiencing. Because pain means a second course of PT, a repeat MRI, narcotics, and a referral to the surgeon for an injury that might have been managed conservatively.

The answer to this convoluted mess goes right back to the beginning – in the work environment. This is a challenge that all employers are experiencing and there really just hasn’t been enough communication and education about how to properly manage these claims. Supervisors and foreman should understand the difference between acute and emergency response injuries vs. musculoskeletal injuries. They should have a script ready for response no matter what the circumstance. One that is consistent and represents the values of your organization. Supervisors should understand the pay/deny period and that they don’t have to “solve the case” on day one.

There are a number of real, and simple solutions that can be put into place as quickly as next week with the right support. Return to work policies should not be a cookie-cutter template sitting in a binder on the shelf. They can be more effective in one paragraph, one that everyone knows and understands.

Do not hesitate to shoot an email or give me a quick call for a free consultation on your very first steps to changing the culture surrounding work injuries in your business.

Gary Lavoie
Account Executive
Tel: (603) 716-2356
Cell: (603) 998-5896
glavoie@clarkinsurance.com