WorkSafeBC streamlines appeals process

When injured workers go to WorkSafeBC to collect or appeal their compensation, the type of assistance they get largely depends on how case workers interpret the laws and policies governing the compensation board. Steve Barnett wants, as much as possible, to remove any room for interpretation.

The vice-president and assistant chief financial officer at the Vancouver-based organization is hoping a social enterprise management program can help guide workers through cases so clients get a more uniform treatment.

WorkSafeBC recently implemented Cúram Software’s Social Enterprise Management (SEM) system for its Appeals Integration Project (AIP) and is currently deploying the system for its claims process.

“It helps our staff navigate claims,” says Barnett.

“It allows us to really transform the way our staff works with our clients.”

Although the new application in some cases means more work for case workers, this is as a result of work that wasn’t being done, Barnett says.

“For the review officers, it was definitely a little additional work. And for the clerical staff, it’s beneficial in terms of productivity.”

Employees are generally positive about the new way of processing claims, he says.

“We’re meeting our goals in terms of consistency.”

The process is now more streamlined and evenly applied, he says.

WorkSafe replaced a passive system that accepted data fed into it with an active system that asks questions of staff and guides them through an appeal. The new system is also more integrated and replaces a number of custom-built outmoded applications with one integrated off-the-shelf application.

The organization also decided to implement Cúram’s application to address changes required to its appeals process as a result of the 2003 Workers’ Compensation Amendment Act (Bill 63). That act created two appeals levels.

“We have a mandate of responding to a request for an appeal within 150 days and we’re tracking that now. The registration staff are getting the right information in the start of an appeal and less information is lost in the system.”

It’s difficult to gauge how the new system is affecting clients, he says, but there seems to be “less noise” these days.

Quicker response
It’s hard to say if the reduction in complaints is a result of the new Act or the changes created as a result of AIP, he says.

“We have had people say that they’re experiencing quicker response to their appeals,” he says. “There seems to be less concern about information not being taken into consideration.”

The software is fairly straightforward to implement, Barnett says.

“The product itself is a framework product. It allows a lot of configuration to it so we can set up our own rules.” WorkSafeBC added a few extensions to the system, but stayed away from anything major to prevent creating any complications in the upgrade path.

WorkSafe hopes to glean similar benefits for its claims system by moving it to Cúram, Barnett says. It recently finished the requirements phase for that application.

While the appeals application has around 200 users, the claims management process will support closer to 2,200 users.

The aim of the claims management process is to help workers get back to work as soon as possible, says Kimberley Williams, vice-president of global marketing for Cúram Software in Herndon, Va.

This means WorkSafe wants to offer more than financial benefits, which is where social enterprise management comes in, Williams says. While traditional enterprise management systems are designed around financial transactions, SEM solutions take a more holistic approach.

In order to get back to work, an injured worker might need physio therapy, counselling and retraining, and WorkSafeBC is building all of those offerings into its system.

Although WorkSafe looked at SAP and Accenture, it chose Cúram because it seemed more suited to the public sector environment, Barnett says.

“ERP focuses on the financials, but doesn’t focus on the program rules, and that’s what social enterprise management does,” Williams says.

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