In late November, there was another terrorist attack on U.S. soil. This time it took place on the Ohio State University Campus.
For some, the timing of another terrorist attack was a “double whammy” as it took place four days before the anniversary of the San Bernardino Massacre.
As the country marked the one-year anniversary of the San Bernardino Shootings, I found it alarming to read and watch multiple stories about some San Bernardino victims who are not only still struggling to recover mentally and physically from this tragic event, but who are also still stuck “in limbo” with medical bills that are not being paid.
According to one New York Times article, the county spokesperson acknowledged that treatment approval had been “balky and slow.” Additionally, both sides conceded part of the problem lies with the State Worker’s Compensation Law and guidelines for applying it. These guidelines only address common workplace injures such as slips and falls.
They do not cover injuries typically seen in a war zone, such as terrorist attacks on U.S. soil.
In the aftermath of the San Bernardino shootings, 14 people were killed and 22 seriously injured. As of the 1-year anniversary, several injured employees are still coping with recovery and some have not been able to return to work.
As I read the New York Times article a number of feelings were re-stimulated in me which included compassion for the victims, as well as anger about the way the insurance carriers in Colorado responded to my PTSD claim after I returned home from the San Bernardino Shootings.
Both worker’s compensation and the short term disability carriers stated they had never seen this type of claim (Acute PTSD) in the workplace before and needed to research how to process and/or approve or deny the claim. The worker’s compensation carrier later denied the claim stating there was no support for PTSD in the workplace. Additionally, they dismissed the fact that I had been sent from Denver, Colorado to building next door to the shooters to investigate two employee claims of harassment by my employer.
After working through my feelings, I recognized this is an opportunity for organizations and their carriers to do things differently in the future.
Because, the reality is, these types of claims are becoming more common in the workplace. As a proactive employer, consider these things:
- Can we implement advance guidelines to address what happens when this type of event occurs?
- What is the cost is to the organization if we lose valuable employees because medical claims are denied?
- How will our brand be impacted should this information become public knowledge? Keep in mind the old saying: For every good experience, we tell one or two people. For every bad one, we tell eleven people.
Finally, when it becomes time to re-negotiate your carrier’s contract, here are a couple of talking points to consider:
- How will they handle situations such as this? Do they, or will they, have staff trained to handle this type of claim?
- What happens when a condition isn’t specifically mentioned? Will they deny the claim?
- If your organization disagrees with how these types of claims are, or will be, handled, what is the organization’s recourse?
- What alternative will the employee have to appeal a claim?
- How will carriers handle questionable claims?
While I realize there are some regulations a carrier cannot negotiate, the organization should at least be aware of the process. Additionally, your guidelines can include how to respond to these types of questions from an employee should they arise.
Instead of taking a “wait and see” approach to the possibility of having to deal with such claims, why not be pro-active, have a system in place, and be seen as the “go to” organization for how to handle (correctly) this type of situation both internally and externally.