The News You Need for Feb. 23
It's Friday, but don't worry: Starting tomorrow, we're going to run weekend editions of the News You Need so you never have to take a break from WorkersCompensation.com
Self-Leadership for Workers’ Compensation Adjusters: A Path to Excellence
Sarasota, FL (WorkersCompensation.com) -- Workers’ compensation adjusters operate in a complex environment where they must balance the needs of injured workers, employers, and insurance requirements. This role demands a balance of empathy, care, compassion, and excellent communication skills. However, there is a noticeable difference in the performance of different adjusters, with some excelling in their roles and others falling short. The core of their role is to manage claims efficiently while providing compassionate support to those affected by workplace injuries. Self-leadership offers a robust framework for adjusters to navigate these challenges successfully, enabling them to handle claims more efficiently while maintaining a human touch.
The Essence of Self-Leadership
Self-leadership is a crucial aspect for workers' compensation adjusters to navigate the complexities of their role effectively. It encompasses self-awareness, self-motivation, and self-influence, which require deeply understanding one's emotional responses and inherent biases. By setting personal and professional goals aligned with their core values, adjusters can strive for excellence in their work, ensuring fairness and accuracy in claim assessments. Adopting behaviors that drive positive outcomes can significantly impact claims resolution, improve claimants' experiences, and foster trust in the compensation process. This approach not only enhances the adjuster's professional development but also contributes to the efficiency and effectiveness of the workers' compensation system.
Essentialism and Negativity Bias: They Affect You
Understanding the impact of essentialism and negativity bias is crucial for workers' compensation adjusters. Essentialism is the tendency to view individuals as embodying fixed traits, which can lead adjusters to unfairly categorize injured workers, potentially overlooking the unique circumstances of each case. The negativity bias phenomenon gives more weight to negative aspects than positive ones. As a result, adjusters may focus on the potential for fraud or malingering instead of the genuine need for support and rehabilitation. These biases can hinder the adjuster's ability to empathize with the injured worker and provide equitable, compassionate service. However, recognizing and mitigating these biases can significantly improve the adjuster's effectiveness and the overall fairness of the workers' compensation process.
From a self-leadership perspective, workers' compensation adjusters should actively practice self-reflection to identify and challenge any essentialist views or negative biases they may hold. Developing empathy through active listening and seeking to understand the unique context of each injured worker's situation can mitigate these biases. Adjusters should set personal goals to approach each case with an open mind, ensuring decisions are based on facts rather than assumptions. Continuous learning about diverse experiences and challenges injured workers face can broaden perspectives. Cultivating a mindset of positive reinforcement, where adjusters acknowledge their progress in overcoming biases, can reinforce their commitment to fair and empathetic claims handling.
Strategies for Enhancing Self-Leadership
By implementing effective self-leadership strategies, workers' compensation adjusters can improve performance, enhance interactions with claimants, and contribute to a more efficient and empathetic Workers' Compensation system.
The Impact of Self-Leadership
The impact of self-leadership in workers' compensation is significant and has many dimensions. Professionals who embody self-leadership principles excel in creatively solving problems, fostering robust and meaningful connections, and carefully navigating claimants through the workers' compensation process complexities with empathy and professionalism. This commitment leads to greater job satisfaction and career advancement for adjusters. Additionally, it significantly improves the quality of service claimants receive, resulting in more positive and efficient claim outcomes. Adopting self-leadership practices can be a cornerstone for developing a more compassionate, efficient, and claimant-focused workers' compensation environment. Such an approach underscores the importance of self-leadership in transforming the workers' compensation landscape, ensuring that adjusters are influential in their roles and instrumental in driving positive changes within the system.
The Transformative Power of the Workers' Compensation Adjuster
The position of a workers' compensation adjuster is highly significant. It has a transformative impact on the lives of injured workers. Every decision, communication, and interaction holds the potential to change the course of an injured worker's life, emphasizing the immense responsibility in this role. Adjusters do more than process claims; they provide guidance, support, and understanding during some of the most challenging times in an individual's life. Recognizing the weight of this role enhances the adjuster's ability to perform with empathy, accuracy, and a sense of purpose, ultimately shaping positive outcomes and facilitating healing and recovery for those they serve. This understanding emphasizes the essential nature of their work, not just in the context of administrative tasks, but as a critical influence on the well-being and future of every injured worker they encounter.
Upcoming Focus
Our series will delve deeper into the role of self-leadership within the workers' compensation landscape. We will explore how it applies to attorneys, employers, injured workers, nurse case managers, human resources professionals, and risk managers. Each segment will offer tailored insights and strategies to empower professionals within their domains. We will highlight the universal value of self-leadership in fostering a more compassionate, efficient, and effective workers' compensation system. Stay tuned as we delve into the transformative power of self-leadership. We aim to create a more empathetic and thriving workers' compensation community.
What Do You Think: Was Meals on Wheels Accident Within Scope of Employment?
Newark, DE (WorkersCompensation.com). When an employer involves employees in volunteer work, that work can result in a compensable injury if it occurred within the scope of employment.
A case involving a customer service representative ?for Sallie Mae who fell down some steps while delivering meals on wheels illustrates some factors that can make the difference in whether such an injury is compensable or not.
The CSR participated in Sallie Mae’s employee volunteer program. She selected Meals on Wheels as her volunteer activity.
The purpose of the EVP, according to Sallie Mae, was "extending PTO to an employee whose chosen volunteer activity occurs during the workday so that she can participate without having to use her personal leave time in order to do so."
Sallie Mae gave employees complete discretion over what volunteer activity they chose, if any. An employee just needed to get management approval to ensure there was? sufficient staffing during her absence. Whether an employee volunteered or not had no impact on their job or how they were evaluated.
While delivering meals, the CSR fell down some stairs and injured her head, neck, right shoulder, and right side. She filed a workers’ compensation claim, which was denied.
On appeal, the court explained that an injury is compensable if it arises out of and in the course of employment.
In determining whether an injury sustained during volunteer work occurred within the scope of employment, courts consider whether:
The customer service rep argued that Sallie Mae brought the activity within the orbit of employment by regulating the EVP.
Were the CSR’s injuries compensable?
A. No. Sallie Mae neither required her to volunteer nor treated her more favorably because she volunteered.
B. Yes. Sallie Mae created specific rules for volunteers, including the need to get permission to volunteer at a particular time.
If you selected A, you agreed with the court in Testa-Carr v. Sallie Mae, C.A. No. N23A-04-004 CEB. (Del. Super. Ct. 02/08/24), which held that the injury did not occur within the scope of employment.
The court pointed out that “making the activity part of the services of an employee” suggests that the employer expects the employee to engage in the activity. But there was no such expectation in this case.
“Instead, as already recognized, the evidence supports that there is no pressure from Sallie Mae on its employees to volunteer.” Further, Sallie Mae did not treat an employee more favorably or less favorably because the employee volunteered.
The court acknowledged that volunteers reaped the benefit of being able to use their PTO. “[H]owever, under circumstances where taking such time is completely optional and voluntary, volunteerism is not found to be part of the services of the employee, the court wrote.
Compliance Corner: Ohio Standards of Conduct
Columbus, OH (WorkersCompensation.com) -- According to Ohio law, it is the policy of the industrial commission and the bureau of workers' compensation to carry out its mission in accordance with the strictest ethical guidelines and to ensure that commission and bureau employees conduct themselves in a manner that fosters public confidence in the integrity of the commission and the bureau, its processes, and its accomplishments.
The following highlights how Ohio seeks to uphold its standards of conduct and enforce ethics rules.
Prohibited Conduct
No industrial commission member, the administrator of workers' compensation, bureau of workers' compensation board of directors member, commission employee, bureau employee, ombudsperson, or employee of the office of ombudsperson shall do any of the following acts:
(a) Solicit or accept anything of value from anyone doing business with the commission or the bureau;
(b) Solicit or accept employment from anyone doing business with the commission or the bureau, unless the member or employee completely withdraws from any commission or bureau discretionary or decision-making activity regarding the party offering employment, and the commission or the bureau approves the withdrawal;
(c) Use his or her public position to obtain benefits for the member or employee, a family member, or anyone with whom the member or employee has a business or employment relationship;
(d) Be paid or accept any form of compensation for personal services rendered on a matter before, or sell goods or services to the commission or the bureau;
(e) Be paid or accept any form of compensation for personal services rendered on a matter before, or sell (except by competitive bid) goods or services to, any state agency other than the commission or the bureau, as applicable, unless the member or employee first discloses the services or sales and withdraws from matters before the commission or the bureau that directly affect officials and employees of the other state agency;
(f) Hold or benefit from a contract with, authorized by, or approved by the commission or the bureau, (the ethics law does accept some limited stockholdings, and some contracts objectively shown as the lowest cost services);
(g) Vote, authorize, recommend, or in any other way use her position to secure approval of a commission or bureau contract (including employment or personal services) in which the member or employee, a family member, or anyone with whom the member or employee has a business or employment relationship, has an interest;
(h) Solicit or accept honoraria except that employees who are not financial disclosure filers may receive an honorarium only if the honorarium is paid in recognition of a demonstrable business, profession, or esthetic interest of the employee that exists apart from public office or employment, and is not paid by any person or other entity, or by a representative or association of those persons or entities, doing business with the commission or the bureau, as applicable;
(i) During public service, represent any person, in any fashion, before any public agency, with respect to a matter in which the member or employee personally participated while serving with the commission or the bureau, as applicable; and for one year after leaving public service shall not represent any person, in any fashion, before any public agency, with respect to a matter in which the member or employee personally exercised discretionary authority while serving with the commission or the bureau; after separation from state employment, this policy does not apply to ministerial acts on behalf of a client or customer;
(j) Use or disclose confidential information protected by law, unless appropriately authorized;
(k) Use, or authorize the use of, his or her title, the name of the commission or the bureau, or the agencies logos in a manner that suggests impropriety, favoritism, or bias by the commission or the bureau, or by a member or employee;
(l) Solicit or accept any compensation, except as allowed by law, to perform his or her official duties or any act or service in his or her official capacity; and
(m) Sponsor parties or other entertainment for the personnel of their agencies, the costs of which are covered in whole or in part by donations or receipts from the sale of tickets to individuals or entities, who are doing or seeking to do business with the commission or bureau.
Definitions
For purposes of Ohio's ethics rules, these phrases have the following meanings:
"Anything of value" includes anything of monetary value, including, but not limited to, money, loans, gifts, food or beverages, social event tickets and expenses, travel expenses, golf outings, consulting fees, compensation, or employment. "Value" means worth greater than de minimis or nominal.
"Anyone doing business with the commission or the bureau" includes, but is not limited to, any person, corporation, or other party that is doing or seeking to do business with, regulated by, or has interests before the commission or the bureau, including anyone who is known or should be known to be an agent or acting on behalf of such party, including any person or entity marketing or otherwise attempting to secure business with the commission or the bureau. Having a policy of insurance with the bureau for workers' compensation coverage, without more, is not "doing business with the commission or the bureau" for purposes of this rule.
"Compensation" means money, thing of value, or financial benefit. "Compensation" does not include reimbursement for actual and necessary expenses incurred in the performance of official duties.
Conflict of Interest
No employee of the bureau or commission shall engage in outside employment that results in a conflict or apparent conflict with the employee's official duties and responsibilities.
Outside employment or activity in which an employee with or without pay represents a claimant or employer in any matter before the industrial commission, or the bureau of workers' compensation is prohibited.
Outside employment with an attorney, representative, or entity that involves work concerning industrial claims, whether filed or to be filed, or which is in any way related to workers' compensation matters is prohibited.
Professional Code of Ethics
If there is a conflict between a professional code of ethics governing any employee of these agencies and this code of ethics for employees, the professional code of ethics shall take precedence over the code of ethics for employees but the conflict shall be promptly reported to the employing agency. In such case the agency shall promptly determine the degree of conflict and take such further action as may be indicated.
Use of State Property
An employee shall not use state property of any kind for other than approved activities. The employee shall not misuse or deface state property. The taking of state property for the private purposes of an employee is prohibited. The use of state property for the private purposes of an employee is prohibited, except for nominal, minimal, occasional, or emergency use. The employee shall protect and conserve all state property, including equipment and supplies entrusted to or issued to the employee.
Diligence and Impartiality
Employees are encouraged to avoid absenteeism and tardiness, to not use sick leave unless necessary and to abide by rules of the Ohio civil service. Recognizing that the industrial commission and bureau of workers' compensation serve many people whose interests are divergent, employees should work in a speedy and efficient manner, strive to be courteous, fair, and impartial to the people they serve, and responsive to the problems that come before them. All segments of the public are to be treated equally, without regard to age, race, sex, religion, country of origin, or handicap.
Appearances of Impropriety
It is understood that standards of ethical conduct may involve a myriad of situations. The good conscience of individual employees shall remain the best guarantee of the moral quality of their activities. The overall intent of this code of ethics is that employees avoid any action, whether or not prohibited by the preceding provisions, which result in, or create the appearance of:
(1) Using public office for private gain, or
(2) Giving preferential treatment to any person, entity, or group.
Confidential Information
The confidentiality of all information which comes into possession of commission and bureau employees shall be respected. In order to properly discharge this duty, all employees must acquaint themselves with those areas of information that are designated as confidential by statutes, by the courts and by the attorney general. Furthermore, they must become familiar with the circumstances under which and the persons to whom such information can be released.
Financial Disclosure
Every member or employee required to file a financial disclosure statement must file a complete and accurate statement with the Ohio ethics commission by April 15 of each year. Any member or employee appointed, or employed in a filing position after Feb. 15 of each year, and required to file a financial disclosure statement must file a statement within 90 days of appointment or employment.
Bureau Personal Investment Policy
Every member or employee subject to the bureau personal investment policy is required to file a personal trading policy annual affirmation with the bureau by April 15 of each year.
Recusal
Nothing in the rules prohibits any member of the bureau of workers' compensation board of directors from receiving compensation or other things of value from the member's outside employer, provided that the member completely withdraws from any discretionary or decision-making activity matters that definitely and directly affect his or her outside employer.