By: Mark Debus, Clinical Behavioral Health Specialist, Sedgwick
We can never forget that at the center of every workers’ compensation claim is a person facing a devastating or challenging injury. Using empathy to connect with an injured employee throughout the claims process is an approach that is leading to more positive outcomes. In short, when a claim starts out well, it will typically end well.
In recent years, we have seen a dynamic shift in the focus of workers’ compensation claim philosophy. Today there is less emphasis on simply managing costs and a greater concern for the overall well-being of the injured worker.
We’ve all heard about how employee engagement can lead to greater productivity in the workforce. Well, the same can be said for the workers’ compensation claims process. By using an empathy-based approach to managing workers’ compensation claims, we are better able to engage the injured worker and foster the healing, recovery, and return to work process. The results include better recovery rates, shorter claim durations, and lower litigation rates. In other words, empathy is helping to drive more positive outcomes for both employers and employees.
5 Ways Empathy Can Have an Impact
How is empathy changing the workers’ compensation claims experience?
- 1. Building Rapport. Since each claim is as different as the individual at stake, the path to a positive outcome must be personalized to meet each injured employee’s needs. Approaching each person with empathy and compassion will help the claims professional build a better rapport with the injured employee so they can better understand their needs and work together toward a better outcome.
- 2. Customer Buy-In. Once the worker feels they are being heard and supported, they are more likely to become engaged in the claim process. They will be more likely to respond to phone calls, submit documentation on time, and work with providers and other experts as the claim progresses.
- 3. Effective Investigation. By using active listening skills and communicating with empathy, claim professionals are better able to gather useful information and facts during interviews and claims investigations. The injured worker feels more open to sharing information about their story and individual needs. Claim professionals can better identify potential obstacles to recovery and provide needed resources more quickly and effectively.
- 4. Better Recovery. When the injured worker is engaged in the claims process, they are often more open to recovery services such as physical therapy or alternative pain management. If the injured worker feels more engaged in their own recovery, there are typically reductions in missed doctor visits and treatment sessions. They are also often more motivated to return to work.
- 5. Acceptance of Claim Decisions. A claim approval or denial isn’t always easy for an injured worker to accept. Showing compassion doesn’t mean that claim professionals will always provide the resolution the injured worker is hoping for. The claim professional’s job is to educate the injured worker about the claims handling process, help explain the decision, and help them to feel understood. For a variety of reasons, they may not be ready to hear that they will be out of work. Alternatively, a claim denial may be upsetting or spark anger. Experience shows that workers who are treated with empathy throughout the claims process are typically more understanding of the final claims decision and less likely to seek costly litigation.
Doing the right thing in each case includes making sure the employee has access to the medical resources they need, listening to their concerns, showing compassion, and being available to assist at every turn. Supportive, collaborative service focused on honoring the whole person has proven to be effective in improving outcomes.
About Mark Debus
As clinical behavioral health specialist since 2015, Mark has a dual role at Sedgwick. He works as a consultant to claims examiners on challenging or psychiatric claims. He is also an advocate for employees who’ve experienced a work-related injury and may be struggling with the aftereffects of a workplace trauma or who are experiencing other types of psychosocial stressors in their lives. Through careful assessment, coaching and advocacy, Mark helps injured workers overcome barriers to treatment and improve motivation for a successful return to work.
Mark started working with Sedgwick in 2006. Prior to his current role, he managed short- and long-term disability mental health claims. Before coming to Sedgwick, he worked as an employee assistance program (EAP) counselor, a trauma specialist, and as a care consultant for the Alzheimer’s Association. He is a licensed clinical social worker (LCSW).
Mark graduated with a bachelor of arts in psychology and communications (BA) from Marquette University and received a master of social work (MSW) from the University of California at Berkeley.
Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. We provide a broad range of resources tailored to our clients’ specific needs in casualty, property, marine, benefits and other lines. At Sedgwick, caring counts®; through the dedication and expertise of more than 21,000 colleagues across 65 countries, the company takes care of people and organizations by mitigating and reducing risks and losses, promoting health and productivity, protecting brand reputations, and containing costs that can impact the bottom line. Sedgwick’s majority shareholder is The Carlyle Group; Stone Point Capital LLC, La Caisse de dépôt et placement du Québec (CDPQ) and other management investors are minority shareholders. For more, see www.sedgwick.com.