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What work comp people are really like

I was thinking it’s about time for another post on the good folks in workers’ comp.  A follow up to the few I’ve published in the past.  In thinking about the subject, I realized I’ll never know many of the really good ones; I’m just one person.

So, allow me to render compliments to a broader group…

The claims handlers, executives, program managers and medical management folks I know – and I know a lot of them – are, with rare exceptions, good people trying to make sure injured workers get the best possible treatment as quickly as possible so they can get back to work.  There’s way more concern about quality care than there is about the cost of that care, a strong focus on figuring out the “right” treatment and the right provider, a real desire to make sure the right thing gets done.

Yes, there are some adjusters who are burnt out, overwhelmed, poorly trained, managed or evaluated based on flawed or downright stupid metrics.  There are misguided “managed care” programs that force adjusters to use crappy vendors so those vendors keep paying fees to the adjuster’s company.  There are mistakes made, documents misplaced, miscommunications and missteps aplenty.

But focusing on the relatively small number of problems gives a grossly distorted picture of the claims adjusting process and profession.

These are people, just like us, who are trying to do a very tough job that involves individuals who are hurt, in pain, scared, and sometimes belligerent.  Claimants’ families are worried about their loved one, their financial future, their security. Claimants’ managers often don’t understand much about work comp, need to get tasks done, and aren’t exactly sure how this whole work comp thing works.  Attorneys may – or may not – be interested in what’s best for the claimant, but won’t allow the adjuster to talk directly with the claimant.  And the C-Suite decision makers may not – for myriad reasons – give claims, medical management, ops, or other departments enough resources, IT expertise, staff, or assistance to do what they need to do.

Despite what some in the press say, most of you are doing a good job under trying and difficult circumstances.


4 thoughts on “What work comp people are really like”

  1. Joe – Thank you for your post. In fact I am lucky that ALL my customers fall into the category of doing the right thing for the injured worker (I wouldn’t work for any other type of customer.)

    We are currently working with a worker injured on the job who is unfortunately a quad as a result of his injury. This worker lives in a place where there are no good facilities for the type of care he has needed and will need. Working in concert, the employer, TPA, excess carrier, the excess carrier’s case manager, and my case manager have made sure that we have provided this I/W with all the medical care and financial reassurance that is available to him. The employer has presented him with financial options that will benefit him over his life time. During the period of time necessary to modify his home, the employer/carriers are renting a $6,000 per month home for him (Resort area – no other option)

    This is a multi-million dollar claim with no attorney involvement.

    Doing the right thing is indeed good business and certainly has gained the attention and good will of this gentleman’s co-workers.

  2. Well written. Thank you for the acknowledgement that there are so many professionals in the WC claims industry that actually to care, try hard, treat recovering workers with respect and dignity and deliver results day in and day out.

  3. That’s just the nature of the world for you though. People love to focus on the problems, focus on the negative. No one really seems to care when things are going well or as expected.

    Thank you for giving some attention to the WC people who truly deserve it!

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Joe Paduda is the principal of Health Strategy Associates



A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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