Workers' Compensation Insights

What role does bias play in workers' comp?  Where can technology ease friction for injured employees and their employers? Here are 4 insights from top workers' compensation thought-leaders.

  • 00:10:11 - 05:10:11

    Bob Wisniewski 00:06

    Everybody wants somebody else to take care of them. And I understand in the system where you get hurt, the system is supposed to take care of you. But I see a little bit more need for participation, maybe the employer should educate the people that they're getting hurt, this is what to do. If they just told them az, they could file a claim. Well, my employer didn't tell me that my employer didn't do this. And they don't know, maybe if the employer would take him to the hospital a couple of times, that might be nice, or send him a get well card, people get really, really upset that they're not being listened to. That's the biggest, no one listens to me, I go to my doctor, he's zooming in, zoom me out. And I didn't tell him about my other shoulder, mostly, my elbow was broken, but that shoulder was bothering me. So then that doesn't become part of the claim, oh, gee, it wasn't documented right away. So I think we could use a little common sense. It's getting better. I the investigation has made lots of strides. In overnight in having a portal, we file everything electronically, you can go on and look at your own portal, you can look at the hearings that have set for today and for the week. And you can find your own claims. Okay. They have lots of educational material on the Industrial Commission website. But trying to get at the worker who isn't tuned into doing this. Yeah, that's the problem. It's interesting. It's almost like we should teach people in high school how to do it, you know, how the old days we taught them how to balance a checkbook.


    Jerrod Bailey 01:35

    Yeah. Something practical checkbooks, but it's something


    Bob Wisniewski 01:39

    practical and how to maneuver through the system, we can have the system compressed a little bit in terms of the time, again, these are people's lives in there. And not only the injured worker, the entire families affected the children, the spouse, if we could just get the system moving a little faster, we'd all be better off.


    Paul Carroll 02:06

    If you actually look, in a lot of cases, worker's comp rates are going down, which isn't typically happening in other parts of insurance. And the reason is that people are doing the sort of thing that I've been preaching that a lot of us have been preaching for a while now, which is prevention, right? So I tell people that nobody wakes up in the morning and says, I'm going to go buy an insurance policy, that's going to be really exciting thing I'm going to do today. Nobody wants to buy insurance, they want protection, they want safety, they want peace of mind. And there are lots of ways that people are making workplaces safer. And because of that, you're seeing the rates gradually decline. And in most states, the US is weird, because all the regulation is state by state. And so the pricing is on state by state. But there is I think real progress going on. There also is progress going on, in terms of how you handle the claims. So I think in general, people think about AI, and it's a sort of fairy dust that you sprinkle on a problem and the problem goes away. That doesn't happen. But there are some very targeted uses of AI in workers comp. So that when a claim starts, you can look at it. And you can say, Hmm, this is likely to become a complicated one. Maybe I are to focus on that now and get one of my best people focusing on that now. And you can look at others and say, this is pretty simple. We're just going to make a payment, we're going to do whatever we have to do, we're going to help the person gets person back to work, whatever. And yet


    Jerrod Bailey 03:57

    today, they're all sort of treated with the same amount of weight coming through, right and you and we find all these bottlenecks of unnecessary bottlenecks, right?


    Paul Carroll 04:07

    That's, that's the thing. And that's where the technology is starting to be applied by some of these TPAs third party administrators, and others and is making progress. People are also realizing that there are the psychosocial as they call them aspects to workers comp. So it's not just oh, Paul has a cut finger, we're going to treat all the cut fingers the same and obviously, the issues are more serious than that. But you don't just look at them. You also look at who Paul is and where he is in his career and what sort of financial stresses he has and all these other things and he look at the environment and decide, okay, this makes Paul more or less likely to go out and hire a lawyer and, and maybe make something more complicated. They're also arm. And this is where you guys are playing a role are analyses of doctors. So you decide that these are the really good doctors in this area. So we're going to try to steer somebody to that doctor, those doctors, rather than just telling the person Good luck, go find somebody and talk to us after you've had your appointment


    Jerrod Bailey 05:23

    in so I need something that's that's top of mind for us. And it might have even been been how we found you. But you've created several articles and videos, about ironies, and specifically the drawbacks for them and right,


    Mark Blane 05:40

    so Right, right.


    Jerrod Bailey 05:41

    Can you unpack that a little bit for me? Yeah, what makes a good irony or a bad one? Like,


    Mark Blane 05:44

    right, right, your perspective. And it's not to say that every defense medical, we call them defense medical exams on the plaintiff side, but it's not to say a defense medical exam is going to always be bad. What becomes bad is when you have a doctor that is routinely abusing the biases, if you will, that's inherent within a defense medical exam routinely. In those cases, you have to be watchful, that's why it's good to have your ear to the community of your colleagues. Because we do talk, we have listserves, here in San Diego, we and then we start seeing who are the new defense doctors that the insurance are using for these defense medical exams. And so depending on which doctor that's going to be, I'll strategically I'll go, I'll go to that exam. Most of the time, I'll be going to the exam with my clients. And it's very, you know, I don't go in there with Hey, I'm recording this, you know, unless I absolutely need to. But that's really rare. I just go in there with the expectation that we're both professionals, this defense doctors doing their job. And they're going to write the report based on the medicine, not based on their bias. And then if it is a biased type of report, then of course, either we settle the case, or we'll let the community of the juror jurors decide who's who's more credible here. But I think that's the only part where it gets bad is when you have a defense doctor that's beholden to the insurance company's interest to get more business, if you will, because they're providing these more of a biased opinion. But there are a lot of good defense doctors I've worked with in San Diego over the over the years that are not in that category, I must say. And that's nice to see, because we're all professionals just doing our best for our individual clients at the end of the day.


    Matt Fendon 07:37

    of all, the public needs to know that Arizona is one of 21 states with their own safety plan. So basically, Arizona has its own state sponsored division of OSHA. It's housed in the Industrial Commission building. And so it's Arizona is one of 21 states that have this, the rest of the states are basically governed by the federal OSHA. So what federal OSHA is saying is that Arizona, OSHA is not up to federal standards, essentially. So for example, in 2012, Arizona failed to implement residential construction fall protection requirements, which federal OSHA requires. So that's what they're essentially saying is, we're gonna pull your pull you out of that one a 21. States, Arizona, and basically wipe out the Arizona state sponsored division of OSHA, and then the feds will just come in here and take it over, essentially. So that okay, yeah, so that's open to comment. So whenever you pass rules, or attempt to pass rules, the subject to public comment, and so I think that's what we're waiting for the final decision to come down,


    Jerrod Bailey 08:57

    or is there a consensus of whether this is a good thing or a bad thing? Does it depend on who you are, what side you're on, like, what's your,


    Matt Fendon 09:07

    what's your assessment of it? I mean, I know the you know, I know many people with the Industrial Commission, obviously, and the Industrial Commission thinks it's ridiculous and they think they should keep you know that house within their building and they think they're doing a good enough job. But I you know, I mean, I just want what's best for, for the workers. So if Arizona's you know, Division of OSHA is not up to snuff, then let the feds take it over. I just want safe work environments, basically.

Top thought-leaders from the workers' compensation industry share their insights. First, Robert Wisniewski, a top workers' compensation attorney, explains the need for more participation and accessibility in the workers' compensation industry. Paul Carroll shares how artificial intelligence is transforming workers' compensation insurance. Mark Blane, a California attorney, explores how bias can impact an independent/defense medical exam and how to mitigate this bias. Finally, Matt Fendon reviews potential upcoming changes to Arizona's workers' compensation system and OSHA laws.


Multiple Contributors

Experts Across Workers' Compensation

Robert Wisniewski - Attorney, Law Offices of Robert E. Wisniewski

Paul Carroll - Editor-in-Chief of Insurance Thought Leadership Magazine

Mark Blane - Owner of Law Offices of Mark Lane APC

Matt Fendon - Workers' Compensation Attorney

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