Our Acrometis “Year of the Adjuster” series is stronger than ever. Can you believe we’re already halfway through the year? We still don’t think we’ve given enough credit to the hardworking adjusters out there but we are going to try. Keep submitting your nominations for All-Star Adjusters so we can give them a chance to enlighten us about a day in the life of a claims adjuster.
Have you seen our adjuster infographic yet? If not, you’re missing an essential piece of office décor. Request a copy for yourself or to mail to a co-worker so you can spread the word about work comp adjusters who are (more often than not) drowning under their caseload and who are finding it difficult to try and efficiently close claims.
Our next claims adjuster comes to us from Chesterfield Companies. Sandra Brown has worked in the claims industry for over 25 years and has developed a strong knowledge of the industry. As we have heard from lots of our adjusters- she knows it is important to stay PROACTIVE in claims handling.
WCInsights- Your nominator mentioned your knowledge of your caseload, and that you always go the extra mile to get the job done and get it done correctly. Can you expand on that?
SB- All claims professionals are trained to investigate and review a claim but it is so much more than that. Hardly ever does a claim begin and end without conflict. In my claims, I am looking for trends, resolving contention, developing relationships with the physician and the injured worker, and at the same time keeping an eye on cost containment for the employer. If you do not develop a relationship with all the key players in the claim (employer, injured worker, physician, etc.) then the claims you handle will drive themselves instead of you being the one to drive the claims to a successful conclusion.
WCInsights- What is the most rewarding part of being an adjuster?
SB- I believe the most rewarding part of being a claims professional is helping an injured worker restore a sense of normalcy after experiencing a workplace injury. Most of our injured workers are not familiar with the Workers’ Compensation process and experience fear and anxiety especially about their employment status. It is important to continually practice empathetic listening and to provide world class customer service to our injured workers, medical providers, and our employers.
WCInsights- What is something that you think would make your job easier?
SB- My job is made easier at Chesterfield because we are empowered to make decisions about our claims, within specific parameters. It is rewarding to work for a company that empowers their employees who have the ability and the initiative to perform their jobs without constant oversight.
WCInsights- What is something you personally do that you think makes the job better for you?
SB- I have constant communication with the injured worker and the physician during the course of a claim. I believe it is important to develop a good relationship with the physician in order to make the right decisions about the claim. A strong relationship with a physician will ensure that you are provided with the information that you need when you need it. Without complete information, it is possible that you will not be able to make correct or timely decisions which could lead to costly litigation. It is equally as important to try and maintain a good working relationship between you and the injured worker. This, too, may help avoid unnecessary litigation costs
WCInsights- How do you stay on top of claims?
SB- I prioritize my work each day by keeping a running list of “critical things to do” as well as my electronic diary of “things to do.” The critical item is not removed from my list until is it completed. New “critical” items are added and/or removed throughout the day and a new “critical things to do” list is created at the end of each day ready for me to start my next day. This helps me stay on top of my claims which require constant care, such as a claimant who has recently had surgery, etc., or a physician who should be releasing a claimant from his care at the next appointment. Another critical piece of staying on top of claims is regular communication with the injured employee. This helps the injured employee stay connected with their claim, the healing process, and the workplace. Regular communication with the employee lets them know that we are truly invested in helping them return to work.
WCInsights- If you had more time in your workday, what kinds of things would you be able to do?
SB- I would review diaries for possible file closure on a more consistent basis. This helps reduce my backlog and closes reserves on files where a reserve is no longer necessary.
WCInsights- Could you share a story of getting an injured worker back to work that had an impact on you?
SB- I had an injured worker who injured his shoulder resulting in a torn rotator cuff while driving truck for his employer. During the course of his injury, he was off several months for shoulder surgery and rehabilitation. The employer normally does not return employees back to work with restrictions due to the amount of lifting, etc., they are required to perform as a truck driver.
The employer and I worked together to place him in a position in the warehouse once he received light duty restriction which helped him return back to work much sooner than he would have if we would have had to wait until he was released without restrictions.
The injured worker was thankful not only for being allowed to return to work at full pay versus his reduced rate of pay through Workers’ Compensation, he indicated that the light duty work actually helped his injury heal faster than his physical therapy treatment was allowing. He was also happy that while performing light duty work, he was beginning to lose weight again because being off work for several months and being inactive had caused him to gain a considerable amount of unhealthy weight.
WCInsights- What’s one tip that you could offer to other adjusters?
SB- Be proactive instead of reactive when handling your claims. Anticipate what may happen and be prepared. We all know that we cannot forecast everything that may happen in a claim; however, exceptional customer service and continual involvement in your claims can likely result in a superior outcome for both the employer and the employee. Every claims professional should also remember to treat an injured employee with the same dignity and respect that they would expect their claim to be handled if they had a workplace injury. I put myself in the shoes of my claimant when I am handling their claim. Why would the injured worker deserve any less attention than I would expect if I had a workplace injury?