'Work as therapy': Sue S. Keener, workers' compensation guru, prevents employees from turning "soft and squishy."

Using three decades of risk management skills and the caring attitude that made her once yearn for a career in psychology, Sue S. Keener has helped Virginia save more than $43 million on its workers' compensation costs over the past five years.

As director of the Office of Workers' Compensation in the Virginia Department of Human Resource Management since 2000, Keener is responsible for managing a program that took in $43.1 million in annual premiums from 125 state agencies for the fiscal year ending last June. Those agencies provided cover for about 110,000 full-time, part-time and faculty employees of the Commonwealth of Virginia.

That means taking care of everyone from a burly state trooper injured while making an arrest to an office maintenance worker who lifts one too many heavy boxes. And it also means trying to control costs and get people back to work in a frequently contentious environment where injured workers can be treated like pariahs.

"It took a lot of time to change the way injured workers are perceived ... by the state agencies, the benefits coordinators and how injured people perceive themselves," says Keener, adding that many times case workers and their co-workers believe the injured workers are trying to beat the system.

A primary goal of the workers' comp program she spearheaded five years ago was to shed the negative attitude surrounding the claims process and develop a "work as therapy" aspect to the program. Helping to eliminate negative attitudes involved simple changes of language--such as calling the person processing the disability claim for the state a "benefits coordinator" rather than a "claims adjuster," and using the term "injured employee," rather than "claimant."

The work as therapy model helps get an injured worker back into the workplace more quickly by placing them in a transitional job they can physically handle, even if they are still unable to carry out their original job description. For example, an injured prison guard who isn't yet physically capable of monitoring prisoners can return to work manning the metal detector machine at a prison entrance, Keener says. "The longer people are out, the less likely they are to come back. And for people in physical jobs, there's less chance of them getting soft and squishy if we can get them back as quickly as we can," she adds. One result has been a reduction in the state's number of lost-time claims (meaning a claim in which a worker's time off exceeds seven days). There were 1,106 such claims for the fiscal year that ended in July 2003, down nearly a third from the 1,596 lost-time claims for the fiscal year that ended in July 1998.

Another way in which Keener--who first became responsible for the state's workers' comp program in 1989 when it was housed within the Division of Risk Management in the Department of Genera Services--shaved costs was by shifting the way premiums are calculated by each state agency. Instead of annual premiums being based on automatic annual budget increases, the premiums are now linked to each state agency's loss experience, the hazardous nature of its employees' duties and other risk factors that any private insurer would consider when developing a private corporation's annual premium payment. "Premiums had been going up since 1980 and controlling them was not high on state agencies' radar screens," says Keener, who first started working with the state in 1986 as a claims manager in the Division of Risk Management.

About two years ago, she helped introduce the use of monetary incentives to encourage each state agency to lower its own workers' comp costs. For the past four years, Virginia's governor and the general assembly have let each state agency keep 25 percent of any premium reductions generated by an improved loss experience. The remaining 75 percent goes back to the overall state budget. Each agency can use the money for any purpose, but is encouraged to sink the money into loss control measures that will further reduce the possibility of injuries on the job. The program has been so successful that Virginia Gov. Mark R. Warner in December proposed that the ratio be sweetened to 50-50, allowing each state agency to pocket 50 percent of any savings its achieves.

The workers' comp program has also benefited financially by managing its cases through a partnership of public and private sources. After months of evaluation that began in the fall of 1997, the state in July 1998 turned over the claims management of its workers' comp cases to a private company. That removed about 30 benefits coordinators from state payrolls. Keener now runs the office with two other full-time state employees.

What Keener enjoys most about her job is knowing that she is directing a statewide system that is helping people--a desire that led her to first study psychology more than 30 years ago at the University of Virginia in Charlottesville. But while the college freshman found her studies irrelevant at the time and later dropped out--Keener never lost her desire to better people's lives. Armed with a degree from the Katherine Gibbs secretarial school in New York City in the spring of 1972, Keener's skills took her into a job at USAA in Washington DC--where she quickly made the shift into the insurance arena as a property claims manager. "I always loved risk management and the claims business ... helping people, working with numbers, solving problems as well as the loss control side of it and helping people from getting injured," Keener also says.

That love of her job motivated her to head back to university in 1990 and plow through 11 years of part-time learning as she gained her bachelor of science degree from the Virginia Commonwealth University in 2001. She graduated summa cum laude from the business school, with a concentration in safety and risk control.

Keener says it pays off for workers' comp administrators to think of new routes--such as investing in education and retraining for employees--to save money and get people back on the payrolls. "You need to think out of the box and do a cost-benefit analysis and see if it makes sense to do something new," Keener says. But it's the knowledge that she is helping people that keeps the 51-year-old manager buoyant through 10-hour plus work days as well as checking her e-mails from home or even coming in for a three-hour meeting while on vacation.

PAULA L. GREEN is a contributor to Risk & Insurance. She can be reached at riskletters@lrp.com.

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