The Connection Magazine AIM MUTUAL Spring 2019 | Page 30
PATIENT ADVOCACY
PATIENT ADVOCACY:
A WALK IN THE SHOES OF THE INJURED WORKER
BY: SEBASTIAN GRASSO, PRESIDENT & CEO, WINDHAM GROUP
IT’S REFRESHING to hear the term patient advocacy used
in the workers’ compensation industry. There was a time when
the workers’ compensation system seemed more adversarial
than supportive toward injured workers.
Getting injured at work and beginning down the workers’
compensation path can be a scary and intimidating journey.
Most injured workers don’t know what to expect. They are
contacted by strangers asking all kinds of questions about
the injury. They may be told that their choice of physician is
limited or that their treatment must be approved before they
can proceed. Their employer may express suspicion about the
injury instead of offering compassion. The injured worker can
easily feel alone and unsupported. History has demonstrated
that when an injured worker feels this way, many will turn to
attorneys for support. Medical and indemnity costs, therefore,
rise accordingly.
So, what does patient advocacy in workers’ compensation
actually mean? In literal terms, it means “injured-worker
supporter.” When the workers’ compensation system supports
the injured worker, he or she is far less likely to seek an attorney
and is more likely to return to work. That helps to keep claim
costs lower.
Three steps need to be taken if patient advocacy is to
occur. First, everyone involved in the claim process (employer,
physician, claim representative, case manager, etc.) must have
an unwavering focus on return-to-work. Second, trust must
be developed with the injured worker. And third, all parties
involved—especially the employer—must keep the injured
worker engaged throughout the return-to-work process.
No. 1 Focus
All medical and rehabilitative aspects of the post-injury
process must occur with one end game in mind: keeping return-
to-work clearly in the injured workers’ sights.
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