What Your Claims Team Doesn’t Tell You Can—and Will—Hurt You 

HR Homeroom

When it comes to workers' compensation, an injured worker's experience can largely depend on the actions and honesty of the claims team. These people handle claims, communicate with workers, and ultimately decide how smooth or stressful the process will be. They can also drastically impact an employer's organizational culture through their treatment and communication with the injured employees they encounter. Many employers don't realize that what their claims team doesn't tell them – or, more importantly, doesn't tell the injured worker – can cause serious harm. One of the more significant problems is when the claims team fails to talk about state-mandated benefits like travel expense reimbursement. Mileage is a benefit injured workers qualify for under the law and should be explained upfront. 

In many states, injured workers qualify for benefits beyond covering medical bills and part of their lost wages. One of these benefits is travel reimbursement for getting to and from medical appointments. This benefit is required by law, meaning that injured workers who qualify for it must receive it as compensation. But often, claims teams fail to mention this benefit or downplay its importance. This lack of communication can cause unnecessary stress for injured workers who may not even know they are entitled to reimbursement. 

When claims teams are unclear nor transparent about these benefits, it can lead to frustration and distrust. Imagine being an injured worker already experiencing pain and uncertainty but later finding out you did not receive the benefits you are qualified to receive. This awareness can be a huge disappointment, especially for workers struggling to pay their bills. The cost of traveling to medical appointments can add up quickly, and knowing that mileage reimbursement is available can significantly reduce that financial stress. However, workers feel neglected when claims teams do not provide this information. 

Employers must be cautious about how their claims teams communicate with injured workers. A claims adjuster's job is not just processing documents and making decisions. It is about guiding injured workers through a complex system and making sure they get all the benefits they are entitled to under the law. When claims teams do not communicate clearly, it can harm the injured worker and damage the relationship between the employee and employer. This lack of transparent communication can lead to increased stress, legal disputes, and a longer recovery process. 

Transparency is essential to building trust and ensuring the workers' compensation process runs smoothly. Employers should ensure their claims teams provide injured workers with clear and complete information. This information includes and is not limited to explaining upfront any state-mandated benefits, such as travel reimbursement, temporary disability benefits, and any other assistance for which the worker qualifies. When claims teams are honest and open, it helps reassure injured workers, making the recovery process less stressful and effective. It is not just about following the rules to pass an audit but also about doing the right thing for those who need help. 

The stakes are high regarding workers' compensation, and the last thing an employer wants is to discover that its claims team has not been honest with injured workers. This situation creates potential legal problems, damages the employer's reputation, and erodes trust within the workforce. Workers who feel they have been misled or kept in the dark are less likely to return to work feeling supported and valued. Instead, they may return resentful, thinking that the system and their employer have failed them. This culture differs from the work environment we want to create for our employees. 

The impact of poor communication extends beyond the individual worker. It can affect the entire organization by creating a culture of distrust and dissatisfaction. When employees see that their co-workers are not treated fairly, this can decrease engagement, morale, and productivity. On the other hand, when employers and claims teams are transparent and supportive, it creates a positive environment where workers feel respected and cared for. This ripple effect significantly affects the injured worker and the entire team. 

Another important point is that state-mandated benefits are not optional but required by law. Employers and their claims teams must understand that withholding information about these benefits is wrong and illegal. The law is clear: If an employee is entitled to specific benefits, those benefits must be provided without delay or deception. Failure to do so can have serious consequences, including fines, penalties, and legal action. But beyond the legal risks, there is also a moral responsibility to treat injured workers with the respect and transparency they deserve. 

Employers should ensure that their claims teams are well-trained not only on the technical aspects of workers' compensation but also on the ethical obligations that come with the job. This moral aspect includes a commitment to clear communication, transparency, and a proactive approach to helping injured workers navigate the system. Employers should regularly review the operations of their claims teams to ensure that all state-mandated benefits are clearly communicated and promptly paid. This awareness is essential to maintaining a positive relationship with injured workers and avoiding unnecessary complications. 

The ultimate goal should be to create a workers' compensation process that is as supportive and transparent as possible. Injured workers go through enough without worrying about whether they are receiving all the benefits they are entitled to. By ensuring that claims teams are transparent about state-mandated benefits, employers can help ease the burden on injured workers and foster a more positive, trusting relationship. It's not just a good deal; it's the right thing to do. 

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