Column: Workers' Comp

Opinion | Depression and Hallucinogens: Cutting Workers’ Comp Costs as a Team

By: | July 30, 2018 • 2 min read
Roberto Ceniceros is senior editor at Risk & Insurance® and chair of the National Workers' Compensation and Disability Conference® & Expo. He can be reached at [email protected] Read more of his columns and features.

Depression treatment possesses some quirky edges, such as a potential cure many in the workers’ compensation industry might find laughable.


A recent book generating media buzz, along with internet postings, focuses on the potential for curing depression with hallucinogenic mushrooms, known as psilocybin mushrooms to scientists and “shrooms” to party goers. And a podcast called “The Hilarious World of Depression” attracted millions of downloads with comedians humorously and seriously reflecting on mental health.

Depression probably doesn’t leap into an employer’s mind when they consider exposures that are driving their workers’ comp losses. Car crashes, falls, machinery accidents, slips, and trips come to mind first.

But the WC industry is learning that psychosocial issues hamper the resolution of hard-to-manage, physical-injury claims that drag on while costs mount.

It stands to reason that reports showing that major depression is increasingly rampant among Americans could mean that the affliction will become a bigger drag on the long-term outlook for workers’ comp claims losses.

Maybe we’ll find salvation in a different kind of trip; by taking shrooms.

Curing depression with magic mushrooms will strike many as laughable. I’m okay with that because laughter, even if induced by a fungus, is a good antidote for depression.

So, of course, I think there is potential that more depression among Americans in general means eventually more workers’ comp losses. I know that’s a depressing thought for claims payors already feeling the weight of the world. Magic mushrooms, anyone?

Depression is a serious ailment that can be debilitating. It can trigger suicidal thoughts, outright suicide, and costs employers tens of billions of dollars in absences and lost productivity.

I’ve learned that exercise, music and socializing fend off the depression that occasionally visits me. For others, fending off depression may seem impossible.

Injured workers commonly develop signs of depression post injury. Financial stress, medication side effects and pain are some causes and often require prescription anti-depressants.

The depression connection is one reason why return-to-work programs are crucial. Being at work helps workers feel less isolated and provides the financial and mental rewards of remaining productive.

That’s all post injury, though. I’m wondering what happens when you have more Americans showing up for work, or newly entering the workforce, already prone to depression.

Research published in May by the Blue Cross Blue Shield Assn. revealed that diagnosis of major depression rose 33 percent among commercially-insured Americans since 2013.


The rate is rising even faster among millennials; up 47 percent. It’s also up 47 percent for adolescent boys and 65 percent for girls. Major depression now impacts more than 9 million commercially-insured Americans.

The report notes that 85 percent of people diagnosed with major depression also suffer one or more serious chronic health conditions, with nearly 30 percent suffering four or more additional health conditions.

Discussing depression in the context of workers’ comp scares claims payors who fear being on the hook for mental claims. But depression is already showing up in claims that drag on.

So, of course, I think there is potential that more depression among Americans in general means eventually more workers’ comp losses.

I know that’s a depressing thought for claims payors already feeling the weight of the world. Magic mushrooms, anyone? Or maybe just a good podcast will do it for you. &

More from Risk & Insurance

More from Risk & Insurance

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.


That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.


Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

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