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Trucking companies that were handling workers’ compensation claims before the coronavirus pandemic may find resolution of these claims stalled for reasons that have nothing to do with the worker’s injury.
The impact of stay-in-place orders, social distancing and scaled-back services can contribute to claims not being resolved as quickly as they would have been pre-pandemic.
Right now, it’s not uncommon to see an issue that occurred pre-pandemic with an expected 12-day absence from work stretch to 14 weeks due to COVID-19 restrictions, according to an internal analysis at Gallagher Bassett.
In this example, an absence that under normal circumstances would have cost the employer $1,700 in temporary benefits would jump to $14,000.
Fortunately, there are steps carriers can follow to both care for their employees and mitigate increased financial risk.
Know the Factors
To help speed resolution of existing claims, employers must understand the factors that may be delaying the injured employee’s return to work — especially if these factors are related to the pandemic.
Modified work: Many trucking companies employ a modified work program, which helps injured employees feel valued and productive and increases their chance of returning to work sooner. A study conducted by the Job Accommodation Network before the pandemic indicated the likelihood of an injured worker returning to work drops to 50% if the employee is off work for more than 12 weeks.
For example, at a trucking terminal the injured worker could perform tasks such as assisting the dispatcher, riding along to provide guidance to newer drivers or performing inventory of equipment.
However, to reduce the spread of COVID-19, many trucking terminals have closed or have limited the number of employees working in one location. In many cases, employers have had no choice but to move the injured workers out of their modified work program and back to receiving temporary total workers’ compensation benefits. But there may be other options. The employer should evaluate the injured worker’s ability with employer needs, to consider work-from-home jobs such as having the injured worker review telematics results and coach drivers, when appropriate.
Ability to return: Indirect factors also can affect an employee’s ability to return to work. For example, some employees may have a need to stay home and tend to children as child-care facilities are closed in some areas. In these cases, employers should listen to the employee and understand their circumstances. Employers can then assess the situation and determine a workable return-to-work strategy such as modified hours or shifts, or a work-from-home scenario in certain cases.
Employees’ access to treatment: Some injured workers may have concerns about seeking treatment from doctors or hospitals, and many physicians continue to defer some nonemergency office visits and elective surgeries. This could delay treatment and claims resolution.
Ultimately, understanding the reasons for a delay is vital to implementing solutions that ensure injured employees receive the proper care and can return to work safely.
Solutions to Move Claims Along
Telemedicine: While not all injuries can be evaluated via telemedicine, it can be used for initial visits and rechecks for specific injury types, such as certain sprains. Claims handlers can assist the injured worker and employer with identifying appropriate claims for telemedicine opportunities.
Virtual physical therapy: Many facilities are offering telephone or video-based physical therapy appointments to help treat injuries.
Leveraging workers’ “essential” status: Many medical offices have limited their hours and the number of nonemergency patients they see per day. This, compounded with physicians’ availability, may make it difficult to schedule appointments. Where appropriate, it may help to inform the scheduling clerk if an injured worker is also classified as an “essential” employee.
Reviewing medical records: If the injured worker’s treating physician and the Official Disability Guidelines have conflicting recommendations on when the employee should return to work, an Independent Medical Exam can be used to obtain another opinion of the disability. If an IME is canceled and not rescheduled due to the pandemic, another option is an independent records review by a physician. All medical records related to the injury (emergency room visit, surgical notes, doctor visits, test results including X-ray, MRI, bloodwork, etc.) could be reviewed. While this doesn’t replace the IME, it may provide sufficient insight for the claims handler to move the claim forward.
The pandemic has disrupted transportation in many ways, both directly and indirectly. Many unknowns remain as it relates to the long-term impact COVID-19 will have on businesses. While the pandemic has forced many organizations — including trucking companies — to rethink what was done in the past, carriers can use these tools at their disposal to ensure workers make it back to work safely.
Lori Ilgenfritz is account principal in the Transportation Practice at Gallagher Bassett, a global provider of risk and claims management services.
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