July 2023 Newsletter – MTI America
ClaimsPulse

July 2023 Newsletter

July 2023 Newsletter

ClaimsPulse360

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Untitled Document
Issue: July 2023
HealthLink360 Newsletter

The Advocacy Approach
in Layman’s Terms

Caring for Injured Workers’ Mental Health Here’s What You Should Do

The term ‘advocacy’ has been around for a while, but industry polls suggest that many professionals handling workers’ compensation claims don’t fully grasp its meaning. It’s understandable because this approach is not associated with a specific launch date, single event, or initiative.  Instead, the advocacy approach is a concept that has evolved over time in our field.

Workers’ Compensation Frameworks

Every employer is unique and wants their claims handled in a certain way. When I started in claims, I managed claims for employers using the traditional workers’ compensation framework. For example, some employers took a ‘deny and litigate’ approach, emphasizing legal procedures and evidentiary requirements. Others took an adversarial approach where the process tended to be more focused on administrative procedures and jurisdictional aspects or perhaps a focus on compensation only.

Over the years, I saw a shift in how some employers view workers’ compensation. I recall working for a telecommunications company that began sending get-well cards to injured workers and who developed an in-house Claims Advocate role. Another employer implemented an advocacy approach to target their rising litigation rates.  They stopped taking recorded statements, reviewed the verbiage in their initial claims packets, and distributed surveys about the interactions with the claims team.

The most memorable shift for me happened around 2017 when I worked for a client who hired us to manage their workers’ compensation, disability, and leave of absence claims/cases. At this point, I truly understood there were so many other pieces outside of the workers’ compensation claim that resulted from the claim. There were touchpoints and impacts to non-work-comp related benefits I never realized. The employer worked hard to reduce redundancies and change how employees perceived their workers’ compensation program.

Understanding the Advocacy Approach

Contrary to what you may have heard, the advocacy approach is not synonymous with ‘accept everything!’ The advocacy approach revolves around being a steadfast advocate for injured workers. Claims professionals must still perform their due diligence in determining compensability, but the way in which the injured worker is treated is different. It means we recognize injured workers who are going through something difficult, help them, and offer support along the claims journey.

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Breakdown of Air Ambulance Fees in Workers’ Compensation

Read More >>

The Rise of Captives

Comparing Telerehabilitation and AI-enhanced Telerehabilitation for Workers’ Compensation

Workers’ compensation claims can bring many challenges, particularly regarding rehabilitation and recovery from an injury. Traditional rehabilitation services may be difficult to access or otherwise not feasible for workers healing from an injury. This is why workers’ compensation insurers and providers are looking to implement telerehab and AI telerehab solutions that can safely and effectively support workers with their rehabilitation needs.
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New Research Shows that Black Lung Disease
is on the Rise Among Modern Coal Miners

Coal miners, particularly those in central Appalachia, are more likely than their predecessors to die from pneumoconiosis, progressive massive fibrosis, chronic obstructive pulmonary disease and lung cancer, according to a recent study from the National Institute for Occupational Safety and Health and the University of Illinois Chicago.

Researchers used data from the U.S. Department of Labor’s Federal Black Lung Program and is described as “the largest existing study on causes of mortality in U.S. coal miners.”

Researchers cite a 2019 government report holding that while the prevalence of CWP declined for several decades in the latter half of the 20th century, PMF had recently been found “at rates not seen since the early 1970s.”

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