Claim adjudication is a lot like putting together a jigsaw puzzle. It takes time and patience, and it’s always easier when someone works with you to get the job done.
In respect to disability claims, there are multiple resources that touch a claim, from physicians to vocational resources to the claims analyst. All depend on each other to build the full picture. To facilitate a strong working relationship among these players, it’s important to understand how each best supports each other.
Especially when assessing return-to-work opportunities, the vocational resource and claims analyst must work closely together to determine the complete picture. Recently we spoke to a vocational expert, Susan Gatti of Gatti Vocational Services, about what claim analysts can keep in mind as they collaborate with vocational resources. Read on for her recommendations.
What does a vocational resource typically need to best understand the complete picture of a claimant’s education, training, and skills for return-to-work opportunities?
It’s important for vocational resources to have detailed information about the claimant’s formal education, continuing education, on-the-job training, computer skills, and job duties. In order to get this information, a claims analyst or vocational resource needs to talk directly with the claimant rather than relying solely on standard transferrable skills form that asks the claimant to list their training, education, and experience.
For example, a claimant typically only includes prior job titles on these forms to explain their past work history. A job title alone does not provide sufficient information to understand the specific knowledge, skills, and abilities they acquired in their past employment. Claimants will also sometimes forget to include certifications, professional licenses, and training they received.
In addition, an understanding of a claimant’s computer skills is essential in evaluating a claimant’s potential for return-to-work opportunities in today’s labor market. Many employers are requiring basic computer skills of all employees (even employees who perform manual labor) because they expect employees to be able to complete annual enrollment forms and mandatory training using a computer.
Asking a claimant if they know how to use a computer is not sufficient to understand their computer proficiency. The following are examples of questions a vocational resource, or analyst, can ask to understand computer skills:
- Do you know how to use e-mail?
- Do you know how to attach a document to an e-mail, open a document, and save it to a directory?
- What specific programs do you know? IE: Microsoft Word/Microsoft Excel?
- Have you ever created a spreadsheet in Excel or have you only inputted data to an existing spreadsheet?
- Do you know how to filter and sort data on a spreadsheet?
- Have you ever worked on an employer-specific database? If so, how did you utilize the database?
- How many words per minute can you type?
- Do you “hunt and peck” or do you type without looking?
- Can you create a letter or document and change margins, cut/copy/paste, set up new folders?
What recommendations do you have for analysts when communicating with a claimant early on in the claim that could benefit the return-to-work process?
An often underutilized resource to explore return-to-work potential is a telephone call to the employer. An analyst or vocational resource can evaluate the potential for returning to work with the original employer by talking directly to the appropriate representative at the company, such as a human resource representative, supervising manager, or department director.
A vocational resource can assist the claims analyst in preparing for and navigating this conversation, or they can conduct the conversation on behalf of the analyst. To adequately prepare for the telephone call to the employer, a claims analyst should be equipped with:
- Specific restrictions and limitation;
- A solid understanding of the claimant’s transferrable skills; and
- An understanding of the functional demands and essential functions of the claimant’s original job.
The discussion can include exploring opportunities for return to the claimant’s original job or another open position within the organization for which the claimant might be qualified to perform. It is important to also discuss return-to-work options with or without reasonable accommodations.
Coordinating with a vocational resource is part of building the picture of a claimant’s future. Remembering these tips can help make the picture that much clearer.
Susan Gatti is a Certified Rehabilitation Counselor (CRC) with over 25 years of combined experience working as a Vocational Rehabilitation Consultant, Long Term Disability Appeals Analyst, and Litigation Coordinator in the Long Term Disability and Worker’s Compensation arena. For more information or to set up a consultation visit www.gattivocationalservices.com