Friday, July 31, 2015

Angry At The System

An interesting observation was made by David Hanscom, MD, in the WorkCompCentral webinar on Tuesday, "We're Beating Back Opioids - Now What?".

Dr. Hanscom is a board certified orthopedic surgeon specializing in the surgical correction complex spine problems in the cervical, thoracic, and lumbar spine. He has expertise in adult and pediatric spinal deformities such as scoliosis and kyphosis. A significant part of his practice is devoted to performing surgery on patients who have had multiple prior spine surgeries.

But more importantly in my mind is that Dr. Hanscom is an advocate in NOT performing surgery. His book, "Back in Control" teaches that pain, particularly chronic back pain, is NOT an orthopedic issue unless there is some structural issue involving the spine, but rather is about teaching the brain to use detours around established pain pathways in the nervous system.

Dr. Hanscom observed in the webinar that engaging injured workers within the workers' compensation system is infinitely more difficult than in general health "because these patients are so angry at the system."

This is a poignant, and from my observations, an accurate assessment.

One need not look too far around the Internet to find postings by injured workers frustrated and angry.

They are mad at delays, denials, disruptions. There is no outlet for their rage, no way to vent. And when they do the perception is that these folks are irrational.

No one likes to deal with angry people, so when these injured workers' blood pressure rises and they vent some steam, they further damage their cases because the wall of anger increases irreproachability. The ability to rationally converse diminishes. Lawyers get involved (unless the emotional damage is too great in relation to the end-of-case financial reward, then they're left to their own devices).

Statistics bear out that a relatively small percentage of claims are responsible for a disproportionate allocation of costs and expenses. I haven't seen any empirical studies, though, on just how many of these claims involve "angry" claimants. I suspect a much larger representative population than we imagine.

It's our own fault. We have created a system where communication and accountability is minimal.

Sure, there's lots of required notices and forms. They have all sorts of warnings, advise, instructions.

That's not communication. Communication is a two-way street and more important than anything is listening - active listening. Sometimes there doesn't need to be a solution other than some empathetic communication.

And accountability is deferred to the penalty process. Workers' compensation systems are filled with negative incentives. Do something against the rules and one gets penalized.

There are lots of ways to run afoul of the rules and consequently lots of ways to get penalized.

Sort of like that beaten dog - rather than looking for a way to make the master happy, the beaten dog is always trying NOT to do something to make the master mad.

Dr. Hanscom's solution is simple in concept, but difficult in deployment: "The first step I think would be to teach claims examiners to be nice to their clients. It happens to be their legal obligation. Nothing good happens in an angry interaction and at the end of the day the costs skyrocket."

Why is this so difficult? Well, for one thing, the claims payer is the "defendant" and we "defend" against claims.

If you're on the defensive, right off the bat your guard is up and it's difficult to be "nice" when you're fighting.

Secondly, being a claims adjuster is emotionally taxing. We all have bad days. When a claims examiner has a bad day the injured worker, unfortunately, is going to experience that. Bad days need time away from the desk. Time to slow down...

I'm reminded of my trip to Italy to ride motorcycles with my son this past May. The morning we went out to the bikes in San Marino to get started, one of the Ducati Monsters had a flat rear tire. It was obvious that someone, likely disgruntled with our arrival, had driven a drywall screw into it.

While waiting for the tire to be repaired I noticed a hand painted sign hanging on a wall adjacent to our hotel, "Slow down. You are on vacation."

Perhaps coincident? Perhaps not.

The lesson wasn't lost on me.

We all have the same rules and regulations to abide by. But sometimes we just need to slow down and not get consumed by them.


If you missed or were unable to attend Tuesday's webinar, the recorded version will be available on WorkCompCentral in the Education section in a matter of days.


  1. David,
    Nice article on a better approach. I found in past years of adjusting that once an adjuster is at odds with the injured worker no one wins when the purpose of the system is to assist workers in finding the best path to wellness after injury. Removing anger may just help workers find the "detours" around the pain pathways. We can always hope and no it is not easy!

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    2. The best path that Employers Compensation Insurance Co. of Nevada and my former employer - Metropolitan Home Mortgage found for me was to have my person systematically maimed, my spinal column from the skull down to the tailbone, muscles, tendons, ligaments, nerves and more. I won't give you the nasty details but if you are curious, you can to my Facebook account and read a little. . Also, I have made comments on "Crimes Against Injured Workers" on FB.

  2. Comment 1 of 2: Indeed! There is seemingly no place and no one for injured workers to turn to for help. Insurance companies, law firms and employers can buy our elected officials and leave us without the representation in government and/or law enforcement that we anticipated we would have as Americans. To our surprise, we receive a firsthand education on the lack of effort made by our elect to protect us from those who contributed to their campaign or provided another kind of “favor”.
    Ask anyone who has been injured at work and has had to navigate a corrupt and fraud laden industry like the workers compensation industry. For a long time, the workers comp industry has successfully pointed the finger at injured workers or employees who may have falsely filed workers comp claims.
    But the truth of the matter is that the workers compensation industry professionals which include medical providers, insurance carriers, lawyers, judges, insurance adjusters, surgery centers are far more likely to be committing crimes against injured workers than an employee filing a false work comp claim. Insurance carriers, employers and law firms have the money to shine a light on the miniscule amount of fraud perpetrated by employees. They also successfully keep the light from shining upon themselves and their dirty deeds. We injured workers refer to it as “reverse blame”. Their crimes have included the intentional maiming and battery of injured workers. This is done for strategic reasons. These malicious crimes are facilitated against injured workers during workers comp medical procedures AND somehow they are able to recruit medical providers outside of the realm of workers compensation to participate in their continued efforts to falsify medical reports and more. No doubt to protect their “medical provider network” from the consequences of committing such heinous crimes as maiming the body of an injured worker. Strategically, they are "creating the look of a condition or conditions" that will or may be later be used in litigation against the injured worker to reduce if not eliminate the employer & insurance carrier’s monetary compensation obligations and medical treatment obligations.
    There are many more crimes that are facilitated against injured workers including falsification of medical reports and surgery reports, wiretapping the injured workers phones, changing documents over and above the injured workers signature, marking a multiple page document one way on the top original form but the pages underneath the top page are marked differently, harassing the injured workers family members, surreptitiously setting up video and audio in the injured workers home, intrusions into the injured workers home to taint their food, water and other refreshments, Theft of documents and medical history, vandalizing the injured workers auto and home, overt aggressive stalking (not to be confused with subrosa surveillance). These and other tactics would make the mafia envious.
    How do they and how have they gotten away with these crimes? Why isn’t there a mandated disclosure that could be presented to injured workers as a warning to look out for these and other such attacks? Could it be because they are protected by our elected officials and by State agencies who treat the injured workers complaints with disregard?

  3. Comment 2 of 2: I can’t tell you how many injured workers have contacted law enforcement, District Attorney’s offices, Assemblymen, Congressmen, Governors, the DIR, WCAB, DWC, and the like, all to be told that they cannot help if they respond at all. Injured workers are told that they need to consult with an attorney. But attorneys cost money and I haven’t met an attorney who wants anything to do with workers compensation! Those attorneys who work in workers compensation handle only the administrative process. They don’t seem to know how or perhaps they won’t handle the criminal tactics utilized against their client(s) - injured workers. Truly, in these cases, the injured worker would need a criminal investigation done. Who will pay for that? On top of all of that, TV and Cable news channels, TV shows including Dr. Phil, The View, The O’Reilly Factor, Foxnews, CNN, ABC, NBC and others don’t seem to think that injured workers being the target of heinous crimes including being maimed during medical procedures and/or having their medical reports and studies falsified, their property vandalized or delayed & denial of medical treatment and much more – is news worthy. But anytime the insurance carrier wants to parade around the news with “how much money they loose from employees falsely opening a WC claim”, the media accommodates them.
    We would like to join together, and some have. However, many of us, like myself, are in pain. Perhaps to keep us controlled, we are then denied legitimate medical treatment and adequate pain medication.
    I’ll say what I have learned is the best piece of advice I can give anyone who is injured at work. Never file a workers compensation claim! If you do file a workers comp claim, you stand the chance of being prolifically maimed during medical treatment or you may just be denied and/or delayed medical treatment but in both cases, you will suffer in pain and suffer a workers comp system that is literally a “cesspool of fraud and corruption”. You might then seek help for yourself and other injured workers by contacting your elected officials… well, jump on the bus with us. We’ve been there and done that! Unfortunately for us, corporate power rules. BUT, we will persevere and continue to spread awareness so that the public understands the the magnitude of malicious crimes that are facilitated against injured workers!