Why Getting In Workers’ Heads May Be Key to Reducing Injury Impact

When many companies think about managing workplace injuries, they may think about OSHA reporting rules, light duty and avoiding litigation, but the real key to improving outcomes and holding down costs is to get inside the worker’s head, according to a new study.

A white paper looks at the RMS Workers’ Compensation Benchmarking Study for 2016, which asked companies to rank the biggest obstacles to improving claim outcomes.   The number one obstacle wasn’t lawsuits, return-to-work problems or late reporting of injuries (although those were high on the list).  The top problem was addressing what the study calls “Psychosocial Roadblocks.” Continue reading “Why Getting In Workers’ Heads May Be Key to Reducing Injury Impact”

Should Workers Comp Cover Injury from a “Bad Trip?”

What a long strange trip its been when it comes to the advent of legalized (at least at the state level) marijuana.   Pot use has come up over and  over in the area of workers compensation.  Should medicinal use be covered?  Is use at the time of an injury a workers comp deal-killer?

But even among all of these new issues, this case stands out as a head-scratcher.   Continue reading “Should Workers Comp Cover Injury from a “Bad Trip?””

Uber & Zika – Two words to watch on employee injuries

Mosquito_Tasmania_cropThe two biggest questions when it comes to occupational medicine and workers comp are:

  1.  Who is covered?
  2. What are they covered for?

Right now those questions can be boiled down to two words, Zika and Uber.

Let’s look at what is covered  first.  There is a lot of concern right now over the mosquito-borne Zika virus.  It not only represents a potential health problem for workers, but may also be a devastating threat to their unborn children.  In Miami Beach, at least two police officers have contracted Zika and they believe it happened while they were on patrol.  Both cops have applied for workers comp and their union is backing them up.  In both cases, the request was denied.  Recently the city weighed in with a letter to the police union saying officers can only get workers comp if they can prove they contracted Zika on the job and identify the actual mosquito that gave it to them: “He/she must show that the exposure/bite took place while on duty and identify the specific infected mosquito.”

Needless to say, the two sides are pretty far apart on this one.  But the implications are huge.  Zika is expected to potentially expand its range throughout the Southern U.S. and the workforce that could be exposed is potentially everyone who works outside.  That’s a lot of people and a lot of exposure.   But why stop with Zika?  We have any number of mosquito, tick and other critter-born viruses.

The question of who is covered involves Uber, the on-demand ride service that turned the taxi industry upside-down by allowing people who need a ride to use a smartphone to contact drivers.  The drivers own their own vehicles and Uber does not consider them to be employees in any traditional sense of the word.   However, labor groups and some employees are challenging that claim. Much of the debate centers on whether drivers should receive workers comp.  One pro-labor organization, the National Employment Law Project, points out in a position paper that most taxi drivers, even the ones who lease their cabs, are considered employees for the purposes of workers comp.   The group argues that these are potentially risky jobs, Uber drivers fall into the same position and therefore, “on-demand companies, especially those operating in highly dangerous sectors, should be required to provide workers’ compensation to those who work for them.”

That is not by any means a legal opinion and Uber is fighting hard to maintain its model.   But it does point out that Uber and competitors like Lyft have become a battleground over the changing relationship between companies and employees.   Uber calls them independent contractors.  The Law Project calls them on-demand workers.  Other terms that crop up are temporary workers and the gig economy.  Whatever it is called, the increase in the number of workers who receive income from companies, but are not employees is raising questions over the 100-year old worker’s compensation system.  Sometimes referred to as the “Grand Bargain,” the trade-off was that workers gave up the right to sue for injuries in civil court in exchange for legal guarantees.  As the Uber model shows, both companies and labor question whether their is a Grand Bargain after all.

Zika and Uber both show that challenges to the fundamentals of workers comp are time-consuming and extremely messy.   Workers comp tends to be a lengthy process and much of it centers on individual cases.  In Miami Beach, the two officers were each handled by different comp requests.  One was rejected and the other was initially approved, then rejected.   With Uber different states have handled them differently and they have even been handled differently within the same states.   Workers comp also is prone to “venue shopping,” picking and choosing states which may be more or less prone to accept a claim.

Answers on the issues raised by Zika and Uber will take a while to resolve, but the stakes are pretty high on both of them.

Nothing Fake About Pro-Wrestler Injuries – Workers Comp For the WWE?

Pro-wrestling is big business.   Big contracts.  Big money.  And apparently big injuries.

More than 50 former wrestlers, with stage names like Road Warrior Animal, the Crippler and the Bezerker, have sued World Wresting Entertainment Inc. over head injuries.  At the heart of the case is the allegation that the wrestlers were misclassified as independent contractors.  If the courts agree, the wrestlers may be eligible for workers’ comp benefits.   WWE calls the claims “patently false” and “ridiculous.”

Many of the wrestlers say that repeated blows to the head and concussions left them with chronic traumatic encephalopathy (CTE), a progressive degenerative brain disease which has been cited in other sports cases, like the quits against the NFL.  No telling when this video was shot, but the WWE says it banned head blows ten years ago.  The wrestlers in the lawsuit say their injuries preceded that ban:

Thanks for the SafetyAlert Website for this story.  Safety Alert points out that disputes over whether workers are independent contractors are tricky, whether they take place in the office or the ring.  On the one hand, wrestlers sign contracts that explicitly state that they are independent contractors.  On the other hand, courts have held that one test of employment is whether the hiring entity determines how the job is done.   So what about wrestling, where, as the lawsuit claims,

“WWE wrestling matches, unlike other contact sports, involve very specific moves that are scripted, controlled, directed and choreographed by WWE … as such the moves that resulted in named plaintiffs’ head injuries were the direct result of WWE’s action.”

The case will have to go through the courts.  When I was a kid, pro-wrestling was held in school gyms or anywhere else the promoters could get a crowd.  Recently, the WWE was valued by Forbes magazine at about $1.5 billion.   So WWE has a lot of money to spend fighting the lawsuits, but there is also a lot of incentive for retired wrestlers to look for their share.

New Study Tracks Causes and Costs of American Workplace Injuries.

Most frequent cause of injuries on the job: Material Handling –  32% of injuries are caused by workers lifting, lowering, filling, emptying or carrying objects.

Most expensive injuries: Amputations – Indemnity claims alone average $102,500 per incident.

Those are just a couple of the facts to emerge from a comprehensive study that Travelers Indemnity Co. did on more than 1.5 million injury workers comp claims over a four year period.   All in all, it is one of the most complete pictures of the causes and costs of injuries in the American workplace.

While material handling shows up as the top cause of injury for every industry and businesses of every size, there are some important distinctions for some segments.  For example, workers in small businesses suffer injuries from hand tools at about twice the rate of other sized businesses. Part of that may be improper training, but it could possibly be that small contractors on construction jobs are more likely to use hand tools.  Oil and gas was the only sector to have motor vehicle accidents in its top five causes.  Those unique aspects should guide companies in their safety programs.

days away graphicStrains and sprains were the most common type of injury, followed by cuts or punctures, contusions inflammation and fractures.  Possibly the most interesting part of the study is what injuries cost and how long they keep workers away from the job.   Travelers found that strains and sprains caused workers to miss an average of 57 days away from work, but that inflammations, which only made up five percent of the injuries, averaged more than 90 days away from work.injury costs

Finally, and most significantly, the study tackles the average costs for injury claims.  The most common injuries are not the most expensive ones.   Again, amputations are by far the most expensive claims coming in at $107,000.  That is just for the claim.  Any fines or other expenses would just add to that total.   Strains and sprains cost an average of $17,000.

What does all of this mean to a company?   Businesses should already be doing all they can to prevent injuries and help injured workers recover.   The study gives clear evidence that protecting workers is a sound financial decision in addition to being the right thing to do.  Now companies can look at hard costs of injuries and make rational decisions about where to spend their money.   For instance, following the NFPA 70E guidelines for training workers on electrical hazards can cost a few hundred dollars.  One electric shock injury costs an average of $55,200 in claims alone.  It is a  pretty easy business decision to make.

If you need help either protecting your workers from injuries or in mitigating the damage through early intervention once an incident happens, contact me at info@lifelinestrategies.com.

How Long is Too Long to Wait to File Workers Comp?

Thanks to the excellent website www.safetynewsalert.com for calling attention to a case where an injured employee waited two months after an alleged incident to apply for workers comp.   His argument was that he didn’t think the injury was serious, but it got progressively worse for two months, when he had to see a specialist. He said he informed the company as soon as he realized the seriousness of the injury.  The company argued that “it always stressed to its employees the importance of immediately reporting injuries because of the presence of bacteria and chemicals in the workplace that could cause even minor cuts to become infected.”

It happened in Kentucky where the workers comp laws say workers need to tell the company about an injury “as soon as practicable.”

The courts found against the worker because so much time had passed, but it creates a question, how long is “as soon as practicable?”    Apparently it is not two months, but is it one month?  Is it a week?   Back injuries may take a while to heal or present themselves as a longer-term problem.  How long is too long to report?

For employers that creates a high degree of uncertainty and potential exposure for incidents they didn’t even know occurred.  It is a pretty common problem in the oilpatch where crews may head home after a hitch, only to see their local doctor and start the workers comp process.

That is one reason why companies should look at companies that provide immediate post-incident injury management.  Typically an injured worker will talk to a trained professional by phone and describe the symptoms. In most cases on-site first aid is warranted and the employee is urged to contact them again if the symptoms worsen.  If the injury requires treatment, the service may recommend a clinic or, if it is an emergency, the worker can be taken to an E.R.

What does this accomplish?

  1. It establishes a treatment regime that is aimed at the right treatment for the injury.  Sending an employee home with an injury that could get worse with time doesn’t help the employee or the employee. Proper and early intervention has been shown to dramatically reduce the need for workers comp and shorten the period before an employee is able to return to work.
  2. It answers worker questions quickly and opens a communications channel in case the injury needs further treatment.  This helps encourage workers to report an injury when it happens.
  3. It “freezes the facts” by giving a quickly documenting what happened, the severity of the injury in real time and the recommended course of treatment.
  4. It gives a clear process and documentation that makes it harder for a worker to not report an incident and come back later with a claim.

CORE Health Network‘s TimeZero injury case management gives companies and their employees the peace of mind to know that an RN is just a call away if there is an incident.  CORE’s nurses are experienced in injury management and OSHA regulations, and are certified on workers comp in all 50 states.  If a worker is injured, they will be on the phone immediately to perform triage, find the nearest clinic qualified to treat the specific injury and will follow-up to ensure that the worker is receiving the right care.   For more information contact kwells@corehealthnet.com. 

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Storm Clouds Ahead For Your Workers Comp Insurance

It has never been more important for you to control your workplace injuries and the reasons aren’t even your fault.

A very good article by Steve Doss of CCIG looks at three signs of trouble for workers comp rates.  They all have to do with national trends.

  1. Obama Care (the Affordable Care Act) – The Affordable Care Act and workers comp are supposed to be two separate programs with two separate purposes.  The problem is that doctors may “leak” cases that should be covered by health insurance into worker’s comp.  Why?  Patients  can avoid high deductibles by going through worker’s comp and doctors can charge more for workers comp treatment than they can under group policies.  So there is an incentive for both to classify things as work-related.
  2. Accident Frequency – As the economy has improved since 2012, accidents have gone up, especially in construction and transportation.  Two distinct problem there – more inexperienced workers entering the workforce and an aging demographic as more people delay retirement.  According to Doss, “non-fatal work-related construction injuries jumped 9.5 percent from 2012 to 2013. Also, as older employees work longer, the number of accidents among those 65 and older rose 18.5 percent from 2012 to 2013.”
  3. Accident  Severity – Fatalities are going up.  For example, the government says that between 2013 to 2015, construction fatalities rose 5.6 percent and manufacturing fatalities rose 9.3 percent from 2013 to 2014.   At the same time, hospital and drug costs are rising faster than inflation and those are the biggest expenses impacting workers comp.

What should you do about it?  Doss says prevention is the best investment you can make; every dollar spent on prevention saves two-to-six dollars in savings.

At CORE Health Network, a leader in integrated occupational health management, the four keys to prevention are:

  1. Documentation – Companies that don’t monitor worker health and on-the-job injuries may have no way to determine whether an injury was really work-related and they have limited options on getting workers back to work quickly.
  2. Make sure the people you hire can perform their job duties safely – That is done through a network of 1300 clinics around the country that can perform drug and alcohol testing, compliance testing and functional assessments during the onboarding process.
  3. Keep track of worker medical conditions as their careers progress – Return-to-work assessments are a critical to preventing re-injury and helping workers return to work.
  4. Post-incident case management – The first minutes after an injury are critical to determining injury severity and the right level of treatment.  They are also important in re-assuring workers that they will receive the proper care and that company wants them to return to work healthy.  CORE’s TimeZero service addresses those concerns.

Let us know if we can help you manage your worker health needs.

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Occupational Health – Knee ACL Reconstruction Has High Rate of Re-injury

Credit:  St. Louis Children's Hospital
Credit: St. Louis Children’s Hospital

The goals of a good workplace health management program are to make sure that workers are not assigned to job duties where the risk of injury is high and to make sure they have timely and proper treatment if there is an injury.

New research shows there is good statistical reason to take a close look at new employees who have had Anterior Cruciate Ligament Reconstruction (ACLR) surgery on a knee or at employees returning to work after that injury. A new study of soldiers in the British Army has just been released.    Apparently, prior to 2005,  ACL surgery was a cause for discharge or rejection, but after 2005, the Brits changed their recruitment policies to allow enlistees who had previously undergone ACL surgery.   As a followup, they wanted to find out whether those recruits went on to experience additional knee problems.   The study compared recruits who had ACL surgery with a control group who had not had the surgery (and we assume, had not had knee problems).  It found that “Sixty-one per cent of cases experienced complications linked to their previous surgery.”

Another, earlier study had looked at young athletes who had ACLR surgery.  It found that about 69% of them experienced a re-injury.

What does this mean to employers?  Well, first you need to recognize that military surgery and sports are likely to place special stress on knees.  Most jobs don’t create that kind of physical stress.   But some do.  There are two lessons here:

  1. It is important to understand job duties and make sure new hires or employees returning to work can perform those duties without risking additional injury.
  2. It is important to document pre-existing conditions or surgeries.   Depending on the severity and where the operation takes place, an ACL operation can cost $20,000-50,000.

If you want to learn more about the onboarding process as practiced by CORE Health Networks, contact me at kwells@corehealthnet.com.

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Worker injuries and mistrust: Why the first few minutes after an incident are so important.

taller de ilustracion digital - 212Near the end of his shift, a warehouse worker lifts a box while talking to a co-worker.  He’s distracted and doesn’t remember to lift with his legs.  He feels a twinge in his back and by 10 o’clock that night, the pain is so bad he can’t sleep.

Want to know one of the top factors that will determine how soon he is back on the job?   Whether he is afraid of losing his job.

The Workers Compensation Research Institute (WCRI) surveyed injured workers in 12 states.  It found that trust, or rather mistrust, of the company and fear of losing their jobs was strongly related to workers staying off the job longer.  In fact, the study found that “concerns about being fired were associated with a four-week increase in the average duration of disability.”  Workers who were afraid of being fired also were much more dissatisfied with the care they received and had more problems with access to care.

There is a very good recap of the study here in CFO Magazine.

Why is this important?  Time off the job is a cost to the company and shows up as OSHA recordables. Workers who don’t trust their employers may also be more likely to sue.  More importantly however, getting workers back to where they can earn a living is a priority.  Good companies understand the value of keeping a productive, engaged workforce.  A high level of distrust and workers feeling like the company doesn’t support them if they are injured can destroy a company culture.

What you can do about it.  The article gives a number of valuable tips.  On the front end, companies should engage workers in identifying hazards and avoiding them as a part of their overall safety program.   They should also plan ahead by identifying transitional jobs that allow workers to return to work without risking their recovery.

One of the biggest recommendations is something that is at the heart of CORE Health Network’s approach – Early intervention by trained professionals who can make sure that worker know they will be taken care of with appropriate, timely treatment.  Here is what the article on the study says:

Providing a 24/7 nurse triage program to speed treatment for injured employees so they get the care they need as soon as possible. The employee can contact the nurse triage line immediately after feeling a twinge of pain or sustaining an injury that doesn’t require emergency treatment. This service not only ensures the employee gets the right care immediately, it also cuts down on unnecessary visits to the physician when the employee can use such self-care treatments as ice, rest, elevation, or (over the counter Ibuprofen).

If you need more information on the early intervention offered by Core Health Network, contact us at info@lifelinestrategies.com.

Weird Workers Comp Claim: Shot at the Shooting Range

Law enforcement officers regular face dangerous situations, but Dalworthington Gardens Police Chief Bill Waybourn didn’t expect the shooting range to be one of them.  The chief was teaching a concealed handgun class when one of his students shot him in the hand.  Officials in the town of 2200 agreed that the shooting came in the line of duty and OK’d workers comp.  Although the class wasn’t officially a city-authorized function, town fathers decided it helped with public awareness.

That would have been the end of it, except that Waybourn is now running for sheriff and it has turned into a bit of a campaign issue.   The chief had made headlines by offering free classes to teachers after a school shooting and to military personnel after an attack on service personnel in Tennessee last year.   This time, though, the student was a doctor and the shooting occurred after the gun jammed.  In the campaign, there were questions whether the injury was truly work-related.

No word on whether the student got a failing grade, but we can only assume.