Psychosocial Issues Are a Steep Barrier to Successful Return-to-Work. Better Support Starts with Asking the Right Questions

Sodexo Risk Management believes a deliberate and careful approach to the design and implementation of claim programs and practices will result in both effective cost mitigation results, as well as superior outcomes for our injured employees.

What follows is just part of our story.

Our workers’ compensation claims management team, made up of myself, director Gary Toth, and senior claims managers Megan Angus and Tamiko Willis, work closely with managing consultant Carol Ungaretti from Aon and our TPA Gallagher Bassett to take a collaborative approach that ensures our programs are grounded in data analytics and designed to support our employees following a work-place injury.

Several years ago, a Workers’ Compensation Benchmarking Study revealed that “psychosocial” issues rank as the number one barrier to successful claim outcomes, accounting for even greater costs, in total, than catastrophic injuries.

This study prompted our claims management team to work closely with Aon to help us design a program that could identify claims involving employees that may be vulnerable to barriers that can lead to a more challenging path toward a successful return to work (RTW).

Injured employees view their recoveries differently, depending on many factors, including their impressions and reactions to pain, anxiety, family concerns, and their manager.

These perceptions directly impact their recovery and will influence their ability to RTW.

The challenge presented to Sodexo was to design a process by which we could capture an employee’s perception of their future ability to RTW at an early point in the life of the claim. If we could do that, we felt there was an opportunity to implement a strategy aimed at addressing that perception.

Working with Aon, Gallagher Bassett and Concentra, we implemented a meaningful solution that leverages data mining, predictive analytics and an understanding of impactful interventions that can prospectively provide greater support to injured employees and thus allow the potential to positively reshape workers’ compensation outcomes.

We first designed a process for adjusters to follow when taking the initial recorded statement from the injured employee. The customized script “grades” targeted questions tied to an employee’s perception of their RTW date and work environment.

The initial questions are asked again at the point in time when the employee has been off work for 30 or more days (receiving TTD).

All responses are tracked in the TPA claim system.

Any and all open/active claims where the employee’s perception is negative, or where the employee appears unengaged in the claims process, are identified and included in a monthly meeting with the Concentra medical directors who are engaged in the medical treatment plan.

This process enables their team and ours to address negative employee perceptions from both a medical and “mindset matters” standpoint.

Implementing a practice that allowed us to obtain the employee’s perception of their return to work – directly from the employee – and use that data to address non-traditional workers’ compensation barriers to mitigating lost time, took a great deal of collaboration.

Our successful partnership with Aon, Gallagher Bassett and Concentra on this initiative, is making a difference.  Enhancing the RTW program to address psychosocial barriers is contributing to meaningful reductions in retained loss costs, as well as providing greater support to our injured employees. &