An interesting study caught my eye last week. It seems researchers from Stanford University studying claim history in Australia found that the stress of filing an injury claim may actually increase the severity of disability over the long term. If their results are correct, it should give those of us in the workers’ compensation industry another reason to look at our procedures and processes, as they may be costing us more than we think.

The survey of accident victims found that claims stress often comes from confusion about the process, delays and related medical assessments. Researchers found those who “were most stressed by filing a claim tended to have higher levels of disability years later”.

David M. Studdert of Stanford reported that, “The novelty of this study was to look within a group of claimants to test whether those who reported experiencing the most stress also had the slowest recoveries”. According to Studdert, the researchers found they did.

They studied “a random selection of more than 1,000 patients hospitalized in Australia for injuries between 2004 and 2006. Six years later, 332 of the patients who had filed for workers’ compensation or another accident claim told the researchers how stressful the process had been.”

The study found “a third of the claimants reported high stress from understanding the claims process and another third were stressed by delays in that process. A slightly smaller proportion said repeated medical evaluations and concern for the amount of money they would receive were sources of stress.”

Studdert and his fellow researchers recommend that programs such as workers' compensation could be redesigned to respond faster and make it easier for patients to understand.

I've spent a decent amount of time the last couple years writing about and speaking on the issues of perception and misunderstanding related to the world of workers' compensation. To me, the surprise here is that there is a surprise here. We seem to have become so involved in “process” that we have lost sight of the overriding goal; and it is a misstep in the name of cost control that is very expensive, both financially and societally. Are we really that far removed from reality that we do not recognize the ramifications of claims complexity and delay?

I was really struck by one quote mentioned two paragraphs back. “A slightly smaller proportion said repeated medical evaluations and concern for the amount of money they would receive were sources of stress.” While citing repeated medical evaluations as a point of stress, respondents did not focus on the quality of care or restoration of function. Instead, they focused, at least to these researchers' questions, on the amount of money they would receive. As I've said before, people rarely seem to ask how they can get better. The more common question seems to relate to how much they will make.

As a society, we set that expectation, and I maintain the system is not and never was designed to fully meet that goal – at least not as it is understood by people entering it today. I have been beating the drum for a change in the way the industry both presents itself, and responds to claims. That change includes a new identity and focus on Return to Function.

(On my soapbox now….)

Workers' Compensation should be called Workers' Recovery. Recovery specialists would work with recovering workers with the singular goal of restoring whatever function possible to their lives. An obvious result of returning a worker to function would be returning them to work and a contributory role in society. It is a concept that will of course not work for all cases, but could break the back of disability dependence that we see developing for many today.

(Off my soapbox now….)

Absent the changes noted above, we can still make a difference with the system as it exists today. Better communication, more clear explanations, and increased expectations for recovery can be instilled to those coming into the system. Many of us, deep down, have known for years that denial, delay and complexity have been working against the achievement of better results. Now we have a study that gives a bit of definition to what had previously been a “hunch”.

 Within the source article about this study, was a quote by Katherine Lippel, who studies occupational health and safety law at the University of Ottawa in Ontario, Canada. Her comment was direct and relevant. She said, “I think the point that needs to be made is that those managing these systems, insurers or workers’ compensation boards, or no fault automobile compensation schemes, should realize that they are undermining their own mission of getting workers back on their feet if the process is unnecessarily stressful.“

Here is a clue – our process in workers' compensation is, in many jurisdictions, unnecessarily stressful; and the evidence is growing that our efforts to minimize fraud and control costs may not be yielding the results we intended. We are, after all, supposed to fix the problem, not exacerbate it.

Getting injured is stressful. Being thrown into a world you do not understand can only compound that stress. We can and should negate much of the stress related to filing a claim by defining better expectations and recovery related results. Failing to do so will cost everyone involved.

And that, quite frankly, is a very stressful thought.

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