The News You Need for Sept. 23
We begin a journey into compassion fatigue and we consider the case of a Kentucky worker's not-so-helpful seat.
What is Compassion Fatigue in Workers’ Compensation Adjusters?
In workers' compensation, adjusters play a vital role in ensuring injured workers receive the benefits they need while balancing the interests of employers and insurance companies. The job of an insurance adjuster requires empathy, critical decision-making, and constant emotional engagement. Over time, this emotional engagement can take its toll, leading to a phenomenon known as compassion fatigue. Although burnout is a more well-known term, compassion fatigue is different. It occurs when employees in high-empathy positions experience emotional exhaustion, leading to detachment and decreased effectiveness in their work. For workers' compensation specialists, understanding compassion fatigue is essential to maintaining long-term well-being and effectiveness.?
What Is Compassion Fatigue??
Compassion fatigue is often referred to as the "cost of caring." Unlike burnout, which results from chronic stress and workload, compassion fatigue results from the emotional stress of working with people in crisis. For workers' compensation specialists, this distress comes from handling the claims of injured workers, i.e., people experiencing pain, trauma, financial uncertainty, and a loss of normalcy. Over time, the burden of constantly managing these cases day after day can wear down even the most empathetic and resilient specialist. Essentially, compassion fatigue manifests as emotional and physical exhaustion, making it difficult for specialists to empathize with or concern their clients. The emotional reserves that specialists rely on to do their job effectively are being depleted. If left unchecked, compassion fatigue can severely impact not only the performance of the individual specialist but also outcomes for injured workers and the financial health of the organization they represent.?
Why Do Specialists Suffer from Compassion Fatigue??
Workers' compensation adjusters face unique emotional challenges that make them particularly vulnerable to compassion fatigue. Unlike other types of insurance, workers' compensation deals directly with human suffering. Specialists don't just process documents; they often face complex emotional scenarios that involve the frustration, anger, pain, and anxiety of injured workers. Several factors make specialists prone to compassion fatigue. Specialists constantly contact injured workers and their families, who may experience significant stress and difficulties. Insurance adjusters don't always receive emotional support from their employers, making it more challenging to manage daily stress. Many insurance adjusters handle cases simultaneously, giving them little time to recover emotionally between interactions. Claims adjusters are responsible for balancing the needs of injured workers with the financial interests of their employers and insurers. This balance can lead to internal conflicts, further contributing to emotional stress.?
The Ripple Effects of Compassion Fatigue?
The effects of compassion fatigue are far-reaching. On an individual level, adjusters who suffer from compassion fatigue may feel isolated, disconnected, and emotionally numb. They may also experience physical symptoms such as fatigue, headaches, and insomnia. Emotionally, they may become cynical or frustrated, feeling they are no longer making a difference in the lives of those they are supposed to help. For organizations, compassion fatigue can lead to decreased efficiency, increased errors in claims processing, and increased employee turnover rates. As insurance adjusters become less emotionally invested in their work, they may rush to settle cases, make poor decisions, or fail to advocate for injured workers adequately. This faltering hurts the employee's recovery process, leading to costly mistakes and damaging the organization's reputation. From a broader perspective, compassion fatigue among claims adjusters can cause systemic problems within the workers' compensation industry. When adjusters feel emotionally exhausted, the human side of workers' compensation – empathy and caring for injured workers – can be lost. This loss can result in a more transactional and less compassionate approach to handling claims, losing trust between injured workers, employers, and insurers.?
Recognizing the Signs of Compassion Fatigue?
One of the biggest challenges in dealing with compassion fatigue is that it often goes unnoticed until it reaches a crisis point. Claims adjusters may not know they are experiencing compassion fatigue, mistaking their emotional exhaustion for everyday work-related stress. Recognizing the signs early is essential for individual well-being and organizational health. Common symptoms of compassion fatigue among claims adjusters include emotional exhaustion (feeling mentally tired or overwhelmed after interacting with clients), isolation or numbness (an increased sense of disconnect from clients, co-workers, or the work itself), decreased empathy (difficulty empathizing with injured workers, leading to a more transactional approach to claims); incapacity or anger (increased frustration or irritability when dealing with requesters or co-workers); and physical symptoms such as fatigue, headaches or insomnia that persist over time. Specialists and their managers must be aware of these symptoms and treat them promptly before compassion fatigue progresses to burnout or more serious mental health problems.?
Combatting Compassion Fatigue?
The first step in combating compassion fatigue is recognizing that it exists and can have severe consequences for claims adjusters and the organizations they work for. From there, steps can be taken to prevent and manage it effectively. Organizations can help by creating supportive environments that recognize the emotional demands placed on claims adjusters. This organizational culture can include providing access to mental health resources, emotional resilience training, or implementing peer support programs where insurance adjusters can share their experiences and coping strategies. Additionally, adjusters should be encouraged to take regular breaks, care for themselves, and seek professional help. For insurance adjusters, self-awareness is essential. Being aware of the emotional impact of work and taking steps to manage stress, whether through exercise, mindfulness, or simply taking time to decompress, can go a long way in preventing compassion fatigue from developing.?
Compassion fatigue is a significant problem in the workers' compensation industry, affecting claims adjusters' ability to do their jobs effectively and with empathy. As the emotional demands of this role continue to grow, individuals and organizations must take proactive steps to recognize and address compassion fatigue. In doing so, adjusters can maintain their emotional health, provide better care to injured workers, and improve the overall outcomes of the workers' compensation process.?
The following article will explore the emotional weight insurance adjusters carry daily and how this emotional labor contributes to compassion fatigue.?
Did Deflated Seat Cause Fuel Truck Driver’s Degenerative Spine Condition?
Chris Parker
What Do You Think?
Pikeville, KY (WorkersCompensation.com) -- To obtain permanent total disability, an employee must show that the disability is causally connected to the workplace injury at issue. A case involving a truck driver for a fuel company addresses that issue in the context of a degenerative spinal condition.
The employee in that case was driving a company truck when he hit a dip in the road. The dip caused the truck’s air-controlled seat to suddenly deflate, injuring the employee’s lower back.?
An ALJ awarded the driver permanent total disability benefits.?
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The ALJ reasoned that the findings of one doctor "noted the progression of [the employee’s] work-related low back symptoms" and concluded, "based upon the report of [the doctor], that [employee’s] limitations and increased restrictions related to his lumbar spine condition constitute a further arousal of his degenerative and congenital stenosis and are therefore causally work-related."
The board reversed the ALJ’s decision, finding insufficient evidence that the accident caused the worsening of the employee’s spinal issue.
On appeal, the court stated that an ALJ must undertake a five-step analysis to determine total disability. The ALJ must determine:?
1) Whether the claimant suffered a work-related injury;?
2) What, if any, impairment rating the claimant has;?
3) The permanent disability rating;?
4) That the claimant cannot perform any type of work; and?
5) That the total disability is the result of the work-related injury
Did the ALJ make a mistake by awarding the driver PTD?
A. No. The doctor’s statement established that the injury was severe and that the employee was no longer capable of working.
B. Yes. The doctor wasn’t clear about whether the accident caused the worsening injury and didn’t mention whether non-work-related factors might have contributed to the employee’s total disability.
If you selected B, you agreed with the court in Cole v. K.Y. Fuels Corp., No. 2023-CA-1478-WC (Ky. Ct. App. 09/13/24, unpublished), which held that the ALJ never connected the workplace injury to the aggravation of the driver’s worsening back condition.
The court found that the ALJ failed to point to specific evidence showing that the driver’s total disability was caused by the work-related injury. While the ALJ discussed the doctors’ findings concerning the severity of the condition, the fact that it was getting worse, the worker’s inability to perform work, the doctor’s report he relied on offered no opinion regarding the cause of the worsened condition.?
“[T]he ALJ points to no specific finding of [the doctor’s] to serve as the necessary substantial evidence that the work-related lumbar spine injury specifically caused the worsening of his condition and that [the employee’s] nonwork-related conditions did not,” the court wrote.
The court remanded the case to the board to remand to the ALJ. It stated that “the ALJ must identify specific medical evidence which establishes a causal connection between the work-related injury and Cole's worsened condition.”
Join us for the First Meeting of 'Comp & Circumstance'
If you have some time tomorrow (Sept. 24) at 2 p.m. Eastern, we'd love to talk comp with you. Topics on the table include what's going on in the world of workers' compensation and what are you up to in your slice of it? Get in touch with Frank Ferreri if you would like to receive an invitation.