The Biggest Challenges for Work Comp Professionals in 2020
Here’s the Top 5!
A recent article by Katie Dwyer published by Risk & Insurance referenced a unique survey of attendees at the National Workers’ Compensation and Disability Conference & Expo designed to ascertain what particular challenges the attendees were focused on for the coming year. We’ve covered the 5 biggest challenges reported by TPAs, Healthcare Workers, Employers, Brokers, Insurers and regulators. Check them out blow.
1) Workforce Demographics –
Changes in workplace demographics at both ends of the work-age spectrum present different challenges. More folks over 55 are remaining in the workplace for longer. With an aging population comes greater potential for chronic conditions and comorbidity.
But challenges are not unique to the aging population. Also presenting as a factor to be reckoned with is the increasing risk of mental health issues among younger workers. According to Caryl Russo, senior vice president, Corporate Care, RWJBarnabas Health, “The increase in psychosocial issues that complicate a workers’ comp claim has been on the rise over recent years, with my employer seeing a profound uptick in this particularly among our under 30-year-olds,”
2) Comorbidities and Poor Worker Health
Simple injuries can present more complex problems when there are other comorbid factors in the mix such as diabetes, hypertension and obesity. It’s estimated that about one-third of Americans are obese and about 9% have diabetes, however these numbers increase with age and having these conditions makes injuries, and recovery from injuries, more problematic and time consuming. Added to the mix is the issue of drug interactions that complicate treatment.
3) Increasing Claim Complexity
Factors that make cases complex include age, physical and mental comorbidities, cost of care, substance dependence and ineffective clinical decision making. These issues can create a perfect storm of complexity. Manager workload is often part of the problem too. Many claims professionals may not have resources to keep up with cases or to explore alternative treatment plans. Getting claims on track might require greater involvement by medical professionals, adjusters and case managers working together at one table.
4) Mental Health Exposures
According to a 2018 report by NCCI, more than 16 states have considered legislation that would expand coverage for mental-only injuries. Previously, mental only injuries was limited to PTSD among first responders. However, the burden of proof is high because workers must prove that their level of stress was extraordinary, and the harm they suffered as a result must be demonstrable. The article also notes that even if a claim is not directly related to a mental health condition, it’s undeniable that stress, anxiety and depression increase the risk of injury and prolong full recovery. Some large employers use the services of neurophyschologists to provide in-depth testing that can help determine causality and extent of the condition. This is an expensive option, however it allows for employees to get the right care faster.
5) Regulatory and Legislative Changes
Staying current on the latest in workers’ compensation legislation is in itself a challenge. According to the NCCI, 700 state and federal workers’ comp bills were introduced in 2019 with most having to do with fee schedules and treatment guidelines. Also noted is the expansion of employee rights which also lawsuits against employers over injuries or lack of compliance with leave regulations.
The above information was taken by a recent article published by Risk & Insurance. For a full and complete listing of the survey responses, Read the full article here.
