Column: Workers' Comp

New Mindset on Mental Health

By: | July 27, 2017 • 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.

Societal changes are tilting public opinion in favor of enacting laws that provide first responders with workers’ compensation benefits for post-traumatic stress disorder.

In June alone, at least two states — Colorado and Texas — enacted laws easing the way for police, firefighters and paramedics diagnosed with PTSD to receive benefits. During the same month, lawmakers in Vermont and Maine sent legislation to their governors that would presume PTSD suffered by first responders is work-related.

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As expected, unions representing first responders support these laws. Local governments, along with some insurer groups, have opposed, for fear of paying for a flood of new claims. Debate over adopting the laws includes conventional workers’ comp considerations like whether the claims are legitimately work-related.

But there is another, not-so traditional force at work.

Nearly six years ago when a former fire captain named Jeff Dill launched an organization called Firefighter Behavioral Health Alliance, few people talked about suicide prevention, addiction, and PTSD among first responders.

 There is a cultural shift underway. The stigma around acknowledging mental ailments is falling away, lending legitimacy to treatment.

That is shifting.

Today, you hear more people openly talking about mental health challenges. There is a cultural shift underway. The stigma around acknowledging mental ailments is falling away, lending legitimacy to treatment.

More first responders are similarly voicing stories about the trauma they experienced following horrific events, Dill said.

Couple that trend with the rise in high-profile mass shootings and you get greater sympathy-generating awareness of the mentally unsettling, war-like situations that police officers, firefighters and paramedics confront.

That adds significant emotional depth to arguments that the nation must take care of its first responders so they can take care of us. The idea of covering mental health conditions, however, still collides with workers’ comp systems that reflexively oppose assuming responsibility for mental injuries that are not as readily apparent as, say, a mangled hand.

Paul H. Sighinolfi took heat, as he put it, from his state’s municipalities for supporting adoption of legislation stating that first responders diagnosed with PTSD presumably acquired the condition as a result of their work

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Sighinolfi is executive director and chairman of Maine’s Workers’ Compensation Board.

“They are exposed to things that the human psyche just isn’t capable of dealing with,” Sighinolfi said of the types of traumatic events that first responders have described to him.

Sighinolfi supported the law’s adoption on the condition that it would mandate that a licensed psychologist or psychiatrist renders the PTSD diagnosis, and that work was the predominant cause.

He figured that would eliminate frivolous claims.

Workers’ compensation historically hasn’t adequately addressed mental health injuries caused by workplace injuries, said Mark Walls, VP of Communications & Strategic Analysis at Safety National.

With more people speaking out about mental trauma, that may be changing. &

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]