SAN DIEGO — Missed medical appointments due to lack of transportation, late-reported claims over fears of job and income loss, and language barriers are all pegged as factors that can delay workers compensation claims progression, according to experts.
By examining so-called social determinants of health and considering such factors as workplace demographics, culture and geography, employers and claims handlers can gain insights into what may be needed to help claims along, say speakers Tuesday at Riskworld, the Risk & Insurance Management Society Inc.’s annual conference.
“It’s looking at a person’s family, social and economic condition in relation to others in the community; and the three factors that we’re looking at here are income, education and occupation,” said Nikki Jackson, Charlotte, North Carolina-based vice president of strategy at MTI America, a company providing ancillary comp services.
Ms. Jackson relayed a labor statistic that 17% of working Americans are considering “working poor,” and that a workplace injury causes a spiral of worry that may delay even reporting the injury over fear.
“The number one question (following an injury) is am I going to lose my job? Then they worry about, will I get paid?” said Dawn Watkins, Los Angeles-based chief risk officer for the Los Angeles Unified School District.
Addressing issues outside of what may be on a claims form is key, according to Ms. Watkins, who said open-ended questions can help sift through the challenges the worker is facing outside of the injury itself.
Language barriers are a common issue, Ms. Watkins said, adding that even if a person can speak English, it doesn’t mean they can understand the paperwork and lexicon common in comp. “Let go of the jargon and the QME, PT, MMI, MPN,” she said of common acronyms used in the industry. “We could do the alphabet soup game right here. It’s hard for people; they don’t understand.”
Ms. Watkins stressed the importance of staying in contact with injured workers.
“It may be questions about transportation… I’ve had nurses come back and say they had a claimant take three buses to get to this appointment,” she said of an issue that could spell missed appointments and delayed return to work. The solution is often to provide transportation.
“We try to think what will help that injured worker where they are,” Ms. Watkins said.