Details of the successful workers’ comp program include a predictive modeling tool, an embedded claims advocate and an enhanced return-to-work program.
When an employee of Lumen Technologies, Inc. finds themselves to be injured on the job, they need not worry.
Lumen’s workers’ compensation program provides several capabilities to ensure that an injured worker is heard and cared for, with an eventual return to work.
Lumen, which primarily provides “businesses and consumers with their communication and data needs across the United States,” according to their application, finds workers’ comp risk for those employees who service businesses and residential customers. Injuries can range from shoulder to back to lower extremities.
Fortunately for the injured worker, Lumen is ready to foster a favorable outcome in the most unfavorable of circumstances.
It’s this exceptional program that earned the Lumen a 2021 Teddy Awards Program of Distinction award.
A Stellar Predictive Modeling Tool
While many organizations use and reap the benefits of predictive modeling systems, Lumen’s modeling is unique in that it was built entirely on its internal data from within its longtime partnership with Sedgwick.
This data included metrics from large loss, return-to-work, medical spend and probable litigation.
The predictive modeling system would be used for the life of claim and would be triggered if any parameters of the claim were changed.
“That’s perhaps a unique way that we use the predictive model,” said Tara Acton, CPCU, AIC, ACI, director of claims & counsel at Lumen Technologies, Inc. “We have the technology, but it’s the marriage of technology with experience and exceptional claims handling skills.”
Acton discussed another component of the predictive modeling that makes it exceptional: a national performance Sedgwick manager who closely monitors and reviews the results from the modeling tool.
One of the manager’s objectives is to assign claims to members of the claims team, with the predictive modeling tool providing the claims team member with much more detailed insight on the specific claim.
“[The manager] is able to give the examiner some direction on what to be looking out for, right at the outset,” Acton said. “[It serves as] a great background as [the examiner] jumps into the claim the best way.”
Since using the tool, Lumen has seen “the median paid on closed files triggered by the model down 54% compared to the baseline year,” per the team’s application.
The use of the predictive modeling has even enabled Lumen and to anticipate and respond to hiccups before they even occur. Dennis Kelley-Jones, assistant vice president of client services, Sedgwick, believes that this capability is what sets this predictive modeling tool apart from others.
Kelley-Jones said that because the Sedgwick claims manager works so closely with the claims within the modeling tool, they have “gotten good at predicting the predictor.”
He continued, “[The manager] can see a new claim and say, ‘I think this is going to hit the litigation model,’ and start giving instructions to curtail that [trigger] before it ever hits the predictive modeling.”
Simply put, as Kelley-Jones said, “We’re getting ahead of the predictive modeling.”
Incorporating an Embedded Claims Advocate
Experiencing the abrupt transition from functioning employee to injured worker can be a challenge on its own. Add in a filed claim and the attempt of settlement, and the stress can feel insurmountable for the injured worker.
Lumen and recognized injured workers could feel “confused, lost, and aggravated,” words which Acton used, when undergoing a claim filing. The program implemented the addition of an embedded claims advocate.
Since incorporating the advocate into the claims program, there has been an obvious benefit observed. According to its 2021 Teddy Award application, Lumen recorded a significant decrease in its litigation rate once it had introduced the advocate into its claims program, going from 5.6% to 2.6% in 2020.
Additionally, “the average number of claim stays open decreased from 92 to 80,” per the application.
While the data clearly speaks to the overall success of the claims advocate, Acton praised this addition to Lumen’s program.
“We’ve consistently had employees tell our advocate that she has answered all their questions [and] there is no need for them to [speak with a] lawyer,” she said. “She answers questions [from] how they’re going to get paid, where they’re going to get their pay stub, how direct deposits work, [and so on].”
The advocate also serves an instrumental role in ensuring that productive communication is taking place between the injured worker and Sedgwick. The addition has allowed for claims to continue to move, and ultimately close.
In an industry that is embracing the advocacy approach, Lumen’s implementation of an internal claims advocate is right on the money.
Addressing Transition-to-Work Concerns
In addition to enhancing its workers’ comp program with both a predictive modeling tool and claims advocate, Lumen also addressed a component of its program that needed more guidance.
Because Lumen did not have a formal return-to-work program, its casualty team enlisted the help of a senior risk analyst, whose primary objective was to “address the difficult nature of transitional duty in a decentralized, sometimes rural, and often physically demanding work environment,” per the application.
Prior to the addition of the senior risk analyst, adjusters had been primarily responsible to discuss return-to-work options with an injured worker’s supervisor. As the analyst was introduced into the program, both the claim and return-to-work processes have seen a greater amount of success in terms of discussions, approval of light-duty jobs, and overall returns-to-work.
Since the closing of the 2021 Teddy Award application, Lumen has also partnered with North American operations to aid in the improvement of its return-to-work program.
“[The team] within North American operations came up with [around] 20 different light duty jobs,” Acton said. “So now, our risk analyst has much more concrete suggestions to make [for approved jobs].”
Kelley-Jones emphasized why fostering a productive and well thought out return-to-work program is so crucial.
“I think we all know that return-to-work is a top-down process, and employers that really put [effort] behind [their] return-to-work [program] see the benefits.”
He continued, “The adjuster can do the best they can to work with locations to try to get people back to work, but it takes a top-down push. Having this internal resource be able to navigate and help [workers return to their jobs] is fantastic. It’s a big step forward for the program.”
Since introducing this risk analyst approach into its return-to-work program, Lumen’s first-year data shows a promising future.
In late 2020, only 10.8% of employees were unable to be accommodated, compared to 19.5% in early 2020.
A Partnership from Day One
It’s evident that Lumen Technologies, Inc. and Sedgwick have formed, and maintained, a productive program. What makes this relationship so successful?
“I truly think it’s been a partnership from day one, since 1998,” Acton said, referring to the year that Lumen and Sedgwick agreed to partner.
Kelley-Jones agreed: “I think it’s twofold; it’s the partnership and it’s what you do with it.”
He continued, “One of the best [components] has been open lines of communication, whether something’s going right or going wrong, whether there’s opportunity to improve, etc.”
The program also thrives because of Lumen’s and Sedgwick’s alignment on their missions, which are focused on caring for the injured worker.
“[We are] trying to constantly improve, not just from a results perspective, but also from an employee experience perspective,” Kelley-Jones said.
This vision, coupled with the program’s constant desire to push the envelope and improve its offerings, is what makes this collaboration of Lumen and Sedgwick successful, thoughtful and a constant revitalization of an important message for the industry: Do right by the injured worker. &