Workers’ Compensation Benchmarking Study Releases White Paper for Overcoming Psychosocial Roadblocks with Claims Advocacy Strategies

Claims leaders rank psychosocial issues as the number one barrier to successful claim outcomes, according to Rising Medical Solutions’ 2016 Workers’ Compensation Benchmarking Study survey. A new white paper, co-authored by study program director Rachel Fikes and industry journalist Peter Rousmaniere, shows how claims advocacy principles at The Hartford, CNA, Nationwide, and Albertsons Companies are taming the effects of psychosocial issues and coaching injured workers to recovery and claim resolution.

This short report – “How to Overcome Psychosocial Roadblocks: Claims Advocacy’s Biggest Opportunity” – examines key best practices, skill sets, and training approaches organizations are using to screen for, intervene in, and effectively address psychosocial factors. Rooted in advocacy, these strategies treat the injured worker as a whole person to proactively resolve non-medical barriers to timely recovery.

“The negative impact of personal expectations, behaviors, and predicaments that can come with the injured worker or can grow out of work injury drive up claim costs far more than catastrophic injuries,” says Fikes. “Through this examination, one can see how adversarial, compliance, and task-driven claim styles are ill-suited for addressing the fears, beliefs, and perceptions of this distressed population.”

Benchmarking Study results confirm that a shift from traditional claim processing styles to advocacy-based styles is more prevalent in higher performing claims organizations. The 2016 Study also confirmed that greater training for claims adjusters in communication and soft skills, like empathy, is associated with higher performers.

To read the entire white paper, visit Rising Medical Solutions’ website here.

About Rising Medical Solutions

Rising Medical Solutions is a national medical-financial solutions firm that provides medical cost containment and medical care management services to the workers’ compensation, auto, liability, and group health markets. Rising also directs and publishes the annual Workers’ Compensation Benchmarking Study, a national research program examining the complex forces impacting claims management in workers’ compensation today.

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