Adjuster X

Preaching to the Choir

By: | September 1, 2013 • 3 min read
This column is based on the experiences of a group of long-time claims adjusters. The situations they describe are real, but the names and key details are kept confidential. Michelle Kerr is the editor of this column and can be reached at [email protected]

When I received the case information I had to read it twice.

I had to investigate a lower back injury claim from a preacher. A preacher? There’s no way that a man of the cloth would lie about an injury, right?

It certainly wasn’t a situation I had encountered before.

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But at the end of the day, tending to a congregation is a job with hazards like any other. I had to figure out the nature of the injury and exactly how it happened. I couldn’t help but wonder though … what does transitional work for a preacher look like? Delivering a sermon while seated?

When I visited the church, it was a gorgeous day with a cloudless, azure sky. In the office, the preacher sat across from me dressed in a black suit, white shirt and dark tie. His voice had a stentorian quality, not unlike James Earl Jones. I imagined his sermons were quite memorable.

The preacher appeared to be in discomfort. He grimaced on occasion, especially when shifting his weight. He said the accident occurred when he was stepping down from the church’s altar at approximately 11 a.m. on the previous Monday. He tripped and twisted his back while attempting to remain on his feet — but wound up falling to the floor. It didn’t happen during services, so there were no witnesses.

The preacher said he experienced immediate back pain, which became worse as the day wore on. He went to a chiropractor the following day, where he was X-rayed and given an adjustment. However, he felt no improvement and now wanted to see an orthopedist and even a neurologist for further testing and treatment.

He claimed he was in extreme pain and could no longer work. He had only come into his office that afternoon to meet with me. He made sure to ask about wage replacement.

I asked the preacher to list his job duties. It turned out that in addition to conducting worship services throughout the week and tending to his congregation’s needs, there were also administrative duties related to managing the physical grounds of the church and offices, supervising other church employees, signing payroll and dealing with vendors.

His supervisor was the area bishop. I winced when I thought about calling the prelate’s office to confirm the minister’s job duties. These were people that dedicated their lives to helping others, who was I to give them the third degree?

The call to the bishop was as surprising as it was awkward. I discovered that the minister’s salary was suspended if he was out of work. Therefore, temporary total disability payments were to be made for the length of the authorized disability.

I arranged for the preacher to see a local orthopedic physician. The doctor diagnosed it as a sprain of the lower lumbar area, and recommended bed rest for three weeks, muscle relaxers and pain medication. Therefore, the minister was unable to complete his job duties and responsibilities.

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My supervisor was shocked that the minister’s salary wouldn’t be continued while he was out of work. But it appeared there was no alternative to temporary total disability payments.

Fortunately, the preacher was an honest guy, and his very real injury lasted less than a month. It’s a good thing because trying to craft transitional duty or effect an early return to work for him would have been a challenge.

When the preacher was again able to minister to his flock, my supervisor and I did our fair share of rejoicing.

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]