Insurer Sees Improved Outcomes, Lower Costs with Workers’ Recovery Approach

Nancy Grover

Des Moines, IA (WorkersCompensation.com) – Being nice can pay dividends. Workers’ compensation managers at Continental Western Group, a Berkley Company, are finding that using simple acts of kindness toward injured workers is reducing their costs.

“Our litigation rate has dropped the most,” said Claire Muselman, director of the Workers’ Compensation Workers’ Recovery Unit at the insurer. “It has a direct correlation on the number of times an injured worker speaks to an adjuster. The more hits, the less likely the worker is to see an attorney.”

Increased communication is one of several strategies the company has employed in the last year to help injured workers recover faster and better, and rein in costs. The techniques they’ve employed focus on the human aspects, rather than the financial implications of workers’ compensation.

Getting Adjusters On Board

“Our workers’ compensation line was not doing very well,” Muselman said. “We looked at the way we approach claims.”

The first step was to help the adjusters gain a new perspective and buy into the idea of workers’ recovery. To help bring meaning and purpose to those whose job is to process claims, Muselman implemented ‘The Challenge,’ to change their mindsets.

Each day, the adjusters were asked to write down three things for which they were grateful and three things they hoped to accomplish that day. At the end of the day, they were asked to write three things they were looking forward to when they went home.

“The goal is to know there are always things you are hopeful for. There is your life outside of work; you always have something to look forward to,” she said. “We had to do this before rolling out the Workers Recovery Unit.”

The effort increased the comradery among the workers, with the team becoming a family. They started treating one another the way she envisioned them treating injured workers.

“They have to have each other’s backs,” she said. “You have to live and breathe it. We want to leave everyone better than we found them.”

Muselman, who is completing her Doctorate in employee engagement, said adjusters and other stakeholders involved in claims should understand that what they do matters to the injured worker. They can, she said, single handedly impact someone’s life every time they pick up the phone and help them with recovery and the return-to-work process.

After 100 days of instilling this idea through ‘The challenge,’ it was time to roll out workers’ recovery. They have three jurisdictional teams, each with its own name and identity: Team M.O.V.E., Team Kokoro, and Team Nightingale. Each has its own logo and motto.

Approach to Injured Workers

Inclusive, engaging, ‘playing nice,’ looking people in the eye, treating them with respect, and understanding that pain hurts, were the messages Muselman wants her team to remember when dealing with injured workers. There are weekly coaching sessions to help

One idea she uses is to help the injured worker create a vision of what life holds after recovery. “When talking to an injured worker, give an example of what their summer is going to look like,” Muselman advises her teams. “If the person is going for surgery, ask if they want to get back to golfing, then strive to get them there. On the next visit, see if the person has a better range of motion ‘to hit the golf club.’ That’s the mentoring and encouraging we give our group.

Among the issues to overcome was the perception of injured workers too often shared by stakeholders, that they are mostly out to game the system.

“I ask people, ‘how much fraud is there?’” she said. “It’s only 1 to 2 percent and mostly it’s from doctors in California and employers who falsify [or misclassify] their employees. That’s where fraud comes in.”

Injured workers, on the other hand, might “stretch their mileage or not recover as quickly as they could because they don’t think you care anyway.” She said they often feel neglected and left out of the process.

“I talk about, if a person breaks a leg we go above and beyond as a society to make sure the person feels taken care of. We send meals, flowers, cards,” she said. “We slap workers’ compensation on it and it’s like they are the plague and we want nothing to do with them. But it’s the same deal; a human being who’s been injured and doesn’t know what’s going to happen.’

On top of that, there’s often little to no contact from work. “That’s the piece employers need to focus on,” she said.

In trying to educate employers, the company has created sample letters that can be sent to injured workers. “Feel good,” letters she calls them, that way, “’we really care, we are really sorry you’ve been hurt.’ Opening the lines of communication.”

The teams have also developed a packet to give the injured worker as soon as he is injured. Included is information on the process and what to expect. It says, for example, “hey, let us know if you get a bill.”

Members of Muselman’s teams also send out cards themselves to injured workers. They are blank, allowing the claims people to write whatever message they deem appropriate, such as good wishes for someone’s upcoming birthday or planned surgery.

“It cost you nothing to be nice to a person,” she said. “When people get fearful and we treat them like lepers, it all falls apart. Understand they are not the experts and it is our job to help them at the worst time of their lives and give them a different perspective on their recovery.”

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