Striking the Right Balance in Workers Compensation Claim Management

By Constitution State Services

2 minutes

Insights on Managing Claims and Controlling Loss Costs

Man and woman sitting at a table talking over paperwork

The COVID-19 pandemic accelerated the wider use and acceptance of technology in the management of injured employees’ workers compensation claims by third-party administrators (TPAs). Even so, in an increasingly digital world and with the growing popularity of digital self-service, injured employees and their employers still value personal connection at important points in their workers compensation claim experience.

Similar to other digital interactions in their daily life experiences, injured employees expect prompt attention to their needs, and easy and intuitive access to their claim information. Constitution State Services (CSS) embraces this new reality through CustomCare^SM, a claim management process designed to create an optimal balance between digital self-service and personal human connections throughout an injured employee’s workers compensation claim experience.

Built-in feedback mechanisms are designed to help provide opportunities where CSS Claim professionals can quickly intervene to keep recovery moving in a positive direction. With CustomCare, employers and their injured employees benefit from the right mix of self-service and personal approaches that enable better workers compensation claim outcomes.

How CustomCare works

Knowing some injured employees are comfortable using self-service tools while others prefer human connections, CSS Claim professionals relate situationally while leveraging employee-centered technologies.

Employees experience a variety of challenges when faced with work-related injuries. Many individuals bounce back after an injury and take a straight path to recovery. Others with similar injuries may struggle against barriers that may lengthen their recoveries.

Consider two individuals with a similar injury. One may take only 8 weeks while another takes 16 weeks before a full recovery and return to work. Variations in recovery time are common, but why does this happen? Complex biological, psychological and social elements often play a role in how fast an employee recovers from a workplace injury. These elements can compound and slow down an employee’s path to recovery after a physical injury.

By encouraging the injured employee to share their thoughts and feelings around their recovery at critical points along the claim journey, CSS Claim and medical professionals can identify opportunities to engage and aid in removing barriers to recovery. CSS regularly surveys injured employees about their well-being, helping employ a more holistic approach to treatment. CSS Claim and medical professionals can often bridge any recovery gaps by moving smoothly between self-service and personal interactions.