Monday, July 16, 2012

Do the words we use to describe WC claims matter?

Workers’ compensation is an extremely complex form of social insurance. Those who specialize in workers’ compensation tend to adopt jargon as a kind of shorthand to express concepts to those in the know. I’m sure you have heard (maybe even said), “I have this back claim…” when what is really meant is, “I am assisting a person with a work-related injury to the back…”. Unfortunately, this use of jargon can have unintended and negative consequences.

Recently, I have read blog posts and heard speakers at conferences referring to “old dog” claims. I have heard many explanations for the source of this idiom. One commentator said the term arose from the dog-eared corners of the large paper files that are the inevitable consequence of serious injuries and long-term claims management. Another suggested the term related to those serious and long-term claims that “hound” adjudicators and frustrate administrators due to their lack of resolution. Regardless its origin, those unfamiliar with the term may interpret “old dog” claims as somehow disparaging the people who made them. Worse yet, the internal use of a term with such a negative connotation may influence the way we think about or act on some claims.
A related term, “long-tail” claims can create barriers between workers’ compensation insurers and those the system intends to help. The “long tail” in workers’ compensation refers to the statistical property of the distribution of claims, particularly as it relates to duration. The vast majority of claims are very short duration but a few go on much longer and a very few go on with some benefits that may last a lifetime. It is impossible to know just how long a particular claim for a particular injury might require active claims management, adjudication of medical costs, and payment of benefits. Insurers use actuarial estimates based on experience to quantify the costs. Claims at the far end of the claim duration distribution—the “long tail” of a graphical depiction—will generally have the greatest costs.

Most of us are not actuaries or statisticians. Those of us who endured rather than enjoyed the statistics courses in our academic careers can probably still recognize the statistical aspect of the “long tail” and recall vaguely the problems of asymtopical distributions, skewing, and corrections for right-hand truncation. For those without statistical knowledge, the term “long tail” has a somewhat negative connotation, an implied variance from some level of “normal” or “typical”. To those individuals, the use of the term may create a barrier or put them on the defensive with the insurer, adjudicator, case manager or other workers’ compensation personnel. It is not hard to imagine people worrying that adjudicators in WC would be actively working to terminate claims in the interests of shortening that long tail—not a recipe for a trusting relationship.
A 2010 survey had good news and bad news for insurers regarding trust. The headline read “Trust in Canadian insurance industry jumps 17%”. The article revealed this significant increase was on a base of only 38%. At 51% of opinion leaders trusting insurers, this improved standing is still well down the in the ranking behind other sectors like health care and technology. Given this significant lack of trust in insurers, it is time we stopped using terms that have such negative connotations even in internal discussions.
I believe workers’ compensation professionals in state funds, private carriers, TPAs and related agencies are sincerely working in the best interests of those WC was created to serve. Abandoning jargon and shorthand terms like “old dog” and “long tail” claims may seem like a small thing but words matter. Words create perceptions and perceptions create reality.

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