By Brian Allen, VP of Government Affairs
Paraphrasing the lyrics from “September”, a major hit by the iconic 70’s rock band, Earth Wind and Fire: will you remember the ravages of 2017 this September, now that we are chasing the clouds away?
With all due respect to one of my favorite rock bands, and apologies for the liberties taken with their lyrics, this truly has been a year of earth, wind and fire with record-setting hurricanes in the South, catastrophic wild fires in the West and a massive mudslide in Northern California. The dramatic news stories are short-lived as the media moves on to other issues, but the recovery efforts and the hardships experienced by individuals, families, businesses and communities will continue for months and most likely years.
The workers’ compensation system is not immune from the impacts of these disasters. As this year has taught us, there are several considerations when taking care of injured workers before, during and well after any disaster. Understanding these risks and challenges will aid those involved in the immediate aftermath and subsequently help them prepare for future disasters.
Injuries Sustained Prior to a Disaster
One of the first considerations in any disaster area is delivering necessary care and benefits to workers who were injured prior to the event. Many states have laws or regulations related to workers’ compensation that commence when a disaster is declared. These laws help facilitate the delivery of benefits to injured workers and waive some of the requirements for using specific providers or pharmacies.
For instance, in the face of Hurricanes Harvey and Irma, Texas, Florida, Georgia, South Carolina and North Carolina invoked provisions designed to expedite benefit payments and medical care to injured workers displaced by the hurricanes. Considerations, such as a temporary formulary to allow these patients to receive up to a 90-day supply of medication, were enacted to help those displaced in the disaster. The full list of updates in Texas can be viewed here, and the updates in the southern states can be viewed here.
It may be helpful to work directly with your PBM provider to ensure that you both can quickly adjust your business rules to not only comply with these mandates, but also help your injured workers when they are impacted by a disaster. Additionally, adjusters may want to consider reaching out prior to the event (if there is warning) to set up plans to support the worker. For instance, prescriptions could be sent ahead of time to where the worker will be staying during the relocation period.
Injuries Sustained by Emergency Responders
The increased risk of injury for those working in and around, or recovering from, a catastrophic event is another concern. During recovery and rebuilding efforts, first responders, utility workers, medical staff, rescue workers, clean-up crews, artisan contractors and others will be called upon to work long hours with little rest and significant stress. This is especially true for public safety, public works and temporary workers called in for the recovery effort.
Many of these emergency workers may be exposed to toxins, gases, smoke, bacteria or other microbes that would not typically be encountered in their daily routine. Because of this, they may not have the equipment to protect them fully from risk. Additionally, long and difficult hours in the pursuit of saving lives and property can lead to risk-taking and subsequent injury.
Each type of disaster creates its own specific concerns, which could include:
- Door-to-door searches in hurricane-damaged structures carries substantial risk to those engaged in rescue and recovery.
- Battling huge blazes in wild, mountainous regions can stretch the physical limits of even the hardiest of fire fighters and that exhaustion could lead to injury.
- Mudslides blocking major highways can create significant stress on equipment operators tasked with clearing the debris as quickly as possible so thoroughfares can be reopened.
With so many workers called to the front line to handle these disasters, insurers should take extra care to make sure their insured are getting the support they need.
Beyond the workers dealing directly with recovery from a disaster, employees across all industries may be returning to workplaces that have new hazards as a result of damage.
Employees returning to work at businesses in impacted areas may be faced with less than ideal working conditions as clean up and repair efforts take place. Both employers and employees should make sure work environments are safe and healthy for everyone before returning.
Additionally, employees facing individual challenges and financial drain due to personal losses may face emotional distraction and anxiety. Such distractions and stress often carry over to the workplace and could lead to a higher incidence of on-the-job injury. It is not hard to imagine a machine operator, distracted by concerns over rebuilding a home, inadvertently placing a hand in the wrong place. Alternatively, an office worker, experiencing too many sleepless nights worrying about where to resettle could miss a step in the stairwell.
With these scenarios in mind, employers should consider the emotional well-being of employees impacted by a catastrophic event and provide support and intervention where practical. It is also important to remember that the same extraordinary stressors that led to injury could also inhibit recovery from that injury.
What Providers Should Consider
For those providing support to injured workers, delivering services in impacted areas is often challenging. For example:
- In some cases, it may be difficult to locate displaced claimants. Social media can be a valuable tool to find these injured workers.
- In other cases, technological tools that are standard in normal circumstances may not be deliverable in disaster areas. For instance, injured workers who rely on public transportation may find it difficult to get to appointments or access necessary services.
- Job retraining, rehabilitation or other non-emergency services may have to be delayed for a time as resources are diverted to deal with the restoration of essential services.
- It is also likely that records have been lost and will need to be re-created. That process will take valuable time that might create a non-compliant situation based on state-imposed rules.
- Many workers’ compensation insurers also provide property and casualty insurance. Responding to the needs of policyholders in disaster areas will be a monumental effort that will test the resources, both human and financial, of even the largest or best insurers. That diversion of attention and resources could affect processes and service delivery in the workers’ compensation areas.
With all of these challenges created for employees, employers and insurers alike, Mitchell Pharmacy Solutions recognizes the need for increased attention in these areas. Mail-order options are readily available to help maintain access to pharmacy care for injured workers who are finding it difficult to access a pharmacy.
Additionally, we have adjusted our programming in states with disaster declarations to comply with the changes and exceptions for refills and days’ supply required or suggested by rule or law.
The unprecedented scope of the fires, hurricanes, floods and mudslides have affected millions of Americans. True to our spirit as a nation, these disasters have also united hundreds of millions of Americans in support of those impacted. As time passes and memories fade, let us not forget that it will take time to recover fully from this challenging year, especially in the workers’ compensation world.
Patience will be a necessary commodity as the recovery moves forward. When your patience wears thin, play a little “September” from Earth Wind and Fire. It is a mellow tune that speaks of hope and a brighter future. As the song says, the stars will steal the night away and in December (a reference to the future), we will remember the good things about who we are and why we do what we do.