Securing Great Outcomes in Workers’ Resolution

Securing Great Outcomes in Workers’ Resolution
No Surprises! The Importance of Conveying Expectations

Welcome to my series, “Securing Great Outcomes in Workers Compensation” which will explore various techniques in effective claims management.

In this installment, I will explore the importance of conveying expectations to the injured worker regarding claim resolution.

Resolution
• Start with the End in Mind: The expectation should always be for the employee to recover, and the claim closed.
• Duration for Recovery: Provide an anticipated duration for recovery.

• The Official Disability Guidelines or ODG is an excellent resource to understand when the average person returns to work based on their diagnosis.
• The injured employee should provide their thoughts as well regarding when they anticipate returning to work.
• This can help in identifying unreasonable expectations or a disconnect of the injured individual.

• The Physician’s Role: Many of the benefit decisions made by the examiner are based on what is communicated by the employee’s physician.
• Maximum Medical Improvement: Explain what this means and the next steps when it occurs.
• Benefit Notices: Make sure the employee is not surprised by a denial of permanent impairment, so explain the various scenarios and resulting notices.
• Conclusion: Outline how a claim is concluded and the forms that will need to be completed.
• Potential State Board/Bureau Resolution Approval: Articulate the role of the State’s Workers’ Compensation Board/Bureau in this process. In many cases, the State’s Board is an additional advocate for the injured individual.

As noted in my prior bogs, it is always important to secure the injured worker’s expectations. Asking the employee’s expectations regarding resolution at the onset of the claim can help temper unrealistic expectations and lend to a conversation on the process and any resulting compensation.

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