Monday, March 20, 2006


Workers' Comp World-view


Workers’ Compensation World-view

Let’s pretend that from our safe and lofty position on this Summit, all the visionaries in attendance discovered a safe place buried deep within the cutthroat workers’ comp jungle where each affected group involved in this safari would find their individual Shangri-La. Beyond the dense smoke and foggy mirrors of second-opinions, peer/utilization review, retrospective hospital bill audits and never-ending record reviews; treacherous three-card Monty attempts to find-the-lower-premium; quicksand bog of paralysis by analysis and countless strategies littering the rainforest landscape with unfunded legislative mandates and other ‘comprehensive solutions’ designed to eradicate the serpentine-like rising costs contributing to choking off and polluting the business environment to the point of extinction. Not too mention the anaconda of run-on sentences …

After much discussion, it was agreed that the time for action was NOW. The land was too contaminated to rehabilitate, let alone restore and recover. The visionary leaders agreed to assemble a revolutionary new concept called the Telescope-of-Hope (ToH) and dialed in on a fixed point on the horizon where they believed Workers’ Compensation Shangri-La was located. In order to gain consensus to rally the troops, they invite each representative from the various stakeholders to come and see for themselves.

At that moment, the Telescope of Hope had been inadvertently and unfortunately transformed into the Kaleidoscope of Chaos (KoC). Each stakeholder who stepped up to the ToH adjusted the viewfinder by just one click and then moved on ~ satisfied the utopian scene identified by the visionary leaders was made even more beautiful because of their ‘insightful’ input.

The visionary leaders’ Telescope of Hope never moved from the originally agreed upon fixed point on the distant horizon, yet their Vista of Victory had been lost forever. Why? Because each constituent representative who looked through the ToH adjusted the view to fit their own ideal image for the Garden of Eden and, from that point forward, no two stakeholders could ever agree what Nirvana looked like.

This was not the first time a calamity like this occurred. The Tower of Babylon was never completed after each constituent’s “voice was heard”. When Moses led the mass exodus out of slavery from Egypt, he had the distinct advantage of Divine Intervention when He parted the Red Sea to evade Pharaoh’s army. One would think that act, on its own merits, would generate a lifetime of loyalty, however, non-committed people forget. It’s always, “What have you done for me lately?” So, it’s easy to understand why Moses wandered aimlessly in the desert for forty years until the original Chosen Constituents died off before he delivered their beneficiaries to the Promised Land. Perhaps the ultimate example of passive-aggressive servant leadership … but I seriously digress.

It’s not the big things that keep us from getting to the Promised Land. It’s the little things constantly challenging our worldview. As we go through life relying on our individual moral compass guided by our personal values, beliefs and ideals; our professional constituency’s stakeholder paradigm is driven and defined by its own mission, vision and values of those we serve, lead or follow.

Employers must acknowledge their role in this crisis. Regardless of their current posturing – they are not victims. Employers are the ONLY ones who can actually change their status quo. The greatest problem facing occupational health professionals may be one of our own making. We may have inadvertently ‘helped’ our employer-clients become corporately co-dependent. By consistently framing the workers’ comp problem in a manner that triangulates the power shift labeling the employer and injured employee as the persecuted, we (providers) help perpetuate the myth that employers are powerless from managing their destiny. And to make matters worse, we are now struggling with the concept of leading an intervention with an unwilling participant who refuses to acknowledge their behavior as a mitigating factor in their ongoing financial misery.

Employers have a duty to pay for any injuries and/or illnesses their employees may experience while performing their jobs. They also have a duty to provide a safe workplace and minimize the risks their employees may be exposed to while performing their jobs. So, it stands to reason that the most cost effective risk management strategy available to employers is a comprehensive absence management program beginning with recruitment, orientation, safety/prevention training, ongoing skills improvement, post-injury transitional duty assignments and an array of other programs designed to help employees become accountable for their actions, behaviors and decision-making.

The chief executive and senior management team must be role models demonstrating their commitment to transforming the workplace culture from what it is to what they want it to become. There is no room for lip service or empty promises in this quest for excellence. And there cannot be any of the usual abdication of corporate responsibilities and accountabilities to any third party. As they pay for the band, they call the tune. The time has come for Corporate America to step up and replace their wishbone with a backbone.
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