Our “Star Adjuster” nominees continue to surprise and impress us with the hard work and dedication that we have found claims adjusters are capable of. We love reading about the enthusiastic and quality adjusters you have been working with. Keep the nominations coming by submitting a form on our Y.O.T.A section of WCInsights. Make sure to grab a complimentary copy of our infographic to feature in your office or share with your friends as well, and while you’re there submit your tips for other adjusters!
Our next nominee comes to us from West Bend Mutual Insurance Company. Wendy DeBlaey was nominated because of her even keeled nature and commitment to her work, especially the peer mentorship program within the company. She has been a Workers’ Compensation Claim Specialist since 2005 but has maintained a great reputation at the company ever since she started in 1995. She has expertise in four jurisdictions and manages an average of 121 claims at a time. She shares a great story that proves how much of an impact adjusters can make in the lives of injured workers.
WCInsights- Your nominator mentioned your participation in the mentorship program and your work ethic. Could you expand on that?
WD- I really enjoy the mentorship program by sharing knowledge that I have learned over the years. It is rewarding to participate in an associate’s professional development and watch them grow and use the skills I have helped to develop. I also continue to act as a viable resource for them on day to day issues such as authoring effective letters and Medicare issues. Being approachable and accessible is important to them. Regardless of how busy I might be, I am always willing to stop and assist others.
WCInsights- Are there any qualities you have that you think make you a great adjuster?
WD- I am honest, dedicated, take great pride in my work and strive for good outcomes on the claims I handle. I am very detail-oriented and take time to investigate and maintain an ongoing investigation to develop creative action plans to resolve.
WCInsights- What is the most rewarding part of being an adjuster?
WD- I am able to use many skills throughout the day and I am constantly learning. At the end of each work day, I know I have made a difference; by positively impacting an insured customer’s bottom line and assisting injured workers that are legitimately injured during a time of need. Many injured workers do not understand the Workers’ Compensation process thus, have a number of questions. They are concerned with how their injury will impact their families and their ability to pay bills. I am able to provide answers to the questions, and provide some reassurance and peace of mind that their medical bills will be paid and that they will have income replacement during their recovery period-removing some of the stress.
WCInsights- What is something that might make your job easier?
WD- My job would be much easier if everyone cooperated with the claim process. It would help if all insured customers conducted a more detailed initial investigation immediately following the incident. It would help if more insured customers were able to accommodate restrictions. It would be extremely helpful if all injured workers called with updates after their medical visits and returned signed medical authorizations.
WCInsights- What is something you personally do that you think makes the job better for you?
WD- I am very detail-oriented and I also have a good memory. I always have a short summary of the claim in my file notes that I can refer to if needed. When I have a really complex claim with a lot of medical treatment, I will put together a treatment log which allows me to look at the treatment in date order. Inconsistencies are brought to the surface. It can take a while to put together the treatment log but it is very helpful when a cover letter is needed for independent medical examination.
WCInsights- How do you stay on top of claims? If you had more time in your workday, what kinds of things would you be able to do?
WD- I try not to procrastinate and tackle difficult tasks in the morning. I am resourceful and brainstorm with my colleagues and manager. Effective use of our diary task system also helps. I would work ahead on my diary tasks if I could!
WCInsights- Could you share a story of getting an injured worker back to work that had an impact on you?
WD- Several years ago I handled a claim for an injured worker (IW) that was struck in the lower legs by a large magnet used to move steel. The IW sustained a severe fracture to the right lower leg and severe fractures to numerous bones in the left foot. Both lower extremities required internal surgical fixation of the fractures. After the surgeries the doctor told the IW he would need to be in the hospital for several months and it would be about nine months until he would be able to bear any weight on the left foot. The IW was also told by the doctors that it would be painful for him to work outdoors and recommended he consider moving south! The IW was also pretty sure that his employer would not have work for him once he was able to return to work for various reasons and wondered what his future would bring.
The IW was not the type to sit in the hospital and requested to go home to recover. He required a transportation service to get him to his doctor and physical therapy appointments. It was not uncommon for the IW to sit for two and a half hours waiting for the van to come and take him home giving the IW a lot of time to think. One day the IW asked me how much these rides cost and was shocked by what the transportation vendor were charging for the service that was actually provided.
As the IW waited for the van one day a “light bulb went off” in his head and he had an idea – he would start his own medical transportation service. During his idle time he did a great deal of Internet research and asked a lot of questions of the van drivers. He decided to start his own medical van transportation service. The IW put his last $500 down on his first van in April 2002. I agreed to continue his temporary total disability benefits during the start-up period of his business as he was still in a healing period anyway. The IW hired his father-in-law to drive the van and he was doing the dispatching. At this point the costs associated with the van were higher than what the company was bringing in so I continued the IW’s temporary total disability benefits until November which allowed him to make his house payments. The IW persevered and his business has continued to grow and he now has a small fleet of vans with a thriving business. In fact, many of the adjusters here at West Bend use the IW’s transportation service.
Although I was not able to get the IW back to his pre-injury job he was successfully returned to gainful employment without having to fund a costly vocational retraining program. The IW never let his injury get him down. He used his recovery period to plot a new career. He is a true inspiration.
WCInsights- What’s one tip that you could offer to other adjusters?
WD- Investigate, investigate, investigate! When something does not make sense, go back and ask questions or get a medical opinion. Take detailed recorded statements, don’t rush through them. During the statement, ask open ended questions, listen for the answers and do not provide the answer. Ask follow up questions until you get complete answers to your questions. Keep the investigation an ongoing process throughout the life of the claim. You never know what might turn up. Request complete sets of medical records, especially priors.