Thursday, October 22, 2009

Preventing Unnecessary Compensable Stress Claims

A lot is said about helping to prevent compensable stress claims with employees -- a medical problem that has severely impacted workers' compensation premiums in recent years.

Well, according to National Underwriter, the largest circulating property casualty news magazine, the most important factor in compensable stress claims is the involvement of an attorney who works on the behalf of a client (your employee) who may have been injured, experienced a traumatic event, or had another experience that could later manifest itself as a "stress reaction." Dealing with crazy supervisors and stopping inappropriate behavior is a large piece of this risk reduction puzzle.

Once an attorney is involved, separating those employees who may be malingering from real stress reactions may be extremely difficult.

Events that follow attorney involvement may include sexual harassment, being forced to participate in illegal activity, or negative effects of a dysfunctional supervisor.

This is still a very controversial area of workers' compensation. Many states disallow reimbursement for stress claims because of the potential for and history of abuse by employees. (California not one of them. Very progessive thinkers--those California folks. Not sure if their financial reforms include reducing the allowance of compensable stress claims.) By the way, I do support compensable stress claims for PTSD, or even acute stress reactions to a point.

According to research, responding quickly to real employee complaints, offering true empathy, and speeding assistance to injured employees may be the best way to prevent the involvement of an attorney and then a compensable stress claim. Please -- begging you to hear this -- the best way to do this is to employ the services of an employee assistance professional who gets to know your employees very, very well, and who by way of promotion gets to be regarded as the "go-to" person to address personal problems.

Give this individual strong confidentiality protection of his or her employee records and make that match the CFR 42 Part II. What that!? These are the federal confidentiality guidelines that are considered the strictest in existence. They are more strict than the medical confidentiality laws that govern primary care physicians and your personal medical records -- even the deepest, darkest, medical issues at your doctor's office. You didn't know about these laws?

CFR 42 Part II was passed into law in 1970 by the Hughe Act that started the National Institute on Alcohol Abuse and Alcoholism. They protect alcohol and drug addiction treatment records but any counseling issue will fall into their provision when a counseling program address substance abuse and receives federal funding. In fact, it's mandatory. But your program or counseling services can adopt these counseling guidelines voluntarily, and I would suggest strongly that you do. Make it corporate policy.

Simply state officially that your employee assistance professional confidentiality and records conform to these laws and you will have a solid promotional tool to get employees calling for help. Promote it continuously.

Now you will a professional counselor working on your behalf to help employees and spinning down concerns, anger, crises, and complaints where appropriate. Recommend any injured employee get help from the EAP. Allow the EAP to do presentation on recovery from injury and stress.

The EAP will encourage employees in sessions to sign a release so it can help resolve issues that can lead to lawsuits and better get the employee's needs met.

EAPs are the underplayed, underutilized, and have been screwed up by managed care companies, most of which have exploited them for their own purposes of limiting access to mental health benefits in exchange for financial performance bonuses paid to top management for their success in doing so.

If the above was not the case, you would already know what I just described above and it would be "household knowledge" because EAPs are so powerful and effective in resolving enormous personal problems that cause companies huge financial losses each year.

Frankly, if you are paying high premiums for Employment Practices Liability Insurance (EPL) or Director and Officer's Liability Coverage, argue for a discount if you use an EAP that is onsite, integrated, tenured, and that has low staff turnover. You're at less risk. They insurance company only needs to do a survey of existing customers to discover this reality.

The mechanism I just described reduces lawsuits related to employment claims, plain and simple.