Nashville, TN (WorkersCompensation.com) – Injured workers who settle their claims often share a common feeling: despair. Even though they may have walked away with a large sum of money and are free to visit the medical providers of their own choosing, experts say many also are concerned and anxious — about having to navigate the healthcare system on their own with no nurse case manager or even a claims adjuster to help guide them, and running out of money. The good news is, there are increasingly programs and services aimed at helping these injured workers get back on their feet.
The situation “reminds me of a family member of mine who didn’t work for many years; his wife supported him, but he was miserable. He found a program for disabled people and began to work again,” said Brian Holmes, director of Mediation and Ombudsman Services for the Tennessee Bureau of Workers’ Compensation. “His quality of life and attitude toward life improved dramatically.”
Holmes is overseeing a new program to help injured workers who can’t return to their pre-injury employment status and are in danger of running out of money. Called Next Step, the program provides money and resources to help them find new ways to earn an income.
Those eligible are injured workers who have reached maximum medical improvement, have either not returned to any work or are working for less than their pre-injury wage, and have received a ‘resulting award’ — a sum of money to help them recover. Holmes says unless these workers get help quickly, many of them never really recover.
“They’ve got 90 days after receiving the resulting award to apply to this program,” he explained. “The idea then is if they receive the award and are not working, we want to get with them soon to assess their job skills, and see if there are areas where they are lacking and need training or skills. That allows us to focus on any available training and get them in that training program, hopefully, before their funds run out, so they can still live off their settlement while they are trying to go to school.”
The program, which grew out of Tennessee’s Second Injury fund, pays $5,000 per year. Through a partnership with American Job Centers, injured workers can get help with job skill assessments. The program also connects them with other federal and state programs that provide additional monies. Tennessee Reconnect, for example, pays tuition for adults who want to attend community college, while Next Step can help with books, fees and other expenses. There is also government money available to pay for ‘wraparound expenses,’ such as childcare and transportation.
Need for the Program
The Next Step program has been on the drawing board for several years. In looking at the cases of several thousand injured workers who had received resulting awards, they found very few were either working or using available government services to help them find new jobs.
“We’re concerned they end up on Social Security Disability Income. Those who can’t get that [benefit] just flounder without much direction,” Holmes said. “We hope that through this program, when we talk with people, it starts to register that there are special opportunities for disabled persons that fit that category.”
Next Step is one of several programs being implemented throughout the country to help injured workers. Others help manage their medical issues. The programs are filling the need to care for injured workers post settlement.
“They are doing this because we’re finding injured workers [who settle] are put in precarious and unfortunate situations,” said Marques Torbert, CEO of Ametros, a professional administrator. “Our [workers’ compensation] system doesn’t always work the way it should … it can be broken for some injured workers upon settlement. So states are putting these programs in place.”
Torbert said many people who settle their workers’ compensation claims and can’t return to their pre-injury work status feel disenfranchised and are not given enough resources. In fact, Ametros is weighing the idea of hiring some of the injured workers who are their clients, or members, to be ambassadors for others. “To make sure they have advocacy after settlement,” he said, “make sure it’s not just a big company but somebody who has been in their shoes; help them understand what to expect and be a shoulder and sounding board.”
Tennessee’s Next Step program is based on the same premise; that injured workers who settle their claims may need additional support and help to move on with their lives. “That’s what I hope,” Holmes said, “that we take people who are scared about what the future holds for them, are uncertain, and give them some direction to go back to work, and provide them with hope.”