Filed Under:Markets, Workers Compensation

The role of empathy in workers' comp

The concept of empathy is beginning to generate a surprising level of discussion, debate, and exploration in the business community. According to the Harvard Business Review, it is time for an “epidemic of empathy in business.”

I confess to being more of a left-brain or analytical type. So as I read current articles on the topic of empathy, it has me thinking about what role it plays in workers' comp. Are we just supposed to be nicer? More sympathetic? And coming back to the analytical side, I have to ask, “Is there a business benefit to empathy?”

It’s important we honestly explore that question. Empathy is defined in psychology as understanding a person from their frame of reference. There is some research referenced in a Wall Street Journal article by Christopher Mims that suggests “one of the most important elements of collaboration is empathy.” The plight of an injured worker requires collaboration between that worker, their adjuster, provider, employer and case manager (and others).

Changing the Paradigm

The problem is, most of us deal with sick and injured workers on a daily basis; it’s become part of the routine. At some point, daily tasks and deadlines take over and empathy may take a backseat. But let’s truly take the time to put ourselves in the injured person’s shoes. That injured worker is in pain--she is not sure if or when she will return to work. There is a lot of confusing paperwork; plus forms and regulations to follow. There is real fear about how the injury will affect her job. Many injured workers ask, “Will I be able to return to work; will it affect my pay and standing; what if there’s not a job waiting for me when I am better?”

What if we changed that paradigm? What if we looked at that individual’s injury not as a component of a larger business process to be managed, but through the injured workers’ eyes? If we asked him or her what was needed? What they wanted to happen over the course of their treatment? The value of this level of empathy was highlighted to me in a recent claim overseen by one of our case managers.

A claimant fell and broke his arm on the job. An urgent care facility said he needed surgery in the ER; the ER said he didn’t need surgery. The break didn’t heal properly, resulting in considerable arm and shoulder pain, rendering this employee unable to return to work. He also gained a significant amount of weight post injury, which led to depression. After four months with no health status improvement and no date set for return to work, the adjuster ordered an independent medical examination and referral to case management. The seasoned case manager approached the case with not only top-notch clinical skills, but a healthy dose of empathy and willingness to take the time to understand the full picture of not only the claimant’s medical situation, but his emotional, motivational and social situation.

The case manager (CM) noted that the claimant was a single man in his 50s, that he had no children, and that his support system was lacking. The CM took time to listen to the claimant, understand his concerns and to treat him as a valued client. From that point forward, there was an improvement in the claimant’s attitude toward his recovery and return-to-work plans. Following an aggressive treatment plan, including occupational therapy and surgery to reduce the pain, the claimant went back to work pain-free, nine months after his injury.

What’s the takeaway from this experience? In reality, quicker case management involvement most likely could have returned the employee to work in half the time, saving thousands of dollars. Likely the weight gain and depression also would have been better managed, contributing to additional savings. When the empathetic case manager did get involved, the result was a resolution and considerable cost savings for the client. Had that claimant continued in his current state, at a minimum he would have lacked motivation to return to work and, worse, he easily could have spiraled into further depression and pain leading potentially to opioid use and perhaps even long-term disability.

Creating a Road Map

This is one example, but virtually any claim--even those that may not require case management--can benefit from a more empathetic approach to resolution.

The question is, how do we get there? As an organization, how can we become more empathetic in workers’ comp? While I think every organization needs to develop their own plan, there are some basic steps we can all consider:

  • Encourage senior management to set the tone and urge all staff, especially adjusters and case managers, to view claimants as they would a client--to work to empathize and understand their needs and concerns.
  • Initiate immediate contact with the injured worker to not only assess the injury but also to listen to the workers concerns, fears and worries. What are his or her goals? What obstacles will be faced? How can we help?
  • Develop set guidelines and protocols for claims referrals and provide your case managers with education, support, and recognition for cases resolved by their skilled and empathetic approaches to injured workers.
  • Refer appropriate claims to case managers--their one-on-one interaction with claimants helps to foster the empathetic relationship that can build better connections with injured workers.
  • Make that employee feel valued and missed throughout recovery. Have a manager call or e-mail to check in and give updates.

I know what some of you are thinking. “We always try to be accommodating to injured workers, but some of these claimants are so difficult and we fear they are trying to milk the system.” The analytics side of me gets that. (I’ve seen the numbers.) But again, that doesn’t mean we shouldn’t ALWAYS put ourselves in the shoes of the claimant and bring to them the same level of commitment we do to our clients. If there is concern that a claimant is “milking the system”--put yourself in his or her shoes and ask why? Is it because they don’t have childcare and need more time off? Is it because they are afraid of re-injury? Is there a pending layoff at the company? All those factors are valid and can be addressed.

If we strive to always take a step back and look at that claimant as if he or she were the client, we can empathize with the situation and then move forward with quick and appropriate resolution. All parties, the worker and the employer or payor, will benefit from a faster and more effective claim resolution--that’s a return on investment that will benefit us all.

 

Leanne Bronold, RN, BSN, works as the clinical guidelines manager at Genex Services LLC, Wayne, Pa., a provider of workers' compensation clinical services that enables industry payers and risk managers to improve their bottom lines. Based in Mobile, Ala., Bronold has served the company for 28 years, first working as a field case manager, moving on to branch manager, and now with the clinical guidelines team.

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