Zombie Case Managers

My only MarkTzombie film experience was the original “Night of the Living Dead” when at university. I’ve read no zombie literature, seen no television zombies nor done a zombie walk yet it’s hard not to know a bit about these reanimated dead creatures.
Now consider another definition for zombie that may apply to a subset of disability case managers: “a person who is or appears to be lifeless, apathetic, or lacking in independent judgment; automaton.”

Sometimes this automaton is seen in the group STD claim arena when case managers rely too much on physician statements and duration guidelines. They are claim processors; not claim managers. While the economy of the STD process requires significant transactional claims management with minimal contact with stakeholders (claimant, physician, employer), identification of claimants with potential for early intervention to aid recovery and return to work to limit the number of transitions to LTD can improve outcomes and customer services to the disabled worker and the policyholder.

For group LTD, zombie like behavior walks into the mix after claim approval. For some LTD claim zombies, there’s little focus on appropriate care, stakeholder communication and return to work potential post approval. De-zombification does not occur until a few months before the change of definition (COD) from own to any occupation. Voodoo does not extinguish this behavior. Transformation comes from internal departmental protocols that require actions to address COD.

When my screen play for Zombie Case Managers is sold, you will see (spoiler alert) zombies of course but also de-zombification. The last scenes of the film will focus on a return to competent case management with the reconstituted human factor to demonstrate:

  • The usefulness of statistics, both internal and external, to target claims with recovery/RTW potential for enhanced disability management
  • How allowing independent thought by case managers to identify claimants with resolution potential will improve customer service and metrics
  • The value of a change in claim philosophy is to consider the claimant as a customer
  • That forward thinking within the claim department, a competency gained via training and coaching, will improve assessment, planning and case management
  • How spending a few dollars (judiciously) in medical and vocational rehabilitation services both for STD early intervention and return to work services during the own occupation period will realize improved outcomes
  • The need to communicate, communicate, communicate with customers (claimant and employer)
  • The importance of early COD assessment to jump start return to work efforts during the own occupation period
  • The imperative to react with resolute force to snuff out zombie case management whenever it occurs

Mark Taylor, MS, CCM is alive and well in Minneapolis post retirement from RGA Reinsurance Company. Taylor Plus, LLC is his vehicle to provide group disability claims management insight and acumen to insurers in the U.S., Canada and Australia.

Email Mark at markctaylor@protonmail.com


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