By: Joseph Berardo, CEO Carisk Partners
As an industry, workers’ compensation is in unchartered territory. We are all required to show up and step up. To predict factors, assess risk or propose to be specialists in treating this disease would be irresponsible based on the fluid nature of the clinical information available.
If we look to the data being published, follow clinical guidelines and share real-time best practices, we can continue to responsibly manage the patients we are trusted to help. But overall, the approach is the same as it was before — manage each patient individually and approach their continuum of care personally. Workflows, clinical and behavioral pathways remain consistent.
Following a Moving Target
Some assumptions have been made around impact and the toll this will take on the workers’ compensation system.
However, more questions arise daily about compensability and the variants for predictability and outcomes. Also, post the development of a vaccine or an effective therapeutic approach, COVID-19-related cases will be time and date stamped. So, what should we do?
This all continues to be a moving target. I believe that the rates of infection and incidences are grossly under reported and that this virus was an issue well before the regulatory bodies began acting.
In fact, I believe the larger part of the population of COVID-19 individuals are/were asymptomatic and may be unaware they had the disease at all. In our world, it is the severity of symptoms, prompting a test, that becomes a leading indicator.
Even the death rates are reported to be inaccurate, because many people have died with the virus and not from the virus, or they were just assumed to have the virus. Never in my 30 years in health care have I seen primary diagnosis captured this way.
Breaking Down Coronavirus in Workers’ Comp
From a workers’ compensation perspective, first responders and health care workers represent the initial wave of patient claims. Layer on essential workers, and it increases the population significantly.
Adding to that complexity are state-by-state compensability standards and a range of variants to consider. Severe cases may have longer-term injury-related challenges.
Furthering liability, as noted in the recent NCCI report, development of PTSD and other mental illness arising from exposure is real and needs to be identified early with appropriate proactive interventions.
While COVID-19 is a new condition, it doesn’t necessarily require a new approach, unless of course your current approach was inadequate.
I applaud the industry for its recent focus beyond the injury or initial diagnosis. We have always needed to equally weigh the medical, psychological, social and environmental factors impacting an individual’s ability to overcome a workplace injury or illness.
Regardless of primary diagnosis, it has always been essential to understand and address comorbid conditions and behavioral health challenges within a process and workflow that provides the most successful pathway to recovery for that individual.
Charting New Territory … Together
Faced with such enormous human suffering, and incalculable strains on our health care and financial systems, we are being called to confront challenges that none of us could have foreseen, even just a few short weeks ago.
It’s a common cliché right now, but perhaps it bears repeating … we are ALL, quite literally, in this together. And while some have been fortunate enough to remain physically well amidst this pandemic, none of us has escaped the feeling of dis-ease.
Amidst the instability and unpredictability, what is called for right now is not a “new” approach, “innovative” program, or “creative” solution or some other shiny new marketing pitch.
We need proven agility, demonstrated expertise, and real action. Amidst all the chaos, mixed messages and re-positioning, committed professionals recognize their responsibility to remain steadfast, and committed to doing what we do every day.
It’s the same call-to-action that demands we meet that patient, their family, their support system, and the dedicated health care professionals that serve them, where they are at; and that we provide the meaningful connection, constant communication, and clinical expertise they rightfully expect.
It means that we answer the call, for those first responders and health care workers who take those calls for us.
We do not have a playbook for COVID-19 – no one does. But we do know from experience that excellence in this area means resolving even the most complex medical conditions and addressing the emotional and psychological needs of our patients and their families.
Now, more than ever, workers’ compensation professionals need to put the patient at the center of everything they do, to always do right by them, to focus on best practices, while maintaining an investment in what is best about that person who got sick, or who got hurt.
These times may indeed be “unprecedented” … new … different … unique … extraordinary, but that’s how our profession should describe every patient and every opportunity to diligently confront their dis-ease, every single day.
Risk Insiders are an unrivaled group of leading executives focused on the topic of Risk. They share their insights and opinions – and from time to time their pet peeves and gripes. Each Risk Insider is invited to publish based on their expertise, passion and/or the quality of their writing. The only rules are no selling and no competitor put-downs. The views expressed in this article belong to the author and are not an editorial opinion of Risk & Insurance.