A New Approach to Workers’ Comp: Being Nice?

Episode Notes

Transcript

Announcer:

Workers Comp Matters, the podcast dedicated to the laws, the landmark cases, and the people that make up the diverse world of workers compensation. Here are your hosts, Judd and Alan Pierce.

Judson Pierce:

Hello and welcome to another edition of Workers Comp Matters. My name is Judd Pierce, and today we have an exciting program with a special guest, Claire Muselman, and to introduce our guest and her topic, empathy’s impact on workers’ compensation, elevating care for injured workers. We have my co-host of many years, my father, Alan Pierce.

Alan Pierce:

Yeah, thank you Judd, the older co-host as well. Yeah, we’re at Pierce, Pierce and Napolitano here in Salem. We’re happy to bring you another addition of Workers, Comp Matters. And as you know, we always are looking for different types of topics, and I think we have a topic here that it’s a little off the usual nuts and bolts that we deal with in workers’ comp and perhaps there’s a reason for that. And hopefully, perhaps after today’s show we will think more about maybe the human aspects of the effects of a work injury, not only on injured workers, but businesses as well.

So we are pleased to welcome our guest, Dr. Claire Muselman. Claire serves as a assistant professor of practice in leadership and organizational behavior at the Ziman College of Business at Drake University. She has nearly two decades in the insurance industry. She has been a transformative force in workers’ compensation and risk management, pioneering initiatives like the Workers’ Recovery Unit, the Workers’ Compensation Center of Excellence and Transitions. She is also Dean of the Workers’ Compensation for the Claims and Litigation Management Alliances Claims College, and she’s on the faculty of Work Comp college in which they offer online courses for different aspects of the field of workers’ comp. She’s an Iowa girl, she’s got a bachelor’s degree from University of Iowa. She’s got a Master’s in public administration from Drake, a doctorate in science from Drake, and a doctorate Ned from Grand Union University. So I don’t know that we’ve had that many initials following any of our guests, so we want to welcome you to Workers’ comp matter, Claire and Judd, why don’t you start it off.

Judson Pierce:

Thank you, Alan, and welcome. Claire, tell us just a brief description of your journey and what drew you to this field that we talk about regularly on our program, the realm of workers’ compensation.

Claire Muselman:

Sure. So when I was in kindergarten and our teacher asked us to take a blank piece of paper and grab that crayon and draw what you wanted to be when you grew up, I absolutely drew a work comp adjuster. Did you guys not, was I the only one? Of

Alan Pierce:

Course. I drew a worker’s comp claims manager. I had perfect greater aspirations. I drew Steve Martin pictures. I also,

Claire Muselman:

Steve, I wrote insurance policy. No, I’m just kidding actually. So I went to University of Iowa. I wanted to be an attorney. I really wanted to focus on family law and doing great things for kids. I’m a adopted child, so have a unique story with that. And so I was really passionate about family law. And when I went to take the lsat, it happened to be homecoming weekend at Iowa. And until about a month ago or two months ago, I’d never actually dawned on me to retake the lsat, but I wouldn’t be here if we hadn’t done all of that. So went away to Europe after I graduated college. And when I returned, I was bartending, trying to figure out what I was going to do next with life. And my best friend from high school, she was my doubles partner for tennis from age three to 18, her dad came into theBar and said, what are you doing here?

And I said, I don’t know. I didn’t do well on the lsat. I don’t know what I’m going to do. And he said, why don’t you come work for me? And if you really like law, we’ll help you with the lsat. We’ll help get into law school. And it was a workers’ compensation defense firm and the rest is history. But while I was there, I also got to see not just the defense side, there was a Latina attorney who was there who also worked with injured workers from some of the meat packing plants. And I had lived in Spain and Mexico, had a little Spanish background at that time because I practiced and now I don’t practice as much anymore. And it gave me a very different side to the workers’ compensation space. And as I continued to figure out what I wanted to do with my life, I miraculously went into the claims world to help people one phone call or email or interaction at a time.

Alan Pierce:

Well, what struck me when I saw the title of your article and Judd brought it into me and said, what do you think of this as a topic? I never connected the term empathy with workers’ compensation claims. Tell me why.

Claire Muselman:

Because people are jaded and have bias. So I think there is a lot of neuroscience behind why we approach this industry and the way we do. And I’m actually researching it right now through Drake University and r Kelly Risk and Insurance School. And there’s a lot that comes into this. So we hear a lot of terms on bias that are used in a negative context, and I think it needs to be normalized where we are all biased to stay alive. It is what it is. And so when we start to look at what influences us out throughout time, we’ve got social media, we’ve got media, we have teachers, parents, family, friends, you name it, everybody’s heard a story of some capacity and storytelling is really powerful. And so when we think about workers’ compensation, the connotation tends to go down that negativity bias where the people that we know, maybe it was a little skeptical or people have had terrible experiences.

Most of the time you don’t hear about the great stories of success in workers’ compensation. So when we automatically assume that we know what’s going on, we’ve got these biases that exist, we tend to be much more hesitant in handling anything that is done at work as well as when we start to look at the verbiage that is with it. In addition, when we hear that people are injured at work for some reason, we don’t ever take accountability on our end that maybe we did something wrong. We’re like, well, why did they do it that way? It’s their fault. And we tend to point the finger at other people. But as we’ve learned over time and with age and grace and experience, when there’s one finger pointed out, there are three fingers pointed back. So when I hear about the disgruntled nature of people’s experience and workers’ compensation or what we know about the system, there’s always a root cause. And the root cause can usually be drilled down to something that could have been handled if we went back to kindergarten when we were drawing with our papers and just said, can I help you? Do you want to play with me in the sandbox? Do you want to come sit with me? And we went back to those very simple behaviors that tend to fall to the wayside as we get older and become more adults.

Judson Pierce:

Yeah. What drew me into your article was my experience with injured worker clients over 25 years now, and what I find to be the most helpful approach is the listening and not the speaking. And there’s not enough listening, I think to go around, whether it be lawyers, whether it be the judges, we like to expound, we like to show off our skills and what we’ve learned. And we don’t really go to the root of why we’re here, which is to help these folks in this very precarious situation and help them back to their normal lives as quickly and as satisfactorily as we can in terms of how the law has been built. And there are some failings, right? Because the law has been built by people and we have to go back and we have to look at the laws and reform them or amend them to meet with common and current day. So what I think is interesting, and the way you start your article out is just briefly describing what empathy is and for our audience, could you just go over that briefly and basically how it’s important in the workers’ comp complex context?

Claire Muselman:

So I think where we fall short when we’re talking about empathy is that it is that you need to do everything under the sun to help this person. And that’s not empathy is just understanding our emotions and our feelings and understanding that in others. So it’s being able to share in the emotional experience of understanding. Okay, I can understand how that must feel for you. I like to use this concept as holding two truths. And I like to think of this in the workers’ compensation spectrum when we’re looking at the different lens of bias where we tend to have a horns effect where we’re like, well, I had a terrible interaction with Joe. Joe’s a terrible employee. Joe gets injured. Well, of course Joe got injured. He’s a terrible employee. Okay, Joe might be a terrible employee, and he very well could have gotten injured in the proximity that puts him in the workplace.

And I think there’s a couple of things that come into this when we start to look at empathy and we look at why it’s so hard for us to digest this in the workers’ compensation realm. A couple of things really go back to this tribal mentality. So you talked about how we need more listening. Well, listening creates trust and validation through experience. And so if we are able to provide that active and reflective listening, people are more likely to feel seen, heard, acknowledged, and valued, and they feel validation as a result of that process. And a lot of that stems back to Maslow’s hierarchy of needs of our basic necessity, trying to have that fundamental need to belong. And when we’re able to voice an understanding from what we know within ourselves that could be true for that person that’s having this experience, and we think about how it could be a relatable situation or a relatable circumstance, we are able to validate that human’s experience.

The biggest problem that I see with leadership or in organizations is that we haven’t done a lot of work on ourselves. And the ability to understand empathy with someone else is only to the extent that you can empathize with yourself. Because empathy is that ability to understand and share feelings with other people. But if you don’t know where you stand or you haven’t processed some of your own stuff, or you don’t know what you stand for, what your biases are, you’re not able to understand what’s going on with someone else because you’ve never taken the time to figure out what’s going on with you. And contrary to popular opinion, there’s a lot of neuroscience that backs this up that people who have had traumatic experiences in life need to fundamentally process through those by feeling the feelings, understanding the emotions, reliving some experiences, otherwise your brain shuts down those areas.

So when we start to look at this, there’s a lot of interesting nature when we think about who’s actually the problem in the workers’ compensation system from an empathy standpoint. Because from what I understand from my own experience and the people I’ve worked with, I don’t have injured workers that have been terrible human beings that were bad employees. I have people that have been failed by a system that was designed to protect employers. And while it is a system that’s designed to protect employers because we’re people and we haven’t adjusted that, and it’s all about follow the money trail, the other piece is that there’s only two benefits that people qualify for in workers’ compensation. They qualify for lost time in medical treatment, but for some reason we have allowed the narrative to sound like everybody’s a freeloader. Who doesn’t want to get back to work that goes and buys boats and yachts and second houses.

That’s fundamentally and logistically statute oriented. None of that is possible based upon the statutes. I’m not saying people haven’t done it, but when we look at the way that the statutes, the laws, compliance, the regulation, that’s all within this system, we’ve allowed a narrative to be created that fundamentally is untrue, yet we don’t change the words or the vernacular or challenge other people’s beliefs along the way. And when we look back at this, that ends up being why empathy is a lot harder for people to rationalize. We let the feelings center of our brain take over versus ever looking back for any logic or rational understanding.

Alan Pierce:

We’re going to take a quick break and then we’re going to dig a little deeper into the role of empathy and how that might affect the bottom line because at the end of the day, for both our client, the injured worker, and for the employers and insurers who are the payers in the system, that for the most part is the sort of driving force here. So we’ll be right back after another short break. We are back, we’re talking with Claire Muselman and we left off sort of talking about empathy and its role in workers’ comp, and I referenced the fact that Jed and I saw a paper that was published talking about empathy’s impact on workers’ comp. Were you writing that paper for my clients, the injured workers and my colleagues that are attorneys representing them or were you writing this speaking to a different audience in mind?

Claire Muselman:

No, I was writing this towards employers and kind of the industry as a whole. When you look at vendor partnerships, third party administrators, insurance carriers, adjusters, leaders of adjusters, HR professionals who might oversee the workers’ compensation space, workers’ compensation coordinators, it’s kind of that extra, it is not directed to my lovely friends, the injured workers.

Alan Pierce:

And I kind of felt that from reading the article and just hearing what you’ve said thus far, and of course you realize that the injured worker, once an attorney appears no longer has any direct contact with any of those people you mentioned with the possible exception of maybe the HR department about return to work issues or modifications of employment. So once we are representing these folks, there is no opportunity, I guess, for empathy between the claims department of TPAs or is there, how does that translate to somebody you’re not talking to anymore?

Claire Muselman:

So I would state that that has not been my experience. So when I was leading claims departments for the workers’ recovery unit, for example, my adjusters would still send cards to the injured worker. They would just send it through you. And I’ve never had an attorney when we’re trying to do something nice for an injured worker ever send it back or say, no, I’m not going to give it to their attorney or give it to their client because all it does is build the relationship most of the time. This is where I think this is where we get a little wonky. We’ve talked about the adjuster relationships. This has been beat into our industry with, yeah, they’re overworked, et cetera, but there’s still good adjusters out there. And usually the issue that if we drill down to the root cause there’s been a ball dropped somewhere.

So if we have people that are trying to be proactive with communication and building rapport, I’ve yet to see an attorney that represents an injured worker that doesn’t want that because it still helps continue that relationship even though there’s been a ball drop of some kind, like a missed check, an employer not returning phone calls, not wanting to get the person back to work. There’s a plethora that exists on the employment side, but if we’re trying to still maintain any type of goodwill, I have not experienced that where an injured worker’s attorney would not pass along well wishes a get well card just checking up on you having a three-way conversation where we’re just, I want to see how you’re doing. I genuinely want what’s best for you.

Judson Pierce:

This is the first time I’ve ever me too of a card being sent a get well card by an

Claire Muselman:

Insurer. Oh yeah, yeah. We used to do that all the time. I think I’m 99% sure they’re still doing it and it has no memorabilia. That’s the big part. It can’t have a memorabilia. So they’re plain cards that don’t say the insurance company’s name, they don’t say anything. It’s literally me as Claire to you as Judd as human beings. Just, Hey, hope your surgery goes well, or just something so small. Oh wow. By the way, we have AI these days. Throw it into ai. If you have no idea what to say to an injured human being, I mean you need two sentences, but it’s that genuine person to person connection that doesn’t have logos, that doesn’t have, well, I’m made to do this, but we would go buy cards at Michael’s and you could get or JoAnn crafts or what else is out there, hobby Lobby and you can get 80 cards for $5. So I know there’s people that say, oh, it’s like $2 and 50 cents. You can go cheaper if you want to. A better RO, I mean 80 cards for $5. All right. Stamps are expensive now though.

Judson Pierce:

Yeah, stamps are getting up there. You’re right.

Claire Muselman:

But do you know how nice it is to receive a card in the mail? I mean, it’s pretty powerful.

Judson Pierce:

I lost a family member and just getting handwritten cards, acknowledging that saying that they were there for me was huge in getting over the grief process. There’s always the fear, certainly the skepticism of insurance. I’m going to use the word claims adjuster, even though I know Bob Wilson, a lot of folks don’t like that term because it connotes something. I know Bob prefers recovery specialist or something like that. I think the entire verbiage surrounding the jargon of what we do kind of sets up this adversarial relationship between injured worker and their representative and insurance company and their representative of the employer. And breaking through that is often difficult, especially when cases are contested. Workers’ comp was never originally designed to be an adversarial system except in the most unique circumstances where there were legitimate real issues. Now it seems from the get go, everybody is circling the wagons or going on the offense. So give us a real world example perhaps of how the use of empathy can affect the outcome of a case, the bottom line of the employer or insurer that’s looking at the cost of a claim. And conversely, the bottom line of our clients who obviously want to get what they’re entitled to and get it in a timely and efficient fashion.

Claire Muselman:

If we’re going to go with words, I don’t like saying that injured workers are entitled to anything. They qualify under state guidelines for what they are issued. I actually had a I call military Mike, who’s from Continental Western, one of my former workers’ recovery representatives who actually asked me to change my vernacular of saying that people are entitled to, he’s like, they qualify for these benefits because they happen to be at work when they were injured. Good point. And it changed my perspective just in knowing that we have generations that are being coined. They’re the entitled generation. And so I thought that was a good thing to state. But I can give you a couple examples here quickly. So I have been an injured worker three times. My second injury was actually while I was a director of workers’ compensation and insurance company, a random incident where I ran into somebody in my hiphop data socket and by the 0.001% chance that the injury that came as a result could be work-related was just purely because of the location and what I was carrying and where I was.

Our CEO text me the day after I had surgery that said, Hey, I just wanted to check in and see how did surgery go? Is there anything we can do? It was the nicest thing ever. Literally just a human being just texting, saying, Hey, I just wanted to make sure surgery went well. Let us know if you need anything. How simple. It probably took him 10 seconds to write it. He didn’t have to. And it’s also like he’s a couple levels up. So it was a little shocking, but I liked that and I remember the feeling. So when I became chief risk officer of Emory Industrial, we had a gentleman who broke his leg in multiple spots, and I remembered a lot about what I liked during the workers’ compensation process as an injured worker after running a worker’s recovery unit and was like, how can we enhance this?

Well, I worked with people that genuinely felt like family, which I know people hate that term too, but there are people that you get to enjoy at work, and those are the people that you’re going to be spending the most time with after age 25. So if whether we consider them family or not, whatever, but we all came together to make sure we did everything under the sun to make sure that this man got back to work and back to life. And this encompassed a multitude of things where we came together as a team from the leadership elements where we had trying to bring him back into the office. We had our administrative team that found him something to do and he would come back and have a great time with them. It happened to be an all staff. So that’s kind of funny now that I think about that.

But regardless, then we had our CEO called and said, Hey, I just wanted to check in on you. He ended up sending a card. We had our safety director go have dinner with this person in the hospital. Actually, he and his wife went and met the injured worker and their wife and the hospital and had dinner with them twice just so that they felt like they weren’t just completely isolated and alone. Again, people just being people being nice and kind to other people because if we were in that circumstance, what would we want? And we also looked at different elements. There’s a lot that goes on from a technology standpoint that the workers’ compensation space has not really embraced. And the one that I would give a shout out to is there’s a group called Pple that has the little device that helps with physical therapy rehab.

Well, when we’ve got guys that are going out to oil fields or going out to oil rigs and doing a lot of manual labor, these aren’t close. They’re not down the street where you can just pop over for physical therapy and it’s a 20 minute drive. These are like four, six hour drives where that’s not available. When our adjusting friends want to say, Hey, we’ve scheduled you for physical therapy at noon on Tuesdays greats, it’s going to take me six hours to get where you just put us. So we partnered with a group called Pple that helped our injured workers. So he would try and go to physical therapy either before or after he would be out on a shift that would cause that driving for six hours or so. And he would just use this little device in the interim time to supplement his physical therapy because it worked better for his job so we could get him back to his hours quicker when we weren’t having to deal with the minutiae and the red tape around things that really aren’t that hard to fix. You just have to care. I think our industry could do so much better and be so much more improved from the customer service, empathy, emotional intelligence standpoint. If people cared, they were competent and they demonstrated confidence in what they did. The three Cs that I think are the most important when you are just being a human,

Judson Pierce:

What is it for diamonds? Cut.

Claire Muselman:

Clarity, color. Yeah.

Alan Pierce:

Claire, we’re going to add a fourth C to your comment. We’re going to talk about a commercial and we’ll be right back after another short break. Okay, we are back talking with Claire Muselman. Judd, do you have a closing area of questioning for Claire? Absolutely. Claire. I was thinking when you were talking about the three Cs that are so important, the other would be, it’s not a C phrase, but it’s thinking outside the box. It’s creativity. It’s using the statute as a sort of jumping point, jumping off point, but not going outside it just saying, okay, here’s a special device, this H wave system or this other portable device that you can wear. Yeah, it’s a couple hundred dollars. No, you don’t have to pay out of pocket for it. We’ll cover it. We’re the insurer and it’s going to be shipped to your house. We see this problem with medications that clients need that they’re waiting at CVS that they really needed like yesterday. So what types of practical things can insurers do to sort of facilitate this sort of healing process and getting people back to work?

Claire Muselman:

So when I look at this from the employer standpoint, what you don’t know will absolutely hurt you. So if you are not actively engaged with your employees throughout this process, you really need to be, it’s kind of what can you do to eliminate the fear of the unknown? Because this process is hard. Most recently, my last told you I’ve been injured three times and my last claim just resolved itself last year, and I ended up having a knee cartilage replacement from a random tear injury in a flooding car that we were breaking out of when we happened to be in New York with clients. So again, I’ve told you random places, random spaces, but one of the things that was really powerful, I think during that was I had the best employers that were making sure that things were going well along the way. Like, Hey, they’re taking care of that, right?

Do you need us to do anything? And they continued to do that. And granted, I worked for A TPA at that point, so we all know what happens when that stuff doesn’t happen. But they were genuinely like the owners of our TPA were so genuine and kind and great with that. And so when I translate that into when I’m educating employers, now you’ve got to figure out what is going on and if a ball gets dropped, what are you going to do about it? Because you need to know. So I encourage employers when their employee has been injured, that you send them a letter that says, here’s who we’ve partnered with to help handle your claim or injury. This is what we expect from them and outline the expectations. We expect them to get you the proper medical treatment. We expect them to pay you timely.

Like here’s what we expect of them. If this doesn’t happen, you need to tell us. And then reaching out to that injured employee weekly to make sure that things are going well and looking for things like I didn’t get a prescription approved during my knee process. I didn’t get my medications when literally right after the hospital we got to do the drive through to CVS or Walgreens and they were denied and the adjuster could not figure out the code to get it to process to go through. I can’t tell you how many times I’ve heard that from injured workers where you are literally coming out of surgery. What on earth? Why is that not approved? Come on people. And there’s groups, and I’m going to give a shout out to RX Bridge for this, that if you tell them that they have a process set up where they can text you the code for the pharmacy to scan and it’s done, it’s fantastic.

Why every PBM doesn’t have that is beyond me and why insurance companies aren’t doing that is beyond me. It’s 2024, it’s time to come to the table. But also something as simple as getting a medical bill sent to your house terrifies people because they innately go down to this whole fight flight freeze. Why did I get this sent to my house? Now, from a logical, rational understanding of how this process works, workers’ compensation insurance gets put in as a number two insurance most of the time, and it doesn’t get flipped on the billing to take over the billing for address one versus address two. So sometimes it defaults back to that injured human being’s personal insurance, and that’s what happens. But the injured worker doesn’t know that and they don’t understand, nor do they care or should they at this point. But when they get a bill home, that’s a perfect time to be like, Hey, employer, I thought you guys were covering this.

So I like to educate employers to tell injured workers. Here is what we need you to look out for. If a check is ever late, you need to call us because we want to make sure that this is a seamless process because what a lot of people also fail to understand. So we talk about workers’ compensation has two benefits that are main. You’ve got your medical benefits and your lost time benefits. Your health insurance premiums still have to get paid. So when people think about workers’ compensation being so lucrative, it is tax free. It’s about two thirds of your income. You still have to pay your health insurance premiums. So I get fascinated when people talk about what a lucrative place this is. No, factually, that’s untrue, but I’ll give you the facts and data and your feelings are still going to overpower what I educate you on. Anyway,

Judson Pierce:

Claire, we could talk about this all day and you really hit a nerve, especially about how an employer should notify the injured worker about their claim. I can’t tell you how many people come in here a day after an injury, but more likely two weeks, three weeks after an injury have hurt from no one. They’re adrift and a loan, they’re hurt, they’re scared. And not only do they have health insurance premiums, they have rental mortgage and everything else. Claire, I just wanted to thank you for coming on the show. Echo Alan’s comments as well. We could talk for days on this subject. And it’s fascinating because it isn’t like the nuts and bolts of this statute, this section, this is an overall arc of what we do as people in our daily lives and what we do as professionals in our work lives. And how is it, and this is my last question of the program, discuss briefly empathy as an investment.

Claire Muselman:

So when we look at how we build relationships with people, relationships end up being trust. And it’s that cornerstone of connection and it’s everyone’s fundamental need to belong. This is an investment with your people once they are hired. If somebody gets injured, that doesn’t change. You are still investing in your people. And I go back to that whole cornerstone of trust and finding those pieces of connection because when you have that, you get better employee engagement. People feel seen, heard, acknowledged, valued, validated throughout that process still continues whether or not they get injured at work. We’ve got to continue that on, but it becomes more apparent because a lot of times we treat people like that leper. It’s work comp, go talk to hr. It’ll be handled by the claims team when they’re still your employee. And I like to say, show me your loss runs. And I can tell you what kind of an organizational culture you have, because depending on how you treat your injured workers, it says everything about your organization. And it really goes down to the characteristics of how you stand for integrity, trust, transparency, and loyalty to your people.

Alan Pierce:

Well, Claire, I want to thank you for being a guest this afternoon on Workers Comp Matters. If somebody wants more information, where can they find? You

Claire Muselman:

Can find me at www.drclairemuselman.com or on LinkedIn, glitter and sparkles as my handle.

Alan Pierce:

Well, thank you to our audience and join us on our next podcast on Workers Comp Matters, and go out and make it a day that matters. Thank you.

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