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EAPs to the Rescue with Workers' Compensation Fraud?

One of my favorite subjects is business insurance. I like to watch news, press releases, and blogs reporting on the many aspects of this field. As I have often opined, business insurance is a stake holder of effective, core technology employee assistance programs. The only problem is, they don't know it. That's the fault of EAPs as a group.

Insurance protects businesses and producers sell insurance. Your bridge to meet these employers and establish yourself is one of following three professionals who know a business owner best: the lawyer, the accountant, or the insurance agent. Insurance agents are your best bet because of synergies associated with the their needs, business needs, and the purpose of EAPs are nicely melded. They must all be concerned about human behavior in the workplace that leads to risk and financial loss.

Who pays for the legal bills of employees sued for sexual harassment? Who pays for the workers' compensation costs associated with sexual harassment (yes, harassed workers have often collected money for sexual harassment) and who will lose money if lawsuits come for sexual harassment? The answer is business insurers. Of course, employers pay too, if insured, through high deductibles.

There are many types of business insurance and there are many behavioral risk exposures that business insurance is designed to address. EAPs interface with many of them.

So the logic is there to team up with this group. Get started. Start in Colorado, or at least follow this legislation to see where it goes an how much influence it carries. Here's the news.

One of the insurance writers I follow is Gary Boop. He writes for "About.com". Gary reported today on a piece of legislation working its way through the Statehouse in the Colorado. The politicians there are focused on prohibiting workers compensation insurers from spying on or doing clandestine surveillance of employees injured on workers' compensation. This technique of finding employees who are stealing money from employers by faking injuries and collecting fat paychecks has been used for decades to reduce workers' compensation costs. Do you know the ramification of such legislation? They are potentially great and it means news skills and capabilities are going to be important to reducing costs. That's where you come in.

Consider this New Colorado bill H.B. 1012

What does this have to do with EAPs? I hope you see the connection, but let me spell it out clearly for you. Limitation of an employer's ability to investigate fraud means there must be some other way to find it, but even better, a renewed interest in preventing it will obviously be on the horizon.

Instead of ignoring injured employees and then seeking to discover criminal malingering to collect benefits, heading these problems off at the pass will get more scrutiny.

I predict that someday a business service will emerge that will be funded by workers' compensation insurers, and that it will play the following role. It will operate confidentially and

• Meet with employees to assess the emotional impact of their injuries,
• Do a family assessment to determine likely areas of distress and conflict at risk for protracting an injury,
• Conduct an occupational alcoholism assessment,
• Help an employee remain motivated and anticipating a return to work,
• Resolve conflicts between an injured employee and the boss or coworkers back at the worksite,
• Offer support for the injured employee during the period of time they are off work,
• Offer guidance, tips, and support upon return to duty so employees experience reduced anxiety and conflict associated with return to light duty or full duty assignments.

I believe these activities would make a hell of a business opportunity to help reduce costs for workers' compensation managed care and employers. Specialists who would do such work would need the skills of employee assistance professionals. So, why can't EAPs get more involved now before such a service robs the field of an opportunity?

EAPs typically don't do these things now, but they could add these services to their continuum of activities and get enormous credit for doing so.

If you have entertained the idea of looking more at the EAP/Workers' Compensation interface, and you happen to service employees in Colorado, run don't walk, to develop your capabilities of servicing these employees with the goal of monitoring their care so they are less likely to fall prey to the temptation of malingering.

Of course, sometimes injuries are very real, except bogus injuries or injuries that were very real at the time become easy to lie about once their pain and debilitating symptoms disappear.

Any thoughts about this? See the drift?

Is Your Quarterly EAP Newsletter Placing Your Program in Danger of Being Cut?

What a weird question? Well, it's one of the many elephants in the EAP living room, so let's discuss it.

Can an EAP newsletter that you distribute too infrequently make your program less visible and more likely to be cut? After communicating with hundreds of EAPs and watching what happens internally with EAPs that I have managed, I have slowly gravitated to an answer on this question. It’s “yes”.

It’s convenient not dealing with the distribution of a newsletter more often, but still appearing as though you are “doing something” to promote your EAP. Is this your mindset?

This vintage approach to communicating wellness information in a technological era has become almost an apologetic frequency as your newsletter sheepishly slips into employee in-boxes every three months.

I would like to make the argument that this is too infrequent and makes a statement about the importance of this material and your program, in particular.

Do you disagree? Consider why you do this. Is it because there is a history of EAPs always doing it this way because that is all that was initially available from vendor sources? So, by default, did it become the standard for EAPs, and you copied others? I think this is precisely what happened.

Since I joined ALMACA (EAPA’s early name) in 1978 – 32 years ago I have witnessed the evolution of this service. And, I have watched it grow more important.

With all the stress that employees face, and with the degree of importance that you place on your EAP as a life-saving and cost-saving mechanism, isn’t it a bit ironic that you only distribute a quarterly newsletter to employees when you could do it bimonthly or monthly for less, and with less hassle?

You may have a quick comeback — employees have too much to read! Don’t fool yourself. This is your codependency talking. You're giving in to a HR manager’s phone call telling you to slow it down about other material you may have sent. Or it's simply your imagination, because you haven't received such a phone call at all. You're just making this statement to avoid the work and it sounds damn good. I have caught many EAPs in this argument. It's not reality. This, too-much-to-read line is bogus.

If you are hearing this line, it is all about muscling you around and telling the EAP how to do its job. Why is that the most important thing employees read regarding their well-being and perhaps the one thing that they really look forward to most receiving, is the one thing that should be cut back?

What you’re hearing from HR, if indeed at all, is one HR manager’s opinion, or at best a manager’s opinion relayed via HR.

You need to understand something: HR managers don’t argue with top managers. They are their primary customers. Instead HR managers ask how high to jump. Corporations are on a big outsource-the-HR-departmet kick these days, and HR managers -- like EAPs are a threatened species.

I assure you that you are not getting the results of a survey that is supported by employee opinions.

Here’s the problem. Employee newsletters have historically been four pages. The problem begins and ends there.

Quarterly newsletters are always print or sub-links to the vendors own web site destroying your seamless look. They are expensive, with 500-600 word articles, and they are a vintage solution manufactured for EAPs in the early 1980’s when anything more frequent would be over-kill. Employees had more leisure time then to read these "books".

But the problem today is that they sacrifice your EAP or program visibility. You become less competitive with other things in the organization. You don’t want that. It will jeopardize your program.

You are sacrificing visibility and communicating the message that quarterly life-saving health and wellness information is quite enough. Trust me, you do not want to send this message.

An EAP newsletter is a resource, and visibility mechanism, and item of extreme interest to employees. And it is a way to compete against other things in the environment that are targeting the employee’s attention. You must not give in to the “stop distributing this material because our employees don’t have time to read it” mantra.

Instead, stop sending 4-page newsletters. Send two-page newsletters bimonthly or monthly.

Employees do not generally finish or complete four-page newsletters in my experience and in my view. This is another reason that you are locked into a 4-page solution distributed quarterly. It’s nuts to send it more often! And its expensive. So, change the model to the 2010 solution. Get out of the 1980's.

In this era, go for less content, shorter more action-oriented tight copy, and more frequency with the ability to edit the content yourself on the fly. This way your EAP will stay visible, be perceived as being more valuable and relevant, and be more effectively mainstreamed. Anything less and you’re in danger of being seen as expendable during next budget cycle.

Distribute EAP-wellness-productivity newsletters via PDF. Post them on your web site and send a link to employees when they are added to the site.

Distribute print to employees without computers, or send copies to appropriate locations. Your utilization will increase, your visibility will be enhanced, you will spend less, and employees will read more, more frequently. Your EAP will be talked about more often, and this is what you want.

A two-page monthly newsletter is 50% more content than a quarterly four-page newsletter! (Read that again.) And, the two-pager is more likely to be completely read. Are you with me?

You’ll will also reduce waste, motivate more self-referrals, and reduce more risk to the organization with a two—pager, monthly newsletter. Oh, and it will cost less than print. Everything I am writing here is pure logic and it holds up in real life.

Still need paper, make copies from your clean PDF supplied by the vendor. Can’t get permission from the vendor? Dump the newsletter vendor!

FrontLine Employee and WorkLife Excel are your modern day solutions to effective employee and EAP newsletters.

You can get brochures here:

FRONTLINE EMPLOYEE EAP WORKPLACE NEWSLETTER
WORK-LIFE-EXCEL WORKPLACE NEWSLETTER

"We have an expert on that subject!"

Throughout the year the major media will visit health related subjects that have broad appeal to the public. They will also report on major calamities and news stories like the recent massacre at Fort Hood.

The media needs mental health experts when these events occur. Who do they call? The answer is whoever comes to mind. That could be you if you know what to do, and first step you should take is to believe that they want you instead of the same old warm body that calls them every time.

There is one national managed care organization that hogs the spotlight on these events. They have a well funded pubic relations arm and they consitently show up in the media, the New York Times, ann Washington Post. There is another large corporate EAP that does the same thing. I am amazed at their prowess, but they deserve the attention if no one else is seeking.

Hey, were talking about capitalizing on tragedy here. The Fort Hood massacre was beyond belief horrible, but the media will pursue experts to help the public cope with these events, and it might as well be you. This is especially important because the some organizations have completely misguided ideas about employees assistance programs and they don't have any resistance to sharing the view to match their economic pursuits, regardless of its grander impact on the profession.

You will notice that specific topics appear in the news periodically, but predictably. For example, you can predict that approximately once a year the topic of alcoholism will emerge. It might be a news event on the cause, a new drug to fight cravings, or some other related topic. Many other topics related social problems will emerge in the mass media.

Pay attention. You will see that this is the case. Your local television station is not the "major media" in our definition. We are referring to AP news wires, and other major media outlets that sell news to the major networks, principally ABC, CBS, and NBC. However, pay attention to enormously important local news, specifically news events that relate to a subject about which you are an expert.

Now, here is what you should do: Listen attentively to the news. When you hear news that relates to your field of expertise, immediately fax to the local television stations your biography (a half page) and call the news room to say that you are an expert on that subject, and that you are faxing a bio. This is a great way to get publicity and to get on TV or the radio. And, it will make you instantly visible to your potential clients and EAP customers. (It's also a rush.)

Television and news stations scramble to find experts on subjects when the news hits. You are doing them a big favor.

If it is national news, you will have a few hours to respond because it will take longer for local stations to run "local expert" interviews. And it could be day later. If it is local news, your window of opportunity is much shorter, about an hour. Obviously you need to prepare ahead of time by getting phone and fax numbers, and contacts lined up. Then, wait for the "big one"--well hopefully not THE big one, but you get the idea.

The scramble for an expert kicks into gear quickly. That's you. Be there.

Workers' Comp: Getting the EAP Involved

Most organizations of any appreciable size pay workers' compensation premiums, and for the biggest companies, they are self-insured. Companies want to keep their premiums as low and self-insureds try to reduce their costs, as well.

A CT-EAP (CT=Core Technology) can play a major cost-beneficial role in helping achieve these goals, but it takes education of human resource managers and those who control referrals after injury to pull the EAP into the picture.

This is a utilization improvement link EAPs.

Research supports the argument that empathic contact and support for injured employees received from the organization, plays a role in helping employees return to work more quickly. This saves money, and therefore a rationale exists to include the EAP in the continuum of care after injuries occur. Beyond coordinating the nuts and bolts of medical service and follow-up, figure out how to get your EAP into the care huddle and you will increase your EAP's utilization and influence by offering employees support for issues that nearly always associate themselves with injury and recovery.

Workers' comp claims are higher for addicts—five times that of non-addicted workers-is the commonly cited figure. NIAAA includes this in much of its literature, so there isn’t much argument about its validity. But this only a small piece of the EAP rationale. There is much more that EAPs can do vis-a-vis Workers' Comp.

While there has been solid promotion of EAPs using this alcoholic employee angle as a rationale to promote them, EAPs can also help injured workers no matter what the cause—alcohol, drugs, stress, absent mindedness, back luck, or mental distraction of any kind. After the injury occurs, employees often need support they aren't getting, and the EAP can fill the void.

Unfortunately NIAAA, and many other stakeholder organizations have not promoted EAPs in this way. If they had done so over the past 25 years, EAPs would be in a completely different place in their evolution. They would be household terms, and your mother would still not be calling an EAP an EPA.

Hundreds of property casualty insurers would be acquiring EAPs by now I think if this linkage were more well established. The direct role of EAPs in the workers comp cost-containment fight would have been identified and popularized.

Post-injury, some of the needs employee have to arrange are home health aides, companionship services, shopping assistance, transportation, and an empathic listening ear. Many injured workers need financial counseling and problem-solving for family problems and communication issues. EAPs are particularly adept at arranging the coordination of services or offer emotional support, and it is here they have no occupational match by another profession in the workplace. Few HR managers understand how to quickly obtain the resources above, and even fewer are want to get involved with these issues.

Workers' comp managed care firms can partner with EAPs for the intervention opportunities that exist with worker injuries. But they are not like to take the first step.

Work toward having your HR representatives or managed care companies that process workers' comp claims include EAP literature, the things EAPs can do, and other types of very direct communication with injured workers. Encourage the referral of the injured worker to the EAP for an assessment after the medical crisis and acute care period ends.

You will add points to your utilization rate by way of these referrals and improve your value as a service to employees and the organization's bottom line.