Independent of their injury or illness, workers’ compensation recipients may face a grim future. In fact, claimants sometimes exit Australia’s compensation systems worse off in a number of ways than they enter them.

Negative consequences experienced by ill or injured workers may be extremely disruptive to their lives and may have a detrimental effect on their family too. On behalf of WorkCover Tasmania, researchers at the School of Sociology and Social Work at the University of Tasmania spoke to compensation recipients who had suffered bankruptcy, loss of the family home, ostracism from or stigmatisation by co-workers and superiors, marriage breakdown, loss of friendships and even—in 21%, of the ‘high cost’ claimants spoken to—psychological injury relating to the process of claiming.

This grim picture is not, however, unrelieved by opportunity. Interestingly, the research reveals ‘satisfaction with the process’ to be a key determinant of how well workers weather the compensation system, regardless of which compensation pathway they follow. 

“Satisfaction with the claims process is one of the strongest factors that shapes compensation recipients long term financial, social and health outcomes. When the claims process is managed well, this leads to significantly better outcomes for workers’ compensation recipients,” the researchers said.

The study demonstrates that claimant satisfaction with the compensation system is a genuine return to work diamond waiting to be mined. Which leads to the question: how can claimant satisfaction be increased? How can we, as we move towards a nationally harmonised workers’ comp system, mine the diamond?

Interviews with Tasmanian WorkCover claimants identified four main determinants of satisfaction with compensation processes, listed here in order of significance:

1. Satisfaction with the payment, be it lump sum, weekly payments or expense reimbursement;
2. The level  of support offered by their employer;
3. The time taken to settle the claim; and
4. Claimant general health.

Below, we take a closer look at these four determinants, examining how each impacts claimant satisfaction. We also make some suggestions as to what policy makers, employers, medical practitioners, insurers and return to work and workers’ comp professionals can do to increase satisfaction with the compensation process, keeping workers healthy, happy and solvent.

Satisfaction with the payment

A person’s level of satisfaction with the payment they receive depends as much on their being given accurate, timely and comprehensive information about what they’re entitled to—and what they’re not—as it does on the amount of money they get.

According to the Tasmanian research, factors that negatively impact satisfaction with payment include:

• Forced lump sum settlements, particularly when the recipient is still physically or psychologically unwell;
• Being unaware that legal and medical expenses will be deducted from their lump sum payment;
• Being unaware that lump sum payments affect Centrelink entitlements;
• Step downs in weekly payments, which may result in financial hardship;
• Not being told about reimbursement entitlements; and
• Delayed or denied reimbursements.

In this context, insurers, employers and WorkSafe / WorkCover have the opportunity to improve claimant satisfaction by:

• Fostering a collaborative and inclusive rather than adversarial approach to claim settlement;
• Providing workers’ comp claimants with clear and comprehensive information about their payments—including entitlements, exclusions and step downs—as soon as they enter the system, for example in an information session like the one offered by WorkCover WA;
• Responding promptly to worker enquiries regarding payments; and
• Processing reimbursement claims quickly and consistently. To facilitate this, a policy of accepting reimbursement claims unresolved after a certain time period could be required of insurers.

Employer support

The research shows that perceived low levels of employer support generate dissatisfaction with the process, for example when workers feel that they are treated:

• Suspiciously;
• Uncaringly; or
• Indifferently.

Being forced into resignation or retirement also generates dissatisfaction.

However, high levels of employer support leave claimants feeling satisfied with the compensation process overall. Positive forms of support include:

• Being treated with care;
• Being treated with respect; and
• A sense of involvement and inclusion in the process.

Employers can ensure that such positive forms of support are on offer in their workplaces by:

• Training supervisors and other relevant staff in:
  • Best practice injury management; and
  • Active listening techniques;
• Encouraging ad hoc supportive actions, such as sending cards to injured workers or inviting them to have lunch with the team; and
• Seeking worker input into return to work and workers’ compensation matters. 

Time to settlement of claim

Understandably, claim settlements that drag on for years cause dissatisfaction with the system.  The survey highlights claimant dissatisfaction with delays caused by employer intransigence and legal postponements and adjournments.

Given the financial, social and health-related hardship dissatisfied claimants and their families may experience, there is a strong ethical case for flexibility, good faith and administrative efficiency regarding claim settlements. Policy makers, insurers and employers should all consider how best to reduce delays around the settling of contentious and drawn-out claims.

Claimant general health

The survey showed that when their general health was poor claimants were likely to experience dissatisfaction with the claims process, particularly in relation to medical and rehabilitation service providers.

Dissatisfaction arose when claimants perceived that:

• They were treated rudely, contemptuously or arrogantly;
• They were subjected to an unsuitable rehabilitation plan;
• Medical personnel were motivated by their relationship with the insurer; and
• Medical personnel did not understand the workplace or job demands.

Methods for increasing claimant satisfaction might include:

• More workplace health and wellbeing programs, which improve the general health of participants;
• After initial treatment for injury or illness, the RTW Coordinator or case manager asking the worker:
  • Do you have a good understanding of your condition and the treatment options?
  • Are you happy with your treating practitioner?
  • Are you confident that the treating practitioner understands the workplace and your job tasks?

If the worker responds negatively, efforts could be made to provide both the worker and the treating practitioner with the relevant information, or the worker could be assisted / encouraged to find a more suitable treater;

• Rehab plans developed via collaboration between the worker, treating practitioner and employer; and
• Efforts made to familiarise medical personnel with workplace and relevant tasks, for example via paid site visits.

The study also noted the dissatisfaction with workers’ compensation processes often experienced by those in very ill health.

The researchers said that, “Those in very poor health, either as a consequence of their work-related injuries or for other reasons, tended to report that the workers’ compensation claims process did not work well for them. This seemed to be a product of the difficulties of dealing with serious and often intractable injuries within a system designed for rehabilitation.”

Given the right support, a safe and speedy return to work is possible for many injured or ill workers. As Workers’ Comp Harmonisation approaches, one of our many challenges is to make the system flexible and responsive enough to promote satisfaction not only amongst these workers, but also amongst those who recover more slowly, and those who may never return to work.

The final report of the "WorkCover Tasmania Long Term Benefits Study", prepared by Associate Prof Douglas Ezzy, Dr Maggie Walter and Dr Allen Welch, is available here.