Workers’ Compensation: My Father’s Story

My Dad.

My Dad

My father was an injured worker. This is the first time I have ever written about this publicly. But since his birthday would have been this week, I am thinking about him more.

Dad was a renaissance man. After writing poetry, acting in plays and running cross-country in high school, he found himself loading trucks for a living to support his wife and family.

Though he was an alcoholic, he never allowed it to interfere with his strong work ethic. He never missed a day of work, no matter how sick he was. He was president of his local teamster’s union, but he hated advocating for workers who did not pull their weight.

He was a tough man. And he had these rules for keeping himself tough. He never wore a winter coat in Cleveland’s famously miserable winters until December to get his body used to the cold. He drank hot coffee in the summer to get used to the heat. 

While I was working to complete my journalism degree in the late 1980s, I was unaware that my father had filed a workers’ compensation claim with his self-insured employer. We did not talk much.

I did not know about his claim when I landed my first job at the Ohio Bureau of Workers’ Compensation. By the time I found out, he had been off work for two or three years due to back problems. This was the early 1990s, when the workers’ compensation cost crisis was starting to inspire employers to initiate activities to save unnecessary workers’ comp expenses, such as return to work.

His employer was not enlightened, so dad did not get a return to work opportunity. Instead, he sat home, waiting for the next hearing, the next letter from the attorney…you get the picture.

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To use my dad’s words, he needed to work so he could feel like a man.
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My parents’ divorce was finalized while my father was on workers’ comp. He told me later that not working was an important contributing factor that led to the divorce. He said he did not feel like a real man because he could not provide for his family and eventually, it pervaded his psyche. Ultimately, he ended up on Social Security Disability.

When I started covering workers’ comp full-time as a reporter in Washington. D.C., I did not tell anyone about my dad. My role as a reporter was objectivity, not advocacy. I kept my opinions to myself and kept them from my work. And I did right.

My dad’s experience did not cause me to become an advocate for injured workers in the traditional political sense. The political arguments were too shortsighted to me. I have always felt the best contribution I could make was to objectively report the truth about workers’ compensation for everyone’s benefit. I also try to inform injured workers when I can. To see more, please click here.

For example, one shortsighted political goal of injured worker advocates was to push for employee choice of physician. I had always wished, however, that labor and employer advocates worked together to ensure insured workers got the best medical care as soon as possible.

Dad might of thought it was great at first that he could get a break from work with the stroke of the doctor’s pen. But if he had known what we know now – that the longer a person is off from a work-related incident the harder it would be for he/she to return to their same earnings – he might have been a little more urgent about finding a solution.

We know now that he did not need the choice of physician; he needed an occupational physician to hasten recovery. He did not need a doctor that would sign an order to stay home from work, but one who encouraged him to explore ways he can earn a living with his disability.

My dad did not need a lawyer to fight with his employer so he could be out of work collecting benefits as long as possible. And he certainly did not need to lose a percentage of his benefits to his attorney. We know now that many employees hire attorneys due to lack of communication on the employer’s part. (I have offered advice on how to improve communication about workers’ compensation in previous blogs. To see one of these blogs, click here.)

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What my father did need, however, was an employer who cared about him.
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Back in those days, at least in Cleveland, it was assumed a lawyer was necessary for workers’ comp. If my dad had known he could self-advocate instead, I think he would have done a fine job on his own and saved money in attorneys’ fees. He was always fantastic at advocating for others.

What my father did need, however, was an employer who cared about him. All workers need that. And thankfully, many employers have found that having a culture of caring pays off in many ways. He also needed a return to work opportunity. To use my dad’s words, he needed to work so he could feel like a man.

Years later, dad got cancer and the fateful call to Hospice had been made. I wanted to see him, but I was far along in the pregnancy of my second daughter and was contagious with a sinus infection. There was no easy way to get from Washington, D.C. to Cleveland in the winter so he advised me not to come.

Just one week before my second daughter was born, and four days before dad died, we prayed together and said goodbye. I hung up the phone in tears knowing that someday, when I reach the end of my journey, I will see him again in a better place.

He died just after his 59th birthday.

I don’t think of my dad much when I write about workers’ compensation because his identity to me was being my father, not an injured worker. I think of him, instead, in the totality of the man he was. Seeing what happened to my dad does give me empathy for how workers’ compensation affects everyone associated with work-related incidents. Families, supervisors, co-workers and others are affected as well.

I am grateful that I have seen the workers’  compensation system improve from so many perspectives since dad filed is claim in the late 1980s. I still believe, however, we have a long way to go.  

Tips for Workers’ Comp Independent Med Exams

Independent medical exams (IMEs) can be an effective way to determine an injured worker’s medical status. But too often, they turn out to be a waste of money.

I asked my colleague, Daniel R. Miller, senior consultant for ClaimDocs, to give me some quick tips. I’ve known Dan for nearly 20 years and his career background includes national consulting firms.

Here are Dan’s tips:

1)   Before scheduling an IME, the claims manager and exam doc must know its purpose. Be specific about the details. Whether the issue is misdiagnosis, causation or degree of disability, provide medical reports, witness and injured worker statements, and other supporting materials.

2)   Find out the state’s laws and applicable treatment guidelines. Make a checklist of what needs to be done, how and when. Follow it to the letter. Some states dictate timing and conditions of the IME. More often than not, IMEs occur too late in the process. Therefore, starts considering an IME when the medical pieces of a claim are not fitting together and/or “red flags” are showing up.

3)   To ensure credibility, hire well qualified and highly respected doctors. Those with a relevant specialty tend to get more weight than generalists. Docs with successful private practices, are affiliated with teaching hospitals or are involved in research are generally given more credence.

4)   IMEs related to returning an injured worker to the job should include specific job requirements according to the employer, physician input and the employer’s efforts to assure return to work. Providing the job requirements on video is generally very helpful.

5)   Communicate clearly to appropriate parties throughout the claims process. No matter how much you follow the other steps, miscommunication can cause something to go wrong.

For more information, you can contact Dan directly by writing dan@claimdocs.com.

If you have other good tips or feedback, please add a comment.

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Workers Need to Know the Truth About Workers’ Compensation (Part 2)

Thanks to solomonsseal.wordpress.com for the photo.

In last week’s blog, I explained that the path to a better workers’ compensation system begins with getting past the political arguments. I am convinced that better informing workers about how the system should work will greatly improve both public policy discussions and the claims process.

Injured workers can be tempted to stay home from work as long as possible. I suspect they do not realize the long-term implications of unnecessarily being off work too long.

Before I make the case for return-to-work for injured workers, I want to state very clearly that I am in no way suggesting that injured employees work hurt. This is inhumane and can lead to possible re-injury, which can make a claim much more complicated than necessary. Injured workers need to know that returning to work as soon as medically feasible is in their best interest in the long term.

Studies have shown that the longer an employee is away from work, the less likely they are to return. One concluded that after 12 weeks, injured workers have only a 50 percent chance of returning to work and by one year, potential for gainful employment drops to less than 2 percent.

There is just something about work that gives people meaning. When I was an outreach worker to senior citizens in my teens, I saw retirees die unnecessarily early because they did not find meaningful activity after retirement. I remembered asking an African-American woman in her 90s who was born before 1900 how she lived so long despite all she had been through. She said she always made sure she had work to do.

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Let your employer know you want to come back to work
as soon as it is OK with your doctor.
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Absence costs workers in several ways. Consider the disruptions in family life and schedules and restrictions from pleasurable activities, such as hobbies or sports. Finding another job in the current economic market may also prove to be difficult.

Workers can be adversely affected psychologically when they are not working and do not feel like productive members of society. For 20 years my father loaded trucks for a living. When he sustained soft tissue back injuries and did not return to work, he didn’t feel like a man because he could not provide for his family. Prior to this he never missed a day of work, but ended up on social security disability. He died about 12 years after filing for workers’ compensation.

What can workers do?

1)   Don’t listen to anyone who tells you to take advantage of workers’ compensation and enjoy the time off from work. While it appears to be a break in the short-term, it really isn’t worth it.

2)   Let your employer know you want to come back to work as soon as it is OK with your doctor.

3)   Help your employer find ways you can work.

4)   Are you eligible for telework? If so, make it known that your willing to work remotely.

5)   Contact your company’s Employee Assistance Program to find out other ways you and your family can get support.

And if your employer does not help you return to work, focus on looking for work elsewhere. You want to work for people who care.

My hope is that this blog will inspire injured workers to take an active part in the process. I also hope it encourages employers and system professionals to help educate injured workers. What else should injured workers know? Please share in the comments section.

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Workers Need to Know the Real Truth About Workers’ Compensation (Part 1)

As a journalist and writer, I have objectively covered virtually every aspect of workers’ compensation from all perspectives for more than 20 years. Everyone wants to see a better system.

But we can’t, however, seem to get past the tired, old post-industrial revolution debates. Public policy conversations feel more like massive labor-management contract negotiations than forward-thinking conversations about how workers’ compensation can better serve injured workers and their employers.

Meanwhile, too many injured workers are being adversely effected because they do not know how the system is supposed to work.

A concerted effort to educate injured workers on what workers’ compensation experts know is the best way to get past the political rhetoric and see immediate improvements. The workforce needs to know the truth about workers’ compensation. Specifically, injured workers need to know the following:

The sooner they let their employers know about a work-related incident, the quicker they can get workers’ compensation benefits. Workers, employers and insurers do not benefit from delayed claim filing. Informing employers about a work-related incident is also the best way an employer can address a safety hazard to prevent other co-workers from getting hurt. So if you get hurt at work, don’t hesitate. File a claim.

Getting the best immediate care is more important for healing than seeing your general practitioner who is not likely to be familiar with occupational medicine.

Injured workers should never pay a medical bill or accept shoddy physician care. Workers’ compensation provides first dollar coverage, except in Washington state, which requires a co-pay. If your doctor is not helping you get better, ask the insurance company for a nurse case manager who knows who the good docs are.

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Public policy conversations feel more like massive labor-management contract negotiations than forward-thinking conversations about how workers’ compensation can better serve injured workers and their employers.

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Giving employers and their insurers a chance to respond to a claim filing is often a better bet than hiring attorneys. Workers’ compensation was originally designed as a self-administrating program intended to discourage litigation. One study showed that 46 percent of injured workers who hired attorneys said they did so because they felt their claims had been denied when actually, they were not yet in the process. To learn more about the Workers’ Compensation Research Institute’s (WCRI) study on why injured workers hire attorneys, please click here. (Full disclosure WCRI, an independent research organization, is a client of Lipold Communications, LLC).

Therefore, if you have not heard from the insurer or your employer within a week of reporting the accident, contact your employer to make sure the claim was properly reported. Attorneys get about 10 to 25 percent of paid wage replacement benefits. As with any professional, get good references for lawyers who will advocate for you, not their wallets. Want to know your claim status? Call the insurer’s claim representative.

I hope this blog will encourage a concerted effort to better educate the workforce. Employers can learn more about workers’ compensation communications plans by clicking here.

Next week I will offer more tips. In the meantime, what else do injured workers need to know?

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Why Injured Workers Hire Attorneys (and What Employers Can Do About It) -Part II

(Due to the popularity of last week’s topic, I am publishing my blog a day earlier than usual.)

Special thanks to watoday.com for pic.


Last week’s blog covered some of the reasons why injured workers file claims according to a study, “Avoiding Litigation: What Can Employers, Insurers, and State Workers’ Compensation Agencies Do? published by the Workers Compensation Research Institute in 2010. (In full disclosure, WCRI is a client of Lipold Communications.) The study is based on the responses of 6,823 injured employees with lost-time claims in 11 states that represent 46 percent of the nation’s paid workers’ compensation benefits.

This week’s blog covers on other factors that boost the chances workers will ask lawyers for help, according to the WCRI study.

Claims with greater injury severity or complexity are more likely to be litigated, according to the WCRI study. Attorney involvement among workers with the most severe injuries was 15 percentage points higher than those with mostly minor injuries.

Not surprisingly, soft tissue injury claims, for example, were more likely to involve attorneys. Unlike claims connected to specific incidents, soft tissue injury claims can often be filed without the employers’ knowledge, which makes it difficult for them to communicate to workers right away.

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By considering employee demographics, employers know their audience better — which is essential for creating effective employee communication plans.
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This underscores the point I made in a previous blog that an effective workers’ compensation employee communication plan should educate workers about workers’ compensation before work-related injury incidents occur. Workers who know what to do and what to expect are more likely to get the best medical treatment.

Employer size is also a potential factor depending on the situation, WCRI found. Larger companies are more likely to have co-workers with negative experience with workers’ compensation. However, larger employers are more likely to have the resources to provide timely and effective outreach to injured workers.

Workers in smaller organizations, however, are more likely to have direct personal relationships with their employers so claims are less likely to involve attorneys.

How long an employee has worked for an employer affected the likelihood of workers hiring attorneys. Workers who had less than one year on the job were injured were more likely to hire attorneys, according to the study. Meanwhile, those with more than 10 years of tenure with the same employer were less likely to involve attorneys due to employer loyalty. This was offset, however, when workers feared a pay cut from being unable to return to a job with their employer.

An employee’s age can also be an influence. Twenty percent of workers aged 55 or older hired attorneys, according to the study. About 17 percent of those between the ages of 25 and 54 hired attorneys, and nine percent of 15 to 24-year-olds did so. The study hypothesizes that older workers are more likely to know others who hired attorneys.

Union membership is often perceived as a reason why workers’ sought out legal help but this depends on the situation. The WCRI study noted union membership is not a reliable factor because the pros and cons of union involvement cancelled each other out.

Unions can provide valuable information to workers and tend to have connections to lawyers. Unions, however, can also provide protection for reemployment and can help members through the process.

An employee’s level of education is also a factor. The less educated workers were more likely to hire an attorney because they were more likely to be intimidated by the claims process. The study notes that high school graduates were six percentage points more likely to hire attorneys than college graduates.

WCRI’s study points to the importance of understanding the demographics of the local labor force. The key to effective communication is all cases begins with knowing the audience you are trying to reach. By considering employee demographics, employers can know their audience better — which is essential for creating effective employee communication plans.

To learn more about the importance of knowing your audience for effective communication, click here. My blog on customer empathy, which you can find by clicking here, should also be helpful.

(Note: This is part of my ongoing series on What Every Employer Should Know About Workers’ Compensation. Check out the “workers’ compensation” in tag in the left-hand column for more tips.)

Why Injured Workers Hire Attorneys (and What Employers Can Do About It)

Special thanks to myremoteradio.com for the pic.

(The discussion based on this blog was named a “manager’s choice” by Mark Walls, moderator of the Workers Compensation Analysis Group–LinkedIn’s largest workers’ compensation group. Thanks Mark!)

Workers’ compensation got started about a century ago to remove workers and their employers from the tort system when occupational injuries and deaths occurred. Unfortunately this oldest form of American social insurance remains highly litigious – and costly.

Attorney involvement in claims is expensive for injured workers and employers alike. Claims involving attorneys cost an estimated 30 percent more in expenses. And too often, workers do not understand they could stand to lose 10 to 25 percent of their compensation to attorney fees.

Hiring attorneys is often unnecessary. When employers do an effective job communicating to workers about workers’ compensation – especially the claims process — litigation can often be avoided.

The Workers Compensation Research Institute (WCRI) published a study in 2010 that points to this reality. Forty-six percent of injured workers who hired attorneys said they did so because they felt the claim had been denied, according to the study, “Avoiding Litigation: What Can Employers, Insurers, and State Workers’ Compensation Agencies Do? (In full disclosure, WCRI is a client of Lipold Communications.)

It turned out, however, that these workers did not understand that their claims had not yet been accepted into the workers’ compensation claims process.

Insufficient information about what happens after a work-related incident occurs can breed fear. Twenty-three percent who hired attorneys strongly agreed they did so out of concern of being fired or laid off. Fifteen percent also strongly agreed that they needed an attorney because they were worried that their employers might consider claims as illegitimate. (By the way, the WCRI asked 6,823 injured employees with lost-time claims in 11 states that represent 46 percent of paid workers’ compensation benefits.)

Thankfully, there are ways that employers can minimize unnecessary legal action.

Employing a communication plan can discourage uncertainty and save thousands of dollars in potential workers’ compensation cases as I outlined in a previous blog. Training supervisors, also covered in a past blog, also makes a difference because they are often in the best position to communicate and set the tone for injured workers’ experiences.

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Insufficient information about what happens after a work-related incident can breed fear.
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Since the largest reason why workers hired attorneys was due to fear of their claims being denied, timely communicating a claim’s status should reduce the likelihood of attorney involvement. This reinforces my contention that workers need communication tools that explain the claims process, telling them what to expect and when. Employers would do well to make that investment.

Employers also need to communicate to workers in language they understand. Those interviewed in Spanish hired attorneys twice as often as those who were interviewed in English. Given that workers’ compensation is hard to understand for those of us who speak English, I can only imagine how difficult it must be for those who do not know the language well.

The WCRI study offers more reasons why workers hire attorneys. I’ll cover those in next week’s blog!

(Note: This is part of my ongoing series on What Every Employer Should Know About Workers’ Compensation. Check out the “workers’ compensation” in tag in the left-hand column for more tips.)