It certainly isn't happening today, but at one point in time a claim rep would spend a considerable amount of time in the field. I can imagine how that might sound to today’s claims community; “in people’s homes?!” Yup, in injured employees’ actual homes, taking statements, working through the details and dealing with all the elements that come along with it. Today, the life of an adjuster is very different. Today a claim rep's desk is so jam-packed, so completely full, drowning in stacks of bills to pay that there is no way they are going out in the field to meet an injured worker in person. What's happening in case loads today that impact our ability to generate positive outcomes?
Big dogs are easy...its the little ones that will get you
Being part of a different generation of claim reps, my work comp. adjusting life varied greatly vs. that of today. I was frequently out in the field. I remember taking a recorded statement up north of the White Mountains here in New Hampshire, which for those unfamiliar with the state might as well have been Canada, or even Greenland. A place where there are no neighbors, just mountains, dirt roads and moose. But this home felt safe, no alarm bells were going off when I walked in the front door.
We sat down, had a nice chat and I explained that I was there to determine this gentleman's eligibility for benefits and if so, walk him through that process. We were about a quarter of the way in when the injured worker’s little dog (one of those half squirrel, half rabbit looking ones) began to love on my leg under the table. So we’re clear, he LOVED my leg. I didn’t know what to do. I tried to gently nudge him away but that didn’t work. I clicked my pen closed and slyly slipped it under the table with the intent to just give him a little poke, to leave my leg alone. Just a little poke, I love dogs! Well, I poked him and immediately knew I hit the wrong spot….like an eye ball. The dog let out a whale of a cry and the injured worker stared at me bewildered. In that moment I would have rather been running from a Rottweiler. Naturally I cleared my throat and politely asked the man, “so, do you have any dependent children?” and kept moving without a flinch.
Another encounter involved a 2ft tall bird landing on my head, but that's a story for another time. The key here is that we don’t adjust claims like this anymore and there is a reason for it. The workers' compensation system was designed to manage acute/catastrophic injury, but the landscape has changed. Sprains, strains, a bruise, or some soreness were always a badge of honor for a hard day’s work decades ago. NOW, these claims are inundating our adjusting desks. And these claims are different. They are volatile. Our response to them matters. Claim loads are growing, and adjusters are drowning. Return to work has become a daunting task against an endless pile of bills.
Standards of Measurement
When you engage a case management provider, the initiative has to be focused on return to work. And return to work should be measured in MINUTES AND SECONDS. That’s how important it is.
That might mean snapping a photo of a work release, uploading to a PDF, highlighting, emailing to an adjuster, contacting an employer to coordinate an onsite ergonomic evaluation all with ten minutes from an appointment. THAT is how outcomes are generated in today’s claim environment. That is how true ROI is established in today’s claim environment. And that is a bit different than how claims were managed decades ago.