How Employee PTSD from a 2019 Mass Shooting in Virginia Beach Was Buffered by Rock Solid Workers’ Comp Procedures
Jeffrey Rodarmel’s cell phone blew up a little after 4 p.m. on May 31, 2019, as he drove the girls’ high school soccer team he coaches from the City of Chesapeake to a game in Norfolk.
A city employee had entered a municipal building with a gun and killed 11 city employees and one contractor.
Four others were seriously injured.
Fortunately, if anything about a mass shooting can be considered fortunate, the City and its third-party administrator, CorVel, was nearly finished overhauling the City’s workers’ compensation program. They had already identified PTSD as an important part of the program.
The focus on PTSD wasn’t arbitrary, Rodarmel said, but emerged from the convergence of recent developments: relatively new Virginia legislation that opened the door for PTSD workers’ compensation claims, an accepted PTSD claim from a firefighter the previous year — unheard of until then — and conversations with CorVel and nurse case managers in the City’s new program.
The fact that the City’s new PTSD program was nearly complete “helped tremendously in the early days when we were trying to figure out if PTSD claims would be accepted or not.”
The year-old firefighter case told him and his colleagues that it might be, but questions remained. “By Sunday morning, I had ton of questions I had to answer, and I didn’t have answers.”
The timing of the overhaul was fortuitous, said Rodarmel, who served as the City’s risk management administrator at the time of the shooting and is currently its financial operations administrator. The program had already contracted with mental health providers in its workers’ compensation network.
Rodarmel had dealt with several catastrophes in his previous military and insurance histories, but while each catastrophe is different and unique, all present “a job at hand.” Amid the chaos over the next two weeks of traumatized people walking into the emergency operations center less than a mile from the shooting, he said “there was a certain calm about it.”
That calm, he said, derived from the policies, processes and procedures he knew to follow in a crisis. “It became a reconciliation of who’s OK and who’s not OK. It became a damage assessment, a needs assessment and reaching out to families.”
CorVel already had a claims supervisor embedded in the City’s risk management office to serve its more than 73 thousand employees.
The City added another adjuster after the shooting to help with the swelling volume of claims. Those included not only claims from the event, but prior claims that were still in progress and new claims also. The City did not close for business after the event.
There were also the political and financial pieces to deal with. “Was I a little tired?” Rodarmel asked. “Yes. But I knew the mission at hand.”
A Methodical Approach
That practiced, methodical response to a crisis was enabled by the methodical approach Rodarmel, the City of Virginia Beach and CorVel brought to the overhaul of the workers’ compensation program.
The pre-planning was not without complications. It’s always hard to bring the behavioral health community into workers’ compensation programs, said Jim Stewart, account manager for the City of Virginia Beach, CorVel. “Behavioral health providers don’t do a lot of workers’ comp. They’re not certain how or if they’ll be paid.”
CorVel’s and the City’s perseverance in setting up a robust program paid off. “We have seen that when you get an injured person to the right medical professional right away, the outcome is better,” Stewart said.
By establishing a relationship with providers in advance of the urgent need, a significant number of the City’s approximately 100 employees who made PTSD claims remained functional and on the job.
“If the shooting had occurred before the program overhaul, the frequency and severity of the claims could have been exponentially worse,” Stewart said.
The overhaul also included a long, hard look at claims. When Rodarmel took the job of the City’s risk manager in 2015, he saw a five-year upward trend of workers’ compensation expenses and that the frequency and severity of claims had increased exponentially year over year.
He asked, “Why?”
A few providers drove the frequency and severity of medical treatments, he found, boosting the cost of medical care. The City cut some small providers responsible for the frequency issues, and Rodarmel negotiated a better contract with the local hospital group, which helped with severity.
This blossomed into a program called the “Tidewater Network,” which brought medical providers who could provide a better discount into the City’s PPO network. The program delivered a savings of $1.3 million in 2019.
The scrutiny of cases identified another cost driver. When Rodarmel first arrived, he found about 600 active claims from month to month, about two-thirds of which had nurse case managers, who are far more expensive than adjusters.
In a move he described as “back-to-basic claims handling,” the City and CorVel reassigned all but 50 to 60 of the more complex cases, the few that really did need nurse case management, to adjusters.
That move reduced nurse case management expenses from close to $400 thousand to less than $100 thousand, Rodarmel said.
Rather than angering employees over a perceived downgrade in their case management, most feedback from employees expressed relief. “Why do I have so many people on my claim?” Rodarmel recalls employees asking.
Instead of fielding an overwhelming number of communications from multiple sources – the nurse case manager, the state workers’ compensation commission, providers, and others – “most want a single point of contact.”
Some might say a single point of failure, Rodarmel said, but “that’s why CorVel has good supervisors and a good chain of command. Every case has an escalation plan.”
In the case of claims for “severe” injuries – which have no precise definition but may include the stabbings, concussions, broken bones, gunshot wounds and vehicle accidents that tend to beset police and firefighters, who account for most of the City’s most severe workers’ comp claims – injured employees could potentially be overwhelmed with communications at a time when they’re least able to respond to them.
“CorVel has a great plan in place to prevent that,” said Rodarmel.
Typically, PTSD claims don’t require nurse case managers, but a few of the 100-odd PTSD claims related to the May 30 shooting did because they involved physical injury also.
The City’s workers’ compensation program exceeds the state’s requirement of paying injured workers who are unable to report for duty 66 and two-thirds of their salary. “Injury leave,” a supplemental policy, makes up the difference when the worker is out of work for more than a day. Workers net 100 percent of their pay and use none of their personal paid time off to attend to their injury.
“We make the injured employee whole,” Stewart said. &