3 Easy Steps You Can Take Today to Avoid Workers’ Comp Claims Litigation

Because accidents happen, the strategies an employer implements at the start of a workers' comp claim will dictate if it becomes a legal affair. Two experts share how to avoid just that.
By: | December 13, 2018 • 3 min read

Accidents happen.

That’s what Michael Stack, CEO, Amaxx LLC, and Stuart Colburn, a shareholder with Downs Stanford, had to say during a presentation at the 2018 National Workers’ Compensation and Disability Conference® & Expo in Las Vegas earlier this month.

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And because accidents happen, they said, the strategies an employer implements at the beginning of a work-related injury will dictate the ultimate success of the claim.

Their presentation “Avoiding, Managing and Winning Workers’ Comp Litigation” was filled with helpful tips and strategies for employers to set a goal of reducing litigation rates in workers’ comp. The main takeaway: The best way to reduce legal expenses is to avoid litigated claims altogether, making learning how to do so equally critical. Stack and Colburn provided three ways to start.

1) Understand why employees seek litigation.

The number one reason people often seek litigation, said Stack, is fear. Colburn added when that fear is driven by perception, litigation is almost inevitable. He said people often have a perception of insurance that is negative, and so their actions are guided by these perceptions. This makes understanding employees’ mindsets crucial.

In a WCRI study released in 2014, 48 percent of the surveyed injured workers responded that the fear of being fired after injury was the number one reason why they sought a lawyer. Alongside that, the fear surrounding money set in. Colburn said that often injured workers’ first thoughts are “how am I going to get paid?” and “who’s going to pay for the ER bill?”

2) Add in advocacy from the start.

Knowing and understanding an employee’s desire to seek litigation is just the start to turning around the claims process, they said. Once employers know why, they can start to implement practices to curb those feelings of fear, ultimately avoiding litigation in the long term.

Stack swore by sending a ‘get well soon’ card. He said it’s the simplest way to show an employer cares. It also shows the employer is thinking about the employee’s health and recovery — not the employee’s lost time. Stack also said employers need to reach out to the employee within the first 24 to 48 hours to review the workers’ comp process and provide reassurance that the employee’s healing is the number one priority.

Of course, not all claims are approved, and the best practice employers can adopt is communicating regardless if a claim is granted or denied. Keeping that flow of communication open is key to preempting fear of losing a job or not getting paid, they said.

“You cannot over-communicate,” added Colburn. “No worker has ever said ‘my boss told me too much about workers’ compensation.’ ”

3) Supervisor training.

Communication is a great tool to have when it comes to advocacy. And Stack and Colburn said supervisors who have been trained in these communication best practices tend to have great results when it comes to avoiding litigation. They are taught how to listen and how to relay information during a claim. Most importantly, they said, the supervisors are taught to use empathy when listening to their employees.

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In fact, they showed data from one study, which found supervisors who had just 1 to 1.5 hours of best practices training had a dramatic decrease in the rate of claims going to court.


Stack and Colburn further provided attendees with three ways to measure how well these litigation avoidance strategies are working:

  1. Track lag time in claims. See how long it takes from an injury to be reported to when a claim is either approved or denied. By being active communicators and listeners in the process, supervisors will be able to see how that lag time impacts each employee and what might stem from that wait period.
  2. Review the return-to-work time frame. Ideally, said Stack, 90 percent of injured workers with non-catastrophic cases should be back to work within zero to four days of initial injury. This will help eliminate the fear of not receiving payment.
  3. Finally, watch litigation rates over time. If the avoidance strategies are in effect and everyone is doing their due diligence, then employers should start to see rates drop. &
Autumn Heisler is the digital producer and a staff writer at Risk & Insurance®. She can be reached at [email protected]

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.

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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.

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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]