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

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]