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Medical Review Board Mediates Workers' Compensation Disputes

February 1, 1993
Related Topics: Financial Impact, Workers' Compensation, Featured Article, Compensation
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To focus further on the process of determining which cases truly are valid workers' compensation claims and which aren't, Steelcase set up a Medical Review Board that meets weekly to discuss workers' compensation claims. Only those cases are discussed that the company's physicians think don't meet the workers' compensation criteria or that employees have asked to have reviewed.

The board comprises individuals representing various departments, such as employee relations, medical, safety and workers' compensation. Employees are welcome to attend the meetings during the discussion of their cases. Fifty percent of the employees whose cases are up for discussion choose to have their employee-relations representative present at the hearing. The employee-relations representatives are individuals who work in the human resources department, rather than in the workers' compensation, benefits and health department, which is one arm of the HR department. "So the employee-relations representatives are unbiased as far as coming to the table with the employees' best interests at heart," says Child. "They don't know how much that injury might cost if we pick it up under workers' compensation. They truly represent the employee."

The other half of the employees who ask for their workers' compensation claim to be heard by the medical review board, argue their own cases. "They have their notes in front of them, and some of them have studied up on medical terminology. They often know as much about their condition as anyone else in the room does," says Libby Child, manager of workers' compensation and medical services.

Before the meeting, someone from the safety department goes to look at the job site and talks with the supervisor about the position and its duties. "When we get together with the supervisor, we try to look at the medical information that's being presented," says Child.

"It's very informal," Child adds. "Everyone around the table asks questions. If there are some pieces missing, we'll postpone making a decision for another week."

Child says that the board tries to look at the case from the employee's perspective. If there's doubt about whether an injury happened on the job, but the probability that it did is good, Steelcase most often will cover the claim under workers' compensation.

"For years, our employees have reported injuries and, depending on the nature of the injury, there may be some bit of subjectivity as to whether it was workers' compensation or not. If there were fairly valid reasons to think that it was, and the person had performed a difficult job, we gave them the benefit of the doubt," says Child. "This approach helps build trust and helps keep many cases out of litigation. It's far less expensive to do it that way."

She adds that the company's entire approach to its workers' compensation claims management, with its emphasis on building partnerships with employees, has helped create an atmosphere of trust. "Over a period of time, we have developed an understanding with our management and employees that people can and do get hurt at work," explains Child. "Today it happened to Harry. Tomorrow it might be Thelma, and as much as we try to prevent injuries, it could happen to you a month from now. As long as we think that the person is working toward getting better and becoming a meaningful, productive employee again, we believe that we should be supportive and encouraging."

Personnel Journal, February 1993, Vol. 72, No. 2, p. 75.

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