Could We Save Money by Reporting MORE Injuries?

Much has been written about the decline of the frequency of workplace injuries over the past 15 plus years. Improved workplace safety, modular construction, cordless tools, and reductions in heavy manufacturing are some of the most popular reasons attributed to the decline.

On the surface, this sounds like a positive thing. But upon further examination, this much-celebrated decline in the number of workplace injuries may not be completely legitimate.

Does it make sense that delays in getting prompt medical care are often increasing the treatment requirements – and therefore the cost - of injuries? Increased rates of surgery and physical therapy are contributing to increased
loss severity.

The June 2008 report to Congress by the U. S. House of Representatives Committee on Education and Labor, “Hidden Tragedy: Underreporting of Workplace Injuries and Illnesses,” states that work-related injuries and illnesses in the United States are chronically and even grossly underreported.

According to the report, “as much as 69 percent of injuries and illnesses may never make it into the Survey of Occupational Injuries and Illnesses (SOII), the nation’s annual workplace safety and health “report card” generated by the Bureau of Labor Statistics (BLS). If these estimates are accurate, the nation’s workers may be suffering three times as many injuries and illnesses as official reports indicate.”

What are the causes of underreporting? According to experts:

• OSHA’s reliance on self reporting by employers. Employers have strong incentives to underreport injuries and illnesses that occur on the job.


• Twenty percent of workers— including public employees in high-risk jobs such as law enforcement, fire protection, and public works; workers on small farms employing less than 11 employees; and those who are self-employed—are not even counted by BLS.


• Work-related illnesses are difficult to identify, especially when there are long periods between exposure and illness, or when work-related illnesses are similar to other non-work-related illnesses.


• Recent changes in OSHA’s recordkeeping procedures have affected the accuracy of the count of musculoskeletal disorders (MSDs).


• Some employers are confused about reporting criteria and OSHA staff are often not well-trained to provide accurate advice.


• Workers report widespread intimidation and harassment when reporting injuries and illnesses. Immigrants are also less likely to report, as explored in last week’s blog entry by Bill Wilson.


• While they may be well-intentioned, widespread and popular safety incentive programs which provide awards for a period of time without a recordable injury, can have the effect of putting pressure on workers not to report their injuries.

Here’s what I’d like your ideas about: Do you think it’s possible that underreporting of injuries may be one of the causes of the increased severity of the injuries that are reported? In other words, are employees resistant to report an injury, and only do so when they can’t stand the pain any longer? If so, does it make sense that delays in getting prompt medical care are often increasing the treatment requirements – and therefore the cost - of injuries?

A report published just a few days ago by NCCI presents an interesting analysis of claim severity as related to the “growth in treatments per claim” over recent years. This report shows that significant contributors to increased claim costs are increased rates of surgery and physical therapy. Catastrophic injuries aside, of course, doesn’t it make sense that the longer you defer medical attention for a problem, the more likely you may need surgery and/or extensive physical therapy?

Here are just a few of the WorkCompEdge modules that relate to this topic.

• The Clock is Ticking – Things You Must Do in the First 24 Hours After an Injury


• Before and After an Injury – The Crucial Role of the Supervisor’s Actions and Attitudes


• Build True Safety Culture – It’s More Than the Incentive of the Month

Ultimately, it’s in the best interest of the employer and the injured employee to report all injuries promptly and get immediate medical treatment. It’s essential for the employer to create a culture that fosters the reporting of injuries. Education and communication is the key. Get the message out loud and clear: if you get hurt, report it. The company, the injured employee, and the employee’s family will all benefit from reporting all injuries. It's the right thing to do - and it may cost us all less in the long run.

http://www.workcompedge.com/
http://www.specificsoftware.com/

Workers Compensation and Illegal Immigrants

One of the few email discussion lists I participate in is a Yahoo! Groups list called "RiskList." Recently, the topic of discussion was illegal aliens and workers compensation. Some issues discussed include whether or not these workers are covered under workers compensation laws and what kind of impact they may be having on loss experience.

Immigrant workers may be more inclined to take risks not commensurate with their skill levels. In cost-cutting measures that played a role in their hiring to begin with, they also may not receive proper safety equipment.

This blog is an abbreviated version of a longer article available to WorkCompEdge members here on our wiki. This article addresses the issue of whether or not illegal aliens are entitled to benefits under state workers compensation laws. The purpose is not to opine about the situation from a political or social standpoint, nor to comment on construction workmanship issues that have been addressed in the press.

Of 9.3 million illegal adults in this country, 7.2 million (77%) are employed and comprise about 5% of the entire U.S. workforce. However, they comprise a far more disproportionate percentage in some industries, such as 24% of farm workers, 17% of cleaning workers, 14% of construction workers, and 12% of food preparers. Within an industry, illegal workers may comprise high percentages of specific (often more hazardous) occupations...e.g., 36% of all insulation workers and 29% of all roofing employees are estimated to be illegal aliens. In general, illegal workers tend to be younger than other workers.

Because of language barriers and lack of training and experience, some experts believe that the exposure to injury may be significantly greater for illegal aliens than other workers. According to an Associated Press story, Mexican workers are about 80% more likely to die from a work injury than native-born workers. In several Southern and Western states, these workers are four times more likely to die than U.S. citizens performing similar jobs.

Given language barriers that might interfere with effective supervision and training, along with the frequent lack of experience, there is a fear that illegal aliens may be at greater risk due to several additional compounding risk factors. For example, because of the reasons many are here, they might be more inclined to take risks not commensurate with their skill levels. In cost-cutting measures that played a role in their hiring to begin with, they may not receive proper safety equipment. And, because they are inclined to avoid attention being directed at their illegal status, they may be hired or assigned to more hazardous jobs by employers who feel they are far less likely to file workers compensation claims....

....which brings us to the topic of this article, which is to answer the question, "Are illegal aliens entitled to state workers compensation benefits?" The short answer to this (as often the case with insurance coverage questions) is, "It depends." In a significant majority of states, illegals ARE entitled to workers compensation benefits. However, this is not true in every state. In addition, the types of benefits or extent of coverage may be restricted in some states depending on a number of factors.

The arguments for and against benefits are further discussed in the full article (available to WorkCompEdge members). Whether or not an illegal alien is entitled to workers compensation benefits will be established in the state statutes or by regulatory or court decision. Are illegal aliens "employees" as defined by most state statutes? If so, are they entitled to all or some of the statutorily-prescribed benefits? In trying to answer these questions, I've constructed a state-by-state chart that references each state's statute, lists any known case law or regulatory ruling, and provides commentary on whether or not it is likely that illegals are entitled to benefits:

Workers Compensation and Illegal Aliens Chart (Word document format)

As you'll see on the chart, most states do allow illegal aliens to claim workers compensation benefits. The only state that expressly excludes benefits by statute is Wyoming. The only state that has excluded benefits across the board by court decision was Virginia, but the decision was subsequently overridden by legislation. The vast majority of other states permit at least the claiming of medical benefits by illegals. Some states (e.g., Georgia, Michigan, and Pennsylvania) attach restrictions to disability benefits. Other states (e.g., California, Nebraska, and Nevada) limit or preclude vocational rehabilitation benefits.

This chart is a work in progress, so information is not currently available for all states, but it is for most. Also, keep in mind that where case law is absent (to the best of our knowledge), any opinion about how statutory law might respond is conjecture on our part, based on how courts in other states have ruled on similar statutory wording. As statutes are reviewed and case law uncovered, this chart will be revised on an ongoing basis. If you are aware of any inaccuracies or missing information, please email corrections to me at Bill.Wilson@iiaba.net.

http://www.WorkCompEdge.com
http://www.SpecificSoftware.com

Is Wellness a Wildcard...Like Sarah Palin?

Editor's note: Today we're returning to our "regularly scheduled programming" after blogging yesterday about our award. Next week we'll return to our once-weekly blog schedule.

Sarah Palin was a wildcard choice...is wellness a similarly unexpected consideration in workers comp issues? Photo from the Wikimedia Commons.

Hold your rants or raves! We're not veering into political territory on this blog; I just can't pass up a good analogy. Republican, Democrat or other, almost everyone agrees that Sarah Palin was a wildcard choice as a vice presidential nominee. Now, as I think about Kory's comment in last week's blog about whether the WorkCompEdge wellness module will be largely ignored by our members, I have to acknowledge that we made our own surprise selection when we included it in the lower left hand corner of the process diagram on the WorkCompEdge home page.

We tagged the module, “A new paradigm – promoting the health of your workers.” Was including wellness in WorkCompEdge a good idea? Does it complement all of the other modules, or was it just some crazy late night selection we made to stir things up? Well, as with McCain/Palin, only time will tell. But, let me explain some of the challenges we have discovered with wellness in the workplace.

I love business. I love systems. And, I really love math. I can relate to the process thinking and math behind the various modules and strategies within WorkCompEdge. The content we developed, the tools that we provide, and the implementation plans we suggest were carefully derived from the experiences of successful employers. Wellness is similar to the other modules in that it can involve numbers on both the corporate and personal levels (How many of your employees smoke? How much weight has John Doe lost?). But wellness won't succeed based on analysis and corporate process improvement. More so than with any other program or module in WorkCompEdge (safety, claims management, supervisor training, medical relationships, etc.) wellness involves individual, self-initiated change.

We developed the wellness module easily, given our in-house health gurus and the wealth of external resources available. But will employers use it? And what can make it most effective? As a broker in St. Louis recently explained to me, wellness is about “boots on the ground.” That is, real change in individuals takes internal motivation that is often ignited and fueled by a wellness "foot soldier" - an everyman/everywoman type of health champion who inspires and leads individual employees to a better and more consistent lifestyle.

So, how does a nationwide program like WorkCompEdge put those boots on the ground? Not easily. But, let’s think outside the gym, so to speak. Can we provide the tools, techniques, and resources to train the champion? What if the WorkCompEdge focus for wellness becomes an effort to identify, train, and motivate that champion at each WorkCompEdge employer? What would this look like? Could it work? What if… we created an army of WorkCompEdge wellness foot soldiers committed to leading their organizations to a higher level of wellness, one individual at a time?

Like McCain's choice of Palin, some may argue that wellness works for the WorkCompEdge Process and is an excellent pick. Others may think we are crazy! Let me know what you think (about wellness, not about the political campaign). And be keeping an eye out for who you might tag in your office to champion this cause. I can't resist saying: this person doesn't have to be a hockey mom, and lipstick will be optional!

http://www.WorkCompEdge.com
http://www.SpecificSoftware.com

You Like Us...You Really Like Us!

When we learned this week that LexisNexis has named the WorkCompEdge blog among the top 25 workers' comp blogs of 2008, we had the urge to gush like actress Sally Field in her well-known, often-parodied Oscar acceptance speech of 1985: You like us, you really like us!

LexisNexis has named the WorkCompEdge blog among the top 25 workers' comp blogs of 2008. Read the announcement or visit the LexisNexis Workers' Compensation Law Center.

In its news release, LexisNexis stated that the top 25 blogs were selected for "a wealth of information for the workers' compensation community with timely news items, practical information, expert analysis, tips, frequent postings, and helpful links to other sites. These blogsites also show us how workplace issues interact with politics and culture. Moreover, they demonstrate how bloggers can impact the world of workers' compensation and workplace issues."

We're doing all that?

Well, we are trying to, and we're delighted that, in the short life of this blog, folks have already noticed. But that brings us to what dear old Sal really said that night at the Oscars:

"...you like me, right now, you like me!" (Emphasis is ours.)

Right now.

In other words, Sally implied, the tide of cultural favor can go in and out, as do the opportunities to earn that favor. We recognize that fact here at WorkCompEdge, and this is a good time to remind you that:

• we're committed to making not only the blog, but the entire WorkCompEdge site a "living" product that undergoes changes and enhancements in response to member needs, suggestions, and the changing market
  
• we need your ideas and feedback to make both the blog and the site thrive. (Well, actually, if you're a member, we need your money every now and then, too. But right now we're talking about valuable content.)

We're very grateful for comments here on the blog and for those you've given to our staff by email and phone. Even if you tell us something you think we might not want to hear, be assured we have open minds. We know from our 20 years of developing and supporting ModMaster software that your input leads us to create a better product.

Now, we'd still like to increase our readership of this award-winning blog, so please, consider forwarding this page to your colleages, state associations, professional groups, and clients. Tell them that subscription options are at the bottom of the page. And like Sally said, do it right now.

http://www.WorkCompEdge.com
http://www.SpecificSoftware.com

Wellness: Showing People You CARE

Wellness is one of the 15 modules we chose to include in WorkCompEdge. To be honest, at this point in the young life of the site, we sometimes wonder if it may ultimately receive the award of “Module Most Likely to Be Ignored by Our Members.” After all, it seems that everyone is talking about wellness in the workplace, so isn’t everyone already doing it?

This is a great way to get a little friendly competition started at the office. Who can raise the most money working out for CARE? Be sure to tell a friend or co-worker!

Well…maybe not. Although a quick Internet search will yield statistics supporting widespread corporate wellness programs faster than you can tie your walking shoes, the feedback we have so far from our recent survey (which is still open, please participate it you haven't) doesn’t agree:

• Brokers and agents indicated that only “very few” or “some” of their clients had an effective wellness program 75% of the time. “Very few” was equated to 0-19% of their clients, and “some” was equated to 20-39% of clients.
  
• Of employers who responded to the survey, 66% reported that their company did not have an effective wellness program.
  

We think that part of the discrepancy between our results and others must be related to a company’s number of employees. It seems that a lot of the statistics we see mention “leading corporations.” It makes sense that smaller employers may find it more challenging to implement a wellness program. (Unfortunately, our survey didn’t capture number of employees. We’ll be smarter about that next time.)

But we also wonder if the key word in our question was “effective.” Are there a lot of wellness programs out there that are being offered, but just aren’t being used?

We recently came across an article that indicated some small businesses are motivated to offer a wellness program not so much because of the possible financial benefits (realized from fewer sick days, quicker recoveries, reduced health insurance premiums, better productivity, etc.) but simply because it’s a positive thing to do for their employees. And that resonates with us. Your own personal wellness is a gift - not only to yourself, but to your family, friends and colleagues. And now it can be a gift to the world’s poor.

Fitness expert, author and professional triathlete Eric Harr has implemented a program at CARE, the humanitarian organization dedicated to reducing global poverty, which will take your workout to a new level. For every hour you exercise and log on the website, Eric’s going to donate $5 to CARE. You simply fill out a brief form on the website, and you’ll receive an encouraging email and a monthly summary of your progress. AND, if you’re not already in a fitness program – or want to infuse your existing one with some new routines - Eric has what you need in free downloads, including a fitness assessment, 18 goal-specific training programs, and stretches.

How’s that for motivation? Head on over to the CARE site now, at www.care.org/workout

This ia a great way to get a little friendly competition started at the office. Who can raise the most money working out for CARE? Be sure to tell a friend or co-worker!

http://www.WorkCompEdge.com
http://www.SpecificSoftware.com