Here’s what was drafted by a local Workers’ Compensation Insurer in a letter to my client:
“I have been requested by your claims adjuster, [John Doe], to assist you in your medical recovery process. As a registered nurse case manager, [Michael (names are changed)] is to coordinate, communicate an (sic) advocate for you during your medical recovery. Your cooperation will assist me with this goal.”
This is a problem. Can we really trust that this Workers’ Compensation Insurer has my client’s best interest at heart and that all communications will be clearly expressed? Language and non-verbal ques, even when spoken or used by native speakers, are very imperfect. Mis-perceptions are common, and they can harm people being “helped” by those who do not have their best interests at heart. Granted, in business we often align our mind-set with our employer, because our employer compensates us. When information can be interpreted several ways, or when a mis-perception is evident but benefits our self-interest – or that of our employer – we often support it, without really questioning whether it is complete or correct. Our human nature drives us to align with entities that benefit our self-interests. Due to these affiliations and affinities, and due to both conscious and unconscious bias, we tend to side with the philosophies of “our group.”
As it is, here are some mistakes that employees working for the workers’ compensation insurance company make on a too-regular basis:
1. All ambiguous or imprecise messaging is interpreted against the injured worker and in favor of our employer.
2. All identified mis-perceptions or mis-communication that adversely affect the injured worker and benefit our employer are never clarified to dispel the mis-perception.
3. We seek only to find, develop, and create information that ratifies all preconceived notions, taught by the employer, that injured workers are all trying to defraud the system.
4. All of our acquisition of information, and of our learning, centers around studies and sources that favor a denial of benefits due to lack of medical and legal causation, or other reasons, to the exclusion of valid contrary studies, sources, and information.
5. We adopt the sentiments, philosophies, and conscious and un-conscious biases of our employer that are adverse to the injured employees’ interests, but we do not view them as such. Having never been exposed to or having never sought out contrary information, we think our unchallenged positions, beliefs, and theories are irrefutable.
Study after study, as well as my own experience in the adversarial system, has shown that we as humans have this tendency.
Consequently, any process that allows the opposition to deign to be an “advocate” – either as the employer or insurance companies’ treating physician, or as a “registered nurse case manager”– will, when it matters, engage in actions and behavior that lead to great injustices, especially when the injured worker is dis-advantaged by class, ignorance, mental and cognitive incapacity, cultural dissonance, and is a minority. In my client’s case, this lead to mis-perception, piled upon mistake, and then and great injustice.
If you are injured, do not use the employer/insurance companies’ treating physicians, nor allow their nurse case workers to go to your appointments. The law only requires that you go to an initial visit and then you can go to your own doctor. We also need to legislate that employers and insurance companies must advise injured workers that these hired professionals work for the employer and insurance company – not the injured worker.
Loren M. Lambert, © July 13, 2017
“I have been requested by your claims adjuster, [John Doe], to assist you in your medical recovery process. As a registered nurse case manager, [Michael (names are changed)] is to coordinate, communicate an (sic) advocate for you during your medical recovery. Your cooperation will assist me with this goal.”
This is a problem. Can we really trust that this Workers’ Compensation Insurer has my client’s best interest at heart and that all communications will be clearly expressed? Language and non-verbal ques, even when spoken or used by native speakers, are very imperfect. Mis-perceptions are common, and they can harm people being “helped” by those who do not have their best interests at heart. Granted, in business we often align our mind-set with our employer, because our employer compensates us. When information can be interpreted several ways, or when a mis-perception is evident but benefits our self-interest – or that of our employer – we often support it, without really questioning whether it is complete or correct. Our human nature drives us to align with entities that benefit our self-interests. Due to these affiliations and affinities, and due to both conscious and unconscious bias, we tend to side with the philosophies of “our group.”
As it is, here are some mistakes that employees working for the workers’ compensation insurance company make on a too-regular basis:
1. All ambiguous or imprecise messaging is interpreted against the injured worker and in favor of our employer.
2. All identified mis-perceptions or mis-communication that adversely affect the injured worker and benefit our employer are never clarified to dispel the mis-perception.
3. We seek only to find, develop, and create information that ratifies all preconceived notions, taught by the employer, that injured workers are all trying to defraud the system.
4. All of our acquisition of information, and of our learning, centers around studies and sources that favor a denial of benefits due to lack of medical and legal causation, or other reasons, to the exclusion of valid contrary studies, sources, and information.
5. We adopt the sentiments, philosophies, and conscious and un-conscious biases of our employer that are adverse to the injured employees’ interests, but we do not view them as such. Having never been exposed to or having never sought out contrary information, we think our unchallenged positions, beliefs, and theories are irrefutable.
Study after study, as well as my own experience in the adversarial system, has shown that we as humans have this tendency.
Consequently, any process that allows the opposition to deign to be an “advocate” – either as the employer or insurance companies’ treating physician, or as a “registered nurse case manager”– will, when it matters, engage in actions and behavior that lead to great injustices, especially when the injured worker is dis-advantaged by class, ignorance, mental and cognitive incapacity, cultural dissonance, and is a minority. In my client’s case, this lead to mis-perception, piled upon mistake, and then and great injustice.
If you are injured, do not use the employer/insurance companies’ treating physicians, nor allow their nurse case workers to go to your appointments. The law only requires that you go to an initial visit and then you can go to your own doctor. We also need to legislate that employers and insurance companies must advise injured workers that these hired professionals work for the employer and insurance company – not the injured worker.
Loren M. Lambert, © July 13, 2017
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