The Biggest Challenges for Work Comp Professionals in 2020


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.

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