Stevens Point, WI – Workers’ compensation insurer Sentry recently announced the launch of its Injured Employee Complexity Factor Models (IECF Models™), which will help identify injured individuals with early factors such as chronic pain and psychosocial risks that can prolong and prevent a successful recovery.
“Studies suggest that up to 10 percent of all workers with injuries may experience delayed recovery,” said Greg Larson, Sentry’s AVP of Workers’ Compensation Claims. “These workers account for a disproportionate amount of workers’ comp claim costs. The earlier we can identify potential risk factors, the sooner we can advocate on an injured worker’s behalf, develop a personalized care plan, and ultimately help them achieve their best post-injury life.”
According to historical data from Sentry, average claims outcomes involving early risk factors can remain open twice as long and cost employers 2.5 times more. By evaluating hundreds of data elements, the IECF Models will help claims professionals identify an injured individual with three or more risk factors.
Examples of risk factors include:
- Feelings of anxiety and stress
- Lack of support from family or friends
- Financial concerns
- Difficulty adjusting to physical and emotional changes
- Fear of reinjury
With the IECF Model information in hand, Sentry can create a managed care plan for a worker that helps address both the physical and mental barriers that may impede recovery. Prior to initiating service, customers, injured employees, and the injured employee’s legal counsel will be contacted to discuss care plan recommendations.
Sentry offers an extensive set of services to injured workers, including:
- Telephonic nurse case management (TCM)
- Optum pharmacy benefits management
- Virtual reality (VR) therapy
- Professional counseling services
- Weekly communication between injured employees and Sentry
“From the moment a claim is submitted, our goal is to provide the guidance, support, and quality care that an injured worker needs through every step of their recovery,” said Jean Feldman, RN, BSN, Sentry’s Director of Managed Care. “We believe these models have the chance to create better long-term health outcomes for injured workers and lower costs for employers. What’s more, it’s the right thing to do.”