Thursday, February 19, 2015

Condottiero & Associates, Vocational Case Management (small business report)

There is no company named Condottiero & Associates.  The small business owner I interviewed requested privacy due to the sensitive nature of his work.

Mr Condottiero started Condottiero & Associates when he was fifty-one years old.  He had risen to the ranks in middle management in a firm that assisted insurance companies in "placing" people on Workman's Compensation into jobs.  He was, after 8 years, ready for a change of scenery.  He became an independent "Vocational Case Manager" (VCM).  That was in 1997.  At that time there was much VCM work in Michigan but the competition was fierce because there were more than 125 Vocational Rehabilitation companies in Michigan.

He borrowed money from a family member.  The first six months were tough due to the lag time in the reimbursement process.  Six months after that he was matching his monthly "net" as a wage earner.  He never looked back.

At that time, Vocational Case Managers were independent investigators who were paid by the insurance companies because the laws in the State of Michigan made the employer (or, by proxy, their insurance company) responsible for the rehabilitation of that worker.   The Worker's Compensation laws are very specific to the state where the triggering incident occurred.  Consequently, Mr Condottiero only worked on cases that originated in Michigan.

A case study


---Details changed to protect identities---
A carpenter in northern Michigan in his early thirties fell off the roof off of a two story building.  He was badly injured.  His bones healed.  He went to physical rehab.  His physical capabilities came back slowly, particularly his flexibility.  He continued to experience back pain that prevented him from returning to his previous employment.

Mr Condottiero scheduled an appointment for an initial interview.  That interview took place in the client's home, 115 miles from Eaton Rapids.

His client was a traditional guy.  He was ashamed that his kids came home from school and he was still on the couch just like when they left in the morning.  In fact, the client's eyes teared up.  He wanted to work.  He wanted his kids to grow up with a work ethic.  The carpenter was depressed.  He was simply incapable of looking for a job.  He was not physically capable of being a carpenter.  He could not see himself doing anything else.

Mr Condottiero contacted several businesses in the area inquiring about jobs that might be within his client's capabilities.  He did not tell them that he was attempting to place a Workman's Comp case.  One of the large, non-profit organizations agreed to find a place for him in their resale outlet store.

Mr Condottiero's client initially resented the job because he considered it demeaning.  He started as a greeter, however, quickly became bored and started doing more of the sorting, material handling and working with customers.

The store management noticed his change of attitude and were impressed by his enthusiasm.  He was offered full time employment.

The carpenter ended up as the roving maintenance guy for the non-profit.  He was responsible for several large stores in the area.  It was a major win for the carpenter since most of the work was "inside work", which is a major bonus in northern Michigan during the winter time.

Not all of Mr Condottiero's stories have such happy endings.  But enough of the stories do have happily-ever-after endings to make his work very satisfying. 

Some details about the work


The insurance company typically mailed Mr Condottiero a file with the disabled worker's history and "restrictions".

One gratifying aspect of making accommodations to put a Workman's Comp case back to work is that the accommodations generally made the job easier for everybody and reduced the likelihood of further repetitive motion injuries.

The most desirable solution was to have the disabled worker return to work with his/her original employer.  Many of these shops were small and did not have much expertise in making "accommodations".

Most Vocational Case Managers will assist in re-engineering work spaces to accommodate people with restrictions.  Mr Condottiero enjoyed more freedom working with employers as an independent agent than he did as an employee.  He is more than willing to offer his expertise in modifying the job if the employer is willing to accept that kind of help.

Examples of accommodations might include work benches that are tilted-and-railed so parts naturally slide to be closer to the worker thus minimizing reach. Accommodations might include variable height or tilting stands for stock baskets to minimize bending over and lifting.  Accommodations might include straps or loops tied to overhead tools to minimize above shoulder reaching.  Sometimes the accommodation is as simple as a carpenter's apron to carry fasteners to reduce gripping multiple fasteners (Carpal Tunnel stressor).

If it was not possible to modify existing work to be within the employee's restrictions and there were no jobs within the facility that met the employee's restrictions, the Vocational Case Manager developed lists of jobs within 30 miles that were within the employee's capability.

The VCM also arranged interviews at those jobs for the client.

The Psychology of Disability


In addition to Mr Condottiero's other qualifications, he has a Master's Degree in Clinical Psychology and a license to practice.  He had some interesting observations regarding the psychology of the various stakeholders.

The claimants cover the enter range of human integrity.  Some are scammers and are simply out to defraud the system.  Most claimants are not scammers.  They want to go back to work but they are scared.   They fear re-injury.  They know they have lost "work hardening", the physical conditioning that results from the physical demands of doing the job five days a week.  They may also be apprehensive about how their bosses and coworkers will receive them.

An additional concern of the claimants is that they will be "...stuck flipping burgers for minimum wage."  Mr Condottiero assures them that getting a good job is like getting a good girlfriend.  It is much easier to get a girlfriend if you are already dating another girl.  There is the presumption of  "there must be something wrong with him" if you are not already seeing someone.   Mr Condottiero assures his clients that good things will happen after they accept the "burger flipping job" and create evidence that they want to work.

Fraud


During the process of writing this essay, I contacted two business bloggers whose work I deeply admire:  Coyote Blog and Of Two Minds.  I asked if there were any questions they would like me to address.  Both bloggers requested that I ask about disability fraud.

Unfortunately, there are people who are successful at defrauding the system.  Figures are not available for Workman's Compensation but there are statistics available for Social Security Disability.  The number of people with active cases has gone up, but so has the percentage of applications that are rejected.

As a frame of reference, there are approximately 110,000,000 households in the United States.  So approximately one in every twelve households has a person receiving Social Security Disability payments.  (This line is too smooth!  It gives the appearance of quotas or targets.---ERJ observation)  Data from Social Security Administration.
The rejection rate for applications steadily rose from 50% in 2000 to more than 67% in 2014.  That is, two out of every three applications for Social Security Disability is rejected.  Data from Social Security Administration.
Increasingly sophisticated medical imaging and standardized evaluation protocols help winnow out many of the fraudulent claims.  Example of a standardized evaluation protocol.  Picture from HERE.

 

If you suspect fraud



You can report Social Security Disability fraud through this website:  https://www.socialsecurity.gov/fraudreport/oig/public_fraud_reporting/form.htm. Confidentiality is one of the options available.

The appropriate venue for reporting Workman's Comp fraud can be quickly found by performing a search with the following keywords "(your state), workers compensation fraud inspector general".  Hint:  It is easy to copy-and-paste the words from this essay into the key-word window of your favorite search engine.

Summary

  • It is possible to start a professional services business even if your service is "thinly traded"
    • The upside of "thinly traded" is that you are competing against a shallow talent pool.
    • Be prepared to travel if your service is thinly traded
    • Have a reliable vehicle and a good mechanic
  • Charge enough for your services.  Bill for all work done...every phone call, every mile traveled.
  • Either hire or start-up support people in their own businesses.  Mr Condottiero hires out accounting, job development and typing.  Mr Condottiero mentored five other people in starting their own businesses as he "spilled" work.  He kept the parts that he enjoyed doing and hires out the parts other people can do better.
  • Be flexible.  The Workman's Comp work dried up after some changes in Michigan laws.  He was able to migrate to Social Security Disability consulting because of the thin talent pool for that kind of work.
  • Get professional insurance for protection from law suites.
  • Most compensation is tied to case load.  Get smart about delegating work.  That allows you to handle a higher case load.  For example, Workman's Comp cases used to net in the neighborhood of $1500-to-$3000 per case.  A Vocational Case Manager could plod along, doing everything they way they always had done things and handle a typical case load of 20-25 cases per year.  Or the VCM could get smart about delegating and handle 60 or more cases per year.

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2 comments:

  1. You get back what you put into the work. And I wish every scammer would be permanently barred from receiving SS payments.

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    Replies
    1. My perception is that Social Security people are good at following up on reports of fraud. More fraud means the fund will go bankrupt that much sooner. There are about 70,000 people working for the Social Security Administration. It is in their best interest to keep the fund solvent.

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