Better Efficiencies in the WC System Could Result from COVID-19

Nancy Grover

Sarasota, FL ( – Workers’ compensation stakeholders have had to quickly change many of their processes during the coronavirus pandemic. That could be a silver lining in the current environment, as some of those adjustments could lead to improvements in how the workers’ compensation system operates.

During the kick-off session of the first virtual edition of the Workers’ Compensation Institute’s annual conference, speakers discussed how they’ve been able to adapt during the pandemic and how business models and the system are evolving.

“Clients have definitely been far more flexible during this particular situation … for example, claim reviews,” said Danielle Lisenbey, global president of TPA Solutions for Crawford & Company. “We’ve been able to really just focus on the vital few versus focusing on thousands and thousands of claims just to have a formal claim review. Let’s take advantage of this situation and capitalize on what we’ve already been doing, looking and focusing on those claims that are truly driving a client’s costs and less attention, or less claim review, on lower cost claims.”

Presentations, where significant sums of money were spent on bringing together large groups of people have been trimmed down to ensure only certain, essential people are included in what are now done through video technology. “If we can pivot from that angle and really drive things more efficiently and effectively for each other, that would be great.” Lisenbey added.

Quick Changes

As part of a multinational organization with a footprint on many continents, Walgreens got a heads-up early in the pandemic. Corporate officials in the U.S. learned from their colleagues in Southeast Asia about what was to come and how to mitigate the risks to employees and customers, with a particular focus on clinical guidelines.

“For me that was the most important learning lesson; to understand the science behind it, the clinical guidelines behind it. Also what’s already applicable regulation coming from the OSHA side of the business and that’s what we took on right from our early planning in late January/early February — to be sure we are ready as we moved forward,” said Anas Al-Hamwi, Walgreens senior director for Occupational Health, Safety, Liability Management, Injury Management and Environmental Services. “… think of the working place environment; it’s all mitigating risk items that we do — anything from social distancing to cleaning, basic hygiene. Everything that was recommended and proven to be one of the key components to combat transmission of the disease.”

The pharmacy chain created its own information website, after learning of the need to have access to information. Training and frequently-asked-questions for team members were included.

“Also, very relevant was an understanding of how you can be able to do a proper intake when you have exposure in your own stores and your own buildings,” Al-Hamwi said. “What type of clinical assessment is needed to make sure you mitigate that exposure, understanding all the circumstances, all the right questions, all the right algorithms, and then how fast and quickly you can do your tracking tracing to isolate the exposure, to make sure those in close contact have also been contacted and isolated according to clinical guidelines, what’s the proper return-to-work procedures and the proper cleaning procedures as you work through all these pieces with what I call, frankly, the speed of light.”

Many quick decisions and actions have been taken throughout the workers’ compensation system this year. One of the biggest initial changes was getting people to work from home.

“We do talk about the fact that if we were to have this project as a corporation, like many other corporations, it probably would have taken us a month if not a year to get 9,000 employees home perfectly, and everybody did it within a week to 10 days,” Lisenbey said. “So that’s the interesting part — when your back’s pushed against the wall how quickly you can respond to a situation and get everybody working from home and almost flawlessly.”

Getting care to injured workers has been a challenge throughout the pandemic. It’s another example of how the pandemic forced quick changes to the workers’ compensation system.

“All non-essential care nearly came to screeching halt. So we transitioned to telehealth,” Lisenbey said. “We’ve seen a 2,000 to 2,500 percent increase in telehealth, especially telerehab. That’s helped at least keep things fairly stable.”

Maintaining Strong Connections

An important piece in keeping things on track during the pandemic has been ensuring constant and consistent communication — with employees and, especially injured workers. The lack of person-to-person contact has made this imperative.

“We did definitely utilize our nurses to stay in touch and in-tuned to injured workers to keep them engaged,” Lisenbey said. “That whole advocacy, being their advocate, keeping them engaged in the whole process.”

Failure to keep injured workers engaged can lead to depression and anxiety, and can impact recovery. “Social isolation is a big reason for disease advancement,” said Kimberly George, senior vice president of Corporate Development, M&A and Healthcare at Sedgwick, and co-host of the session, along with Mark Walls, Vice President Communications & Strategic Analysis with Safety National. “It’s a significant change in work that does impact mental health and wellbeing, compounded with caregiving needs [among many workers] and fear.”

That applies to employees as well as injured workers. Employers can effectively address the issue by asking, ‘how are you?’ and ‘do you feel you can come back to the office?’ George said.

Some organizations are offering various apps to help employees with such things as meditation and sleep. They are also addressing the caregiving needs of workers, whether for children at home, elderly parents or others.

“Many companies are also thinking about how they engage employees, whether in peer groups [for those with young children or elderly parents]” George said. They are “allowing employees to create the groups that are the most meaningful, and in an informal way.”

Future of WC

The pandemic has led to changes in the workers’ compensation system that have been perhaps needed, or at least discussed for some time. Now may be the perfect time to act on ideas that have been festering for years, the speakers said.

“What if we were able to create a new model or significantly transform our existing model,” George suggested. “We’ve had the need to evolve process, engagement and our technology for a really long period of time.”

One change, for example, could be allowing injured workers to self-report their injuries. “Certainly from an efficiency perspective that’s helped during COVID,” George said. “It’s allowed us to triage and get people to the right individual and the right level of care.”

Another idea is a 24/7 model of adjudication and customer support. “Our workforce is 24/7. We have people working not only all shifts but they’re working longer shifts.” George said. “Maybe they need to interact with claims teams at night.”

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