2016 NWCDC

The Claims Experience, Reimagined

For Disney's Tim East, the way forward is to change the way we think about — and talk about — workers' compensation.
By: | November 30, 2016 • 3 min read

Fast approaching its centennial anniversary, The Walt Disney Co. witnessed an extraordinary amount of change, with more dips and twists than any of its own amusement park rides.

Tim East, a director of corporate risk management for the company, has been on that ride with Disney for more than four decades. He says it boils down to three things: Change is going to come at us. Change is hard. But, ultimately, change is good.

“Change is going to be an unrelenting force,” East said on Wednesday in the opening keynote address of the 25th National Workers’ Compensation and Disability Conference® & Expo in New Orleans.

It requires the workers’ comp industry to adapt, and to make a solid commitment to continuous improvement, he said.

The change can begin with language.

“Dairy products and chopped meat go through processes. People should not be processed.” — Tim East, director of corporate risk management, The Walt Disney Co.

Employers have been advised for years to refer to their people as “injured workers” rather than claimants. But East took that concept further, noting that Disney refers to its claims adjusters as workers’ comp representatives.

“The worst thing we can call somebody is a loss adjuster,” he said, because it sends a message to injured workers that they’re just numbers in need of adjustment.

“The labels you give people reflect how you think about them,” said East.

But that point extends beyond people. The claims process, for instance, should be reframed as the claims experience, he suggested.

“Dairy products and chopped meat go through processes. People should not be processed,” said East.

It also shifts perceptions when employers stop talking about return to work, and start talking about “recovery while working.”

East went so far as to say that we should drop the term workers’ comp altogether, and start calling it worker recovery – an idea he credits to blogger Bob Wilson, president and CEO of WorkersCompensation.com.

If we make that change, said East, we shift the entire perception of the goal of workers’ comp, placing the emphasis where it more rightly belongs.

Walking the Advocacy Talk

East supports an advocacy-based claims model, with the goal of building trust and holding organizations accountable for results beyond cost containment.

“We’ve become so focused on red flags, that we can’t see the people behind the red flags – people that need our help,” East said.

Some in the industry might be surprised by other employee-focused recommendations East had to share, including eliminating unwarranted fraud investigation, clamping down on the overuse of utilization review, and engaging in fewer of what East calls “cheap denials” of claims.

He also advises employers to do everything within their power to make sure that injured workers have access to actual people who can answer their questions.

“Why is it so hard to talk to a human being in the workers’ comp industry?” he asked, noting that the No. 1 complaint he hears from union leaders is that injured workers can’t get to a real live person.

 

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]