Simple Concepts for a Complex System: In a World of Negativity, it's Time to get Positive

The workers compensation system is rife with negative experiences and outcomes.  

When workers get hurt on the job, the accident is usually not their fault.  They are thrust into a confusing system where the incentives are not always aligned to achieve optimum outcomes.  If they cannot return to work, they may suffer severe financial losses and even have a reduced mortality.  Injured workers may blame their negative experience on the system on the claims examiners, or their employers.  Sometimes, the injured worker is right to blame the claims adjuster.  Many times, they are blaming the wrong person.  

The third largest cost driver in workers compensation is a poor employer / employee relationship.  Some employers inappropriately blame their injured workers for the impact to their experience modification or their bottom line.  They may also direct their anger at the claims examiner for the claims handling process.  Any delay in reporting the claim by the employer increases litigation and always results in significant increases in the claims costs.  In an attempt to manage their losses (and resulting premium), employers may have their broker representatives attempt to influence the examiners to reduce the reserves.  Some employers do not provide adequate settlement authority in a misguided attempt to reduce the settlement costs. This always results in increased case loads and increased claims costs.  Sometimes employers even sue the insurance carrier (the claims adjuster) for inappropriate claims handling.  

The attorneys have pitched battles trying to maximize or minimize benefits.  The litigation process increases claims costs as well as increases case loads.  Applicant attorneys may subpoena, depose and even sue the examiners in an attempt to extort better settlements.   

Claims executives are trying to control overhead expenses that may include, in some instances, carrying  higher caseloads. This may leave the examiners overwhelmed with a high volume of claims.  

Turnover in the claims offices also result in transitioning higher workloads for the examiners with limited or future relief in sight.   

All this activity and negativism takes a toll on the examiners.   

One way to counter all of this negativity (and improve employee retention) is to look for every opportunity to create positive experiences.  

Here is a preliminary list of three buckets (because there is always three), of positive successes and experiences that should be celebrated in a workers compensation office.