The News You Need for Jan. 15

The start of post-claim strategies and a look at a case from Y2K.

Post-Claim Strategies: Fostering Long-Term Recovery and Prevention in Workers’ Compensation?

Dr. Claire C. Muselman

Roadmap?

The conclusion of a workers' compensation claim marks the beginning of an equally important phase: post-claim strategies. While the resolution of the claim itself is significant, how employers and organizations handle the aftermath often determines the true success of their workers' compensation programs. This phase is where organizations can demonstrate their commitment to the holistic well-being of their employees and extract valuable insights to improve processes, prevent future injuries, and strengthen workplace culture. In this final segment of the Workers' Compensation Roadmap, we explore strategies that support the injured worker's recovery and reintegration and leverage lessons learned to build a more resilient, proactive organization.??

Why Post-Claim Strategies Matter?

Post-claim strategies are critical in shaping long-term outcomes for the employee and the organization. A comprehensive approach ensures the injured worker feels supported throughout their recovery journey, reducing the risk of re-injury or lingering challenges. Simultaneously, organizations gain valuable insights from claims data, allowing them to address systemic gaps and foster a culture of continuous improvement. Why do post-claim strategies matter? Key reasons include:?

1. Promoting Full Recovery.?Even after returning to work, injured workers may require ongoing support to achieve complete physical and psychological recovery.?

1. Reducing Re-Injury Risks.?By addressing contributing factors to the initial injury, organizations can prevent similar incidents in the future.?

1. Strengthening Safety Culture.?Using post-claim insights as a teaching moment reinforces the organization’s commitment to employee well-being.?

1. Enhancing Program Efficiency.?Post-claim evaluations identify strengths and weaknesses in claims management processes, paving the way for improvements.?

1. Boosting Employee Morale. Demonstrating genuine care for injured workers post-claim builds trust, loyalty, and employee engagement.?

A Framework for Post-Claim Success?

Step One: Welcome Back: A Thoughtful Return-to-Work Strategy.?

• Develop a customized return-to-work plan for each injured worker. Tailor the plan to their physical limitations, psychological readiness, and job responsibilities, ensuring a smooth and confident reintegration.?

• Address potential challenges before they arise. Collaborate with medical professionals, supervisors, and the injured worker to anticipate obstacles and develop solutions that support a successful return.?

• Provide clear expectations and ongoing support. Ensure that employees know their roles, responsibilities, and available resources while offering consistent check-ins to address concerns and adjust as needed.?

Step Two: Ongoing Support and Monitoring.?

• Assess the employee's progress post-return regularly. Schedule periodic follow-ups to evaluate their recovery, address lingering effects, and ensure their continued well-being.?

• Offer resources to support physical and mental health. Provide access to physical therapy, counseling services, or employee assistance programs to help employees navigate recovery.?

• Maintain open communication channels. Encourage employees to voice concerns and share feedback about their reintegration experience, fostering collaboration and trust.?

Step Three: Post-Claim Assessment and Documentation.?

• Conduct a comprehensive review of the claim. Analyze what went well, what challenges arose, and what could be improved to inform future practices.?

• Involve all relevant stakeholders. To capture diverse perspectives and ensure a thorough evaluation, include HR, claims adjusters, supervisors, and safety officers in the review process.?

• Document findings and recommendations. Maintain detailed assessment records to guide future claims management practices and foster a culture of continuous improvement.?

Step Four: Analyzing Injury Trends and Identifying Gaps.?

• Identify patterns in claims data. Review multiple claims to pinpoint common risks, such as specific tasks or departments with higher injury rates.?

• Address systemic issues proactively. Use insights from trend analysis to implement targeted interventions, such as updating equipment, refining procedures, or enhancing training.?

• Collaborate with teams to close gaps. Engage safety committees, supervisors, and employees in identifying solutions that address underlying risks and prevent future incidents.?

Step Five: Developing a Claims Feedback Loop?

• Gather feedback from injured workers. Create opportunities for employees to share their experiences with the claims process, including areas for improvement and positive aspects.?

• Incorporate adjuster insights. Include feedback from claims adjusters to understand better challenges in managing claims and opportunities for streamlining processes.?

• Act on feedback consistently. Use the information gathered to refine policies, enhance communication strategies, and improve the overall claims experience for future cases.?

Step Six: Enhancing Employee Wellness Post-Injury.?

• Promote holistic health initiatives. Implement wellness programs addressing physical, mental, and emotional well-being to reduce re-injury risk and improve employee health.?

• Provide education on injury prevention. Offer resources and workshops to help employees avoid repeat injuries and maintain long-term health.?

• Encourage peer support networks. Foster connections among employees who have experienced similar injuries to provide mutual encouragement, share recovery tips, and build community.?

Step Seven: Updating Training Based on Lessons Learned.?

• Use claim outcomes to refine training materials. Integrate real-world examples and lessons from past claims to make safety training more relevant and impactful.?

• Focus on high-risk areas. Target training efforts on tasks, roles, or departments with higher injury rates, ensuring employees are well-equipped to handle potential hazards.?

• Reinforce training with practical application. Incorporate hands-on activities, simulations, or on-the-job coaching to solidify knowledge and build confidence in safety practices.?

Step Eight: Evaluating Claims Management Partners and Processes.?

• Review the performance of claims management partners. Assess their responsiveness, effectiveness, and alignment with your organization’s values and goals.?

• Seek feedback from stakeholders. Involve HR, supervisors, and injured workers in evaluating the claims process to identify areas for improvement or adjustment.?

• Update agreements and processes as needed. Negotiate terms with third-party administrators or insurers to better align with your organizational objectives and employee needs.?

Step Nine: Reinforcing Safety Culture After an Incident.?

• Share lessons learned with the workforce. Use post-incident insights to educate employees about potential risks and the importance of adhering to safety protocols.?

• Celebrate improvements and successes. Highlight changes made due to the incident, such as updated procedures or reduced risks, to build morale and reinforce the company's commitment to safety.?

• Foster a culture of accountability. Encourage employees to take ownership of their roles in maintaining a safe workplace, creating a shared sense of responsibility.?

Step 10: Continuous Improvement - Build a Stronger Workers’ Comp Program.?

• Conduct an annual program review. Evaluate the effectiveness of your workers’ compensation program and identify areas for enhancement or adjustment.?

• Stay informed about industry trends. Monitor regulatory changes, emerging risks, and best practices to ensure your program remains relevant and effective.?

• Engage stakeholders in the improvement process. Involve employees, safety committees, and claims management partners in shaping the future of your workers’ comp program, fostering collaboration and buy-in.?

Looking Forward: Beyond the Claims Process?

The end of a claim is not the end of the journey. By investing in post-claim strategies, organizations create a comprehensive workers’ compensation program that prioritizes prevention, recovery, and growth. As we move into the final phase of this roadmap, remember that every claim is an opportunity to learn, improve, and strengthen our commitment to employee well-being. Together, we can build a brighter, safer future for all.?

Iowa Top Court Finds Latex Allergy Injury Arose Out Of & In Course Of Nurse’s Employment

Frank Ferreri

25 for 25 in '25

Over the next 12 months, we will be taking a look back at important and noteworthy workers' compensation cases that have come up in each of the 25 years WorkersCompensation.com has been around. First up: 2000 and the Iowa Supreme Court.

Case

St. Luke's Hosp. v. Gray, 604 N.W. 2d 646 (Iowa 2000).

What Happened

A registered nurse of a hospital began noticing symptoms of latex allergy about five years into her tenure. These symptoms led her to eventually quit her job and file a workers' compensation claim. She received an award of benefits, and the hospital and its insurer appealed, arguing that substantial evidence did not support the industrial commissioner's finding that the nurse's latex injury was caused by her employment.

Rule of Law

Under Dunlavey v. Economy Fire & Cas. Co., 526 N.W. 845 (Iowa 1995) and Almquist v. Shenandoah Nurseries, Inc., 254 N.W. 35 (Iowa 1934), "A personal injury, contemplated by the Workmen's Compensation Law, obviously means an injury to the body,?the impairment of health,?or a disease, not excluded by the act, which comes about, not through the natural building up and tearing down of the human body, but because of?a traumatic or other hurt or damage to the health?or body of an employee. ... The injury to the human body here contemplated must be something, whether an accident or not, that acts extraneously to the natural processes of nature, and thereby impairs the health, overcomes, injures, interrupts, or destroys some function of the body, or otherwise damages or injures a part or all of the body. This is the personal injury contemplated by ... the ... Code."

In the Course Of

An injury occurs in the course of employment when it is within the period of employment at a place where the employee reasonably may be in performing his duties, and while he is fulfilling those duties or engaged in doing something incidental thereto.

Arises Out Of

An injury “arises out of” employment if there is a causal connection between the employment and the injury.?

What the Iowa Supreme Court Said

Although the compensability of a latex allergy had not previously come up in an Iowa Supreme Court case, the court found plenty of persuasive cases from across the country to guide its reasoning. For example, the court cited the following:

Webb v. New Mexico Publishing Co., 141 P.2d 333 (N.M. 1943). This case involved a workers' compensation claim by a printer for a publishing company who was highly allergic to the type of soap provided by the employer. The allergic reaction was compensable because "his duties required him to wash his hands to prevent soiling the products of his labor."

Hardin's Bakeries, Inc. v. Ranager, 64 So.2d 705 (Miss. 1953). A baker became disabled as a result of a rash on his hands and arms caused by an allergy to mittens used in handling hot pans of bread. According to the court the allergy was like asthma, which had previously been found to be an accidental injury and not an occupational, because it was "not a usual concomitant or result of the work he was doing" and it could not "be attributed to the occupation because it is not a disease which [workers] in the occupation are subject to contract."

Bidermann Industries v. Peterson, 655 So.2d 997 (Ala. Civ. App. 1994). The court found that a seamstress who experienced allergic contact dermatitis at work suffered from an accidental injury rather than occupational disease because when she was away from work, her condition improved, and when she returned, it worsened.

National Underground Storage v. Workmen's Compensation Appeal Bd. (Durochia), 658 A.2d 1389 (Pa. Commw. Ct. 1995). This case recognized that allergic reactions were compensable as an injury, even though the underlying allergy would not be.

Following these cases and acknowledging that Iowa had a broad definition of "injury," the court found that the commissioner and lower court were correct in holding that allergic reactions were compensable and that the medical evidence supported a finding that the nurse's injury arose out of her employment at the hospital.

Takeaway

In Iowa, an allergic reaction to latex that is required on the job, as happened in a case involving a hospital nurse in 2000, is a compensable injury.