Improving Outcomes

Building Trust With Injured LGBTQ Employees

Actively addressing issues related to injured workers' sexual orientation or gender identity can help employers overcome hidden barriers to recovery.
By: | June 1, 2017 • 5 min read

Workers’ comp providers and payers in recent years have been taking note of the broad range of social and psychological issues that can impact recovery outcomes for injured workers. But a factor that flies mostly under the radar is how to navigate issues related to employees’ sexual orientation or gender identity.

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Prompt reporting is a key concern with employees that identify as lesbian, gay, bisexual, transgender or queer (LGBTQ). Data from the Institute of Medicine and the Kaiser Family Foundation suggest that the LGBTQ population is more likely to delay or avoid seeking treatment because of past discrimination, said Genex branch supervisor Chikita Mann during a recent podcast on the Inside Workers’ Comp blog.

HIPAA privacy rules also work differently within workers’ comp, which can complicate things further, if employees are worried that sexual orientation or gender identity information might be included in the information disclosed to their employers.

Employers should consider the employment non-discrimination laws (or lack thereof) in the states where they operate. There are currently 28 states where employers are not barred from discriminating against or even firing employees because of their sexual orientation or gender identity.

LGBTQ employees working in those states understand all too keenly that even if the law states they can’t be fired for reporting an injury, their sexual orientation or gender identity could easily be used as a smokescreen to justify termination after filing a workers’ comp claim.

Chikita Mann, branch supervisor, Genex

That’s why having a culture of inclusion and a track record of treating all employees with dignity is so important for employers, said Mann.

“When it comes down to it, the company’s culture really has a lot to do with getting the LGBTQ individual back to work,” she said. “If [LGBTQ individuals] feel that the culture of the company is not accepting of them, you have another brick wall as to trying to get them back to work, because it starts from the organization and it trickles down to the workers.”

And the same goes for the culture throughout a company’s workers’ compensation team, both in-house personnel and third-party providers that the injured employee might interface with.

If a gay employee is seriously injured, and the case manager assigned to him snubs or ignores the same-sex partner or spouse at his bedside in the hospital, the injured employee isn’t likely to feel respected, and will have precious little belief in whether his best interests will be looked out for by the workers’ comp team.

In turn, he’ll be less likely to comply with his treatment or return-to-work plan, and will be far more likely to feel that he needs a lawyer to represent him.

Even if it doesn’t come to that, said Mann, studies have found that LGBTQ employees are more likely to suffer from comorbidities such as depression and substance abuse. That makes it all the more urgent that employers connect with them in a positive way before they get isolated.

Setting the Right Tone

Including sexual orientation and gender identity in a company’s non-discrimination policy is important, but companies need to do more to create the kind of environment that will foster better outcomes for all employees.

“You’re dealing with diversity issues of course, but [it’s] really about inclusion, said Minnesota-based harassment and bullying consultant Susan Strauss.

“How do you establish and sustain an organizational climate that is inclusive of the LGBTQ community?”

That means looking at everything from a company’s mission statement and the kinds of advertising messages it presents to whether it includes the LGBTQ community in its recruitment outreach efforts and other community involvement.

“When people feel that they are being really treated with respect and with dignity, we’re going to get the buy in that we need from the individual in order to get back to work.” — Chikita Mann, branch supervisor, Genex

“Organizations should be involved in community efforts that are geared for the LGBTQ community, like any pride parade that might occur, or — depending upon the size of the community — an LGBTQ chamber of commerce,” said Stauss.

“There’s just so much that should be done. It should not be piecemeal. It needs to be a strategic approach.”

It comes down to making inclusiveness part of the organization’s corporate identify. Strauss noted that participating in the Human Rights Campaign’s Corporate Equality Index (CEI) can be a part of the overall strategy for some companies.

The index is the national benchmarking tool on corporate policies and practices pertinent to lesbian, gay, bisexual and transgender employees. Top scoring companies earn the distinction of “Best Places to Work for LGBT Equality.”

“Depending upon your score, that would be something that you would proudly display on your website,” said Strauss, letting potential employees and existing employees know about it.”

Non-government employers in the U.S. with 500 or more full-time employees can request to participate HRC’s Corporate Equality Index.

Ensure Partners Are Aligned

Case managers can help build trust with injured LGBTQ employees by consistently making it clear that the employee is understood and respected, said Genex’s Mann.

“When people feel that they are being really treated with respect and with dignity, we’re going to get the buy in that we need from the individual in order to get back to work,” she said.

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“It’s even more critical with the LGBTQ individual, that we use the motivational interviewing skills. … We are letting them know that, ‘We’re here for you. We’re going to do our best to help you get the medical treatment that you need.’ “

Strauss added that employers should include LGBTQ philosophy among the things they look for in their workers’ comp partners and providers.

“Make sure that everybody you’re doing business with has been educated in what some of the unique challenges might be in dealing with an LGBTQ patient,” she said. The onus is on the employer to ensure that their partners share a commitment to respect, equality and non-discrimination.

Otherwise, “you’re running a risk of that patient being undermined and potentially discriminated against.”

The bottom line, said Mann, is that everyone who comes in contact with injured workers should be reinforcing how much each individual is valued as an employee.

“Everybody wants to be needed, and everybody wants to be shown that they have value. If we can do that, that will go a long way with the LGBTQ individual.”

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

Black Swan: Cloud Attack

Breaking Clouds

A combination of physical and cyber attacks on multiple data centers for cloud service providers causes economic havoc. Even the most well-prepared companies are thrown into paralyzing coverage confusion.
By: | July 27, 2017 • 10 min read

Scenario

By month 16 of the new presidential administration, the Sunshine Brigade is more than ready to act.

Stoked by their anger over rampant economic inequality, the mostly college-educated group of what might best be called upper-middle-class anarchists — many of them from California, Oregon and Washington State — put in motion the gears of a plan more than two years in the making.

Their logic, to them at least, is unimpeachable. Continued consolidation of economic power into the hands of fewer and fewer corporations is creating a world where the rich increasingly exploit and shut out the poor.

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The rise of the techno giants is accelerating this trend, according to the Sunshine Brigade’s de facto leader Emily Brookes, an All-American rugby player and a graduate of Reed College in Oregon.

With a new presidential administration seemingly bent on increasing the economic advantages of the rich with no end in sight, nothing to do then but break things up; and in so doing break the hold of this technology oligarchy.

As Emily Brookes so forcefully put in her instant messages to the other members of the brigade: Break the Cloud.

With more than 500 members, many of them with ample financial and technical resources, the Sunshine Brigade is very capable of delivering on its plan for a two-pronged attack.

It is also radicalized enough to justify the loss of some human life, even its own countrymen, to “save” — in its collective logic — the tens of millions of global citizens that are living as virtual slaves in this callous, exploitative global economy.

With websites and digitally connected services large and small down for days, irritation turns to fear.

The first wave in the attack is an attempt to infect and shut down the data centers for the top three cloud service providers. It takes months to set up this offensive.

Rather than rely on a phishing scam from outside the firewalls of the service providers, The Sunshine Brigade uses its social and business connections to place three members on each of the cloud provider’s payrolls. An infected link from someone you know, someone in the cubicle right next to you, seems like an unstoppable play.

It only partially works. Only one of the cloud service providers is harmed when an unsuspecting employee clicks on a link from their traitorous co-worker. The released malware manages to cripple a major cloud service provider for 12 hours.

With millions of users affected, the act creates substantial disruption and garners global headlines. Insured losses are around $1.5 billion. But this is just the beginning.

The morning after, the Sunshine Brigade unleashes a far more devastating and far more ruthless Round Two.

Using self-driving trucks, the Sunshine Brigade smashes into five data centers; three on the West Coast, and two in the Midwest. Fourteen employees of those cloud servers are killed and another 23 injured; some of them critically.

This time the Brigade gets what it wanted. The physical damage to the data centers is substantial enough that it significantly affects three of the top four cloud service providers for five days.

With websites and digitally connected services large and small down for days, irritation turns to fear.

Small and mid-sized banks, which host their applications on clouds, are shut down. Small business owners and consumer banking customers immediately feel the brunt. Retailers that depend on clouds to host their inventory and transaction information are also hit hard.

But really, the blow falls everywhere.

In the U.S., transportation, financial, health, government and other crucial services grind to a halt in many cases.

Not everyone is disrupted. Some of the larger corporations are sophisticated enough in their risk management, those that used back-up clouds and had steadfast business resiliency plans suffer minimal disruption.

Many small to mid-size companies, though, cannot operate. Their employees can’t get to work and when they can, they sit idly in front of blank computer screens connected to useless servers.

For the man on the street, this is hell.

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Long lines blossom at the likes of gas stations, banks and grocery stores. A population already on edge from a steady diet of social media provocation becomes even more inflamed.

By nightfall of Day Five, the three major cloud service providers are recovered, and digital “normalcy” begins to creep back. But for many small and medium-sized businesses, the recovery comes way too late.

Economic losses promise to register in the tens of billions. It’s not being too imaginative to think that losses could hit the $100 billion mark.

Two multinational insurers based in the U.S., three Lloyd’s syndicates and a Bermuda insurer signal to regulators that their aggregate cyber-related losses are so great that they will most likely become insolvent.

Emily Brookes and her cohorts were willing to kill more than a dozen people to promote their worldview. In their youthful naiveté, they could not know just how much suffering they would cause.

Observations

For some commercial insurance carriers, the aggregated losses from a prolonged disruption of cloud computing services could be catastrophic, or close to it.

“It’s on a par with any earthquake or hurricane or tornado,” said Scott Stransky, an associate vice president and principal scientist with the modeling firm AIR Worldwide.

AIR modeled the insured losses for the Fortune 1,000 were Amazon’s cloud service to go down for one day. They came up with a figure of $3 billion.

Now consider that most businesses in this country are small businesses, with not nearly the risk management sophistication of the Fortune 1000. Then consider a cloud interruption of five days or more.

Mark Greisiger, president, NetDiligence

“Almost any company you talk about today would rely to some extent on the cloud, either to host their website, to do invoicing, inventory, you name it — the cloud is being used across the board,” Stransky said.

“It’s a significant issue for insurers and one we think about a lot,” said Nick Economidis, an underwriter with specialty carrier Beazley.

“Should a cloud service provider go down, everybody who is working with that cloud service provider is impacted by that,” he said.

“Now, pretty much every software maker is on the cloud,” said Mark Greisiger, president of NetDiligence.

“In the old days, someone would come in and install software on your servers and come in annually for maintenance. That’s all gone bye-bye. Everybody who makes software is forcing you onto their private cloud,” Greisiger said.

The aggregation risk for carriers is complicated by the degree of transparency they have into which insured’s applications are hosted on which cloud provider.

Now here’s the even trickier part. Clouds outsource to other clouds.

“It’s almost becoming a spider’s web of interdependencies on who has access to what in terms of upstream and downstream providers,” Greisiger said.

Determining which of their insureds is hosted on which cloud, and in turn, where that cloud is outsourcing to other clouds can be very difficult for carriers to determine.

Even if a company is careful to diversify the risks they’re taking, they might not realize that a high percentage of insureds are even with the same cloud provider. They could be hit with devastating losses across their entire portfolio of business, said an executive with BDO consulting.

AIR’s Stransky said his company launched a product in April, ARC, which stands for Analytics of Risk from Cyber, which is designed to help carriers gain that much needed transparency.

Among insureds, surviving an event of this magnitude will depend not only on the sophistication of their risk management department, but on the company’s overall ability to negotiate contracts with vendors and suppliers that will indemnify the company in the case of a cloud outage of this duration.

It will also depend on organization’s understanding that there is no off-the-shelf solution that will prevent an event like this or make a company whole after it.

Shiraz Saeed, national practice leader, cyber, Starr Companies

Experts say contracts with cloud service providers, customers and suppliers must be structured so that a company is defended should it lose cloud access for as much as five days or more.

Best practices also include modeling just what your losses would look like in this area, and vetting your full portfolio of insurance policies to understand how each would respond.

One broker said buyers can’t be blamed if the complexities of the coverage issues at stake here are initially hard to grasp.

“It’s becoming a spider’s web of interdependencies on who has access to what.” —Mark Greisiger, president, NetDiligence

“I think it’s the broker’s job to inform the client of this exposure,” said Doug Friel, a vice president with JKJ Commercial Insurance, based in Newtown, Pa.

“You may have business interruption coverage for direct physical damage to your building. But have you ever thought about your business income if your IT structure goes down?” Friel said.

He said many buyers might not realize there is a difference.

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Large businesses should have the resources to demand from their cloud service providers that they be indemnified for the entirety of a cloud failure event. There will be a fee for that, but it will be well worth paying, Friel said.

“You have to push,” Friel said. “They are going to say, ‘Here is our standard contract, sign it.’ ”

Don’t settle for that, he said, although many do in ignorance, he added.

“Where possible, we would look for clients to negotiate their contracts. These business relationships should be mutually beneficial, even if one of these events occur,” said Shiraz Saeed, national practice leader, cyber, for the Starr Companies.

It’s a partnership, he said.

“It shouldn’t be a zero sum game on either side. I think there should be an understanding of what the potential loss might be and then designing a contract around that,” he said.

While cloud service providers are known for having high grade security systems, most average organizations don’t have the means for that. But no matter what a company’s resources, the first step is modeling where your digital assets are, and what you and your customers stand to lose if you lose access to them.

“Most insureds don’t seem to understand the amount of individual loss that you could be subject to,” said Jim Evans, leader of insurance advisory services at BDO Consulting. “Usually this stuff is measured in hours,” he said. “But what if a cloud provider is out for three or four days?” he said.

“Trying to quantify what you did lose in an event is hard enough. Trying to do a modeling exercise about what you could lose? It’s something that just doesn’t get done enough,” he said.

Once you have an understanding of what you own and what you stand to lose, the next step is prioritizing the protection of the assets you have. That means drilling into your contract with your cloud service providers to get the maximum indemnification.

It also means spreading your risk so that if at all possible, not all of your assets or your customers’ assets are housed by one cloud service provider. Cloud platforms can be public, private, or a hybrid of the two.

Understanding where your assets are in that architecture is crucial. Spending the money to insure that they are protected behind a diverse menu of firewalls is highly advisable.

Navigating the different iterations of business interruption coverage in property, cyber and kidnap and ransom policies is also important.

Make sure your broker can provide clarity on the different types of coverages and tailor them to your needs, experts said.

The concept of design thinking is really what’s in play here. Organizations have to work with vendors in every aspect of their operations to design a risk management system that can sustain this kind of hit.

“Build a better mousetrap to protect yourself,” said JKJ’s Friel.

“Depending on your service, you need to have the best and the brightest designing this stuff. Spread the risk.”

“Don’t be afraid to ask for more,” he said.

Postscript

In engineering an attack on the cloud, Emily Brookes and her cohorts accomplished the opposite of what they set out to do.

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Only the largest corporations with the most sophisticated risk management programs were able to survive the attempt to break the cloud with manageable losses.

Small businesses, the true backbone of the U.S. economy, suffered terribly. Entrepreneurs who put their life’s work into their business lost it in many cases.

Those on the lowest part of the economic scale, the working poor, lost their jobs and their ability to cover their rent and grocery bills. They joined the ranks of those subsidized by the government by the millions.  The attempt to break the cloud resulted in an even more polarized society. &

Dan Reynolds is editor-in-chief of Risk & Insurance. He can be reached at [email protected]