Archive for March, 2005

And The Green Cross for Safety Medallion goes to…

Thursday, March 31st, 2005

Congratulations to Liberty Mutual for winning the National Safety Council’s highest award, The Green Cross for Safety Medallion. It will be presented to CEO Ted Kelly tonight at a dinner in Chicago.
Liberty Mutual has long been in safety’s vanguard. In the middle 1970s, when I was still a young man directing the Army’s Safety and Health program in New England, I have fond memories of my many visits to the company’s Research Center in Hopkinton, MA, to listen to Dr. Stover Snook expound on his cutting-edge ergonomic research (a brilliant scientist, Stover would stop me cold as he casually discussed the misadventures surrounding the frequent disappearances of his pet python at home) and to watch Gil Drake and his staff teach emergency driving maneuvers to the teenage sons and daughters of Liberty’s policyholders.
Gil, a very lucky man who had the good fortune to marry a wonderful woman who also happened to be the former Miss Venezuela, was the best driving instructor I ever met. Nearly all of the techinques taught today by the instructors at the Research Center, including Liberty’s Decision Driving concept, were invented by him. A man dedicated to saving lives on the road, he was also a good friend. It is very gratifying to see that Gil’s message and that of his peers still resonates at the company he gave so much of his life to. Ted Kelly can be very proud tonight. The National Safety Council chose wisely.

Extreme Commuting: Not Exactly the Sporting Life

Thursday, March 31st, 2005

There is a relatively new phenomenon for a growing number of working Americans: extreme commuting. According to Business Week, 3.4 million Americans have a commute to work that takes 90 minutes or longer each way. Fueled by outrageous inflation in housing prices, American workers find themselves

“What are my rights?” Employer frustration with workers comp

Thursday, March 31st, 2005

A reader asks: Is there a guide for employers’ rights? Who makes the final decision to award a disability retirement? Who checks to insure that there is no fraud being committed?
The short answer to these questions is “prevailing state law.” All jurisdictions have variations in the laws that govern the rights and responsibilities of both the employer and employee. Each state insurance authority also has a mechanism for reporting suspected fraud. While your workers comp insurer might investigate a claim and accept or deny it based on the circumstances of the claim, their interpretations are subject to review by state workers comp boards and authorities if challenged by the employee. You can find a link to your state workers comp authority on the All 50 States’ and D.C.’s Home Pages and Workers’ Compensation Agencies site. Or the Department of Labor offers a an overview of State Workers Comp Laws that allows you to compare provisions and benefits state by state.
There is a longer answer to this question too, perhaps too long for us to address fully in one fell swoop, but we’ll try. Behind these questions, we pick up a familiar air of frustration. Many employers – particularly small employers – are pretty much in the dark about workers comp until something wakes them up and makes them take notice. That “something” is usually an adverse event: premium rates that suddenly skyrocket, being thrown into the state’s assigned risk (or “insurer of last resort”) pool, or an award of benefits to an employee in a situation the employer perceives as fraudulent or unfair. Many employers we’ve talked to feel mugged by workers comp – they feel like unwitting victims of a system run amuck.
To those employers, we would have a few words of advice: take charge. If you rely on your insurer or some outside party to manage your workers comp experience, you are likely to be frustrated on more than one occasion. Think of your insurer as essentially a financier who finances the risk. A good insurer might provide services to help you prevent, mitigate, or control losses, but essentially their raison d’etre is about money, not the people issues.
Taking control of your experience
At its very essence, workers compensation is not really an insurance problem or a money issue … it’s a people issue, a “human” issue. It’s about your employees and your relationship to your employees. It’s about people who get hurt on the job and how you take care of them. When it comes to your work force and your relations with your work force, the real person in the driver’s seat is you.
There may not be a lot you can do about a past judgment, even if it seems unfair. But the worst thing you could do going forward would be to communicate your frustration to your work force in the form mistrust, suspicion, or unfair practices designed to prevent a repeat occurrence. A punitive approach will tarnish your good relations with your workers and will be unfair to the many good employees that comprise the overwhelming majority of your work force.
The best thing you could do going forward would be to educate yourself about your rights & responsibilities about the law in advance, and to develop a proactive rather than a reactive workers comp program to protect both your business and your employees. Some important components in that program include:
Prevention. We can’t say this enough: the cheapest injuries – both in human and financial costs – are the ones that never occur.
Good communication. Take the mystery out of workers comp. Educate employees about their rights and responsibilities in advance.
A pre-established plan. Train your managers and supervisors in what to do if an injury occurs.
Excellent medical care. Develop a relationship with a superior and responsive physician who understands workers comp and how to treat occupational injuries.
Early reporting. Set an expectation that all injuries be reported promptly; also, have a “same-day” reporting standard for communicating any claims to your insurer.
Good, ongoing communication. Stay in frequent communication with the injured employee throughout the recovery process.
Return to work program. Build a plan to help the injured employee to return to work as soon as possible, including modified duty.
Fairness and consistency. Think of the “Golden Rule” – how would you want to be treated if you had an on-the-job injury? Be consistent and apply the same principles to all.

Older Workers : Protection for a Growing Majority

Wednesday, March 30th, 2005

We recently blogged the increasing reliance on older workers among some of the nation’s largest retail chains. While we welcome the inclusion of older workers into the workforce, we caution employers about the potential impact on workers compensation. The older you get, the more likely it is that you have pre-existing conditions that may impact your ability to do the job safely.
I don’t have exact numbers, but I would guess that in 1967, when the Age Discrimination in Employment Act (ADEA) was passed by Congress, older workers comprised a minority of the workforce. Today, nearly 40 years later, the 75 million workers over 40 make up about 53% of the total workforce. Protections for older workers, in other words, are now protections for the majority. (Which of course does not mean the protection is not needed!)
“Disparate Impact”
In the years since the ADEA was passed, the Supreme Court had never decided whether it authorizes cases involving unintentional discrimination, known as “disparate impact” suits. Federal appeals courts have issued contradictory rulings on the issue.
Today the Supreme Court found in Smith v. City of Jackson, Mississippi, that discrimination need not be intentional. In other words, you don’t have to prove that the employer intentionally discriminated against workers above the age of 40. You only need to prove that the actions had a disproportionate impact on older workers. Nonetheless, the standard of proof remains high. Indeed, in this particular case, the Court found in favor of the employer.
Occupational Geriatrics?
As the workforce ages, and as people prolong their careers into their late 60s and 70s, we will be facing unprecedented issues for the workers compensation system. Keep in mind that the system was created when people trained for a single job, generally worked for a single employer, and retired right at 65. Today, people change jobs (and even careers) numerous times, they work for many different employers, and they might not retire until they reach their 70s. State legislatures across the country are faced with obsolete notions of work and retirement. In addition, the medical profession is about to be confronted with older and older people trying to overcome injuries and get back to active employment. Will medical schools soon offer a new specialty in occupational geriatrics?
Hiring is Always Risky
Any act of hiring, regardless of the age of the applicant, is full of risk. Indeed, hiring a stranger may be the riskiest action an employer makes. So we recommend that you make the hiring process as thorough and rigorous as possible. Don’t just require a written job application: read it carefully! Talk directly to applicants, preferably in a variety of settings, using different members of your team. And check references. Even if prior employers will only verify dates of employment, push hard for full disclosure. (There is such as thing as a “negligent reference”!) If your jobs are physically demanding, explore the feasibility of pre-employment physicals. Once you hire someone, you’ve made a commitment with profound ramifications for your organization. There is no such thing as a “casual” hire!

Post Traumatic Stress: How do people heal?

Tuesday, March 29th, 2005

In this country, when traumatic events occur, we send in the counselors. Whether it

Weblog roundup: business reads, prescription drugs, functional capacity, & more

Monday, March 28th, 2005

Sometimes it�s good to look at the forest, and other times it�s good to look at the trees. To get a take on macro economic and business trends that affect the day-to-day work place, check out Library Journal’s recommendations for Best Business Books of 2004 .
Managed Care Matters reports that the Second Annual Survey of Prescription Drug Management in Workers’ Compensation has been completed. Prescription drug costs are seen as an increasingly significant cost component in benefit payouts. Joe also has a good post on managed care and physician choice.
Dedicated safety activist and blogger Jordan Barab is on vacation, but in his absence, Tammy and Kelly bring us the Weekly Toll and an update on the BP explosion.
George’s Employment Blawg has an excellent post on functional capacity and similar testing, information that can be helpful in building ADA-compliant job descriptions as well as in identifying appropriate temporary return-to-work assignments.
Strategic HR Lawyer notes that staffing company employment is up in 2004. Nearly 12 million temps and contract workers were engaged, an increase of about one million over the prior year.
Thanks to Inter Alia for pointing us to 10 Things To Know About Evaluating Medical Resources on the Web – useful advice that should actually apply to evaluating the credibility of most online sites.

Never Again�Until Next Time

Friday, March 25th, 2005

How often does tragedy strike and we vow never to let it happen again? This is the 94th anniversary of the horrendous Triangle Shirt Waist factory fire, in which 146 workers died because of blocked exits. (We blogged the event and a recent book about it back in February). Although the fire eventually led to reforms in workplace safety, the immediate result was the acquittal of the owners in a criminal negligence trial, due in large part to a brilliant lawyer named Max Stueur. It

What is Disability Management?

Thursday, March 24th, 2005

At the heart of workers compensation is — or should be — the concerted effort to treat workplace injury and illness and get people back to productive employment. Sounds reasonable, but how do you do it? What exactly is “disability management?”
Our esteemed colleague, Dr. Jennifer Christian, host of the informative WebilityMD website, takes a shot at defining disability management, in response to a simple question from someone new to the field. Just click on her link for the February Q & A. We think her casual outline deserves wider notice.
Comp Benefits
Dr. Christian’s list begins with the effort to control indemnity losses. Over the past two decades, this effort has centered in state legislatures across the country. Once workers comp came onto the national radar screen, legislatures tried a variety of strategies to lower costs. These ranged from the highly successful Qualified Loss Management Program (QLMP) in Massachusetts, to Governor Schwarzenegger’s recent efforts in California (where a 10% rate reduction is finally in the offing). In the ongoing effort to cut costs, it’s always tempting to cut benefits, which many states have done. (We happen to believe that you control the costs of comp without cutting benefits — but that is fodder for another blog.)
Workers Comp and Medical Care
Dr. Christian looks at three areas related to medical care, not surprisingly, as she is Board Certified in occupational medicine. First, she thinks that vocational rehabilitation programs represent a missed opportunity in many instances. We agree. The problem may be in the current disconnect between the employer where the injury occurred and future employment. There should be a better way to tie voc rehab to real employment opportunities.
Dr. Christian next examines the need to speed up medical care, specifically, through the prudent use of nurse case managers. While recognizing the utility of nurse case management, she believes strongly that these services require more than just a conventional nursing background. The key is developing a strategy for every open claim — a strategy that maximizes the return-to-work probabilities.
In addition, Dr. Christian takes a very interesting look at her own profession. I especially enjoyed her laundry list of the ways doctors can be the problem: they can be incompetent, disorganized, enabling, erratic, inattentive, neglectful, inappropriate, corrupt, greedy and unethical. She singles out the “predatory physicians” who provide serial, unnecessary services to unsuspecting and often innocent workers. (This has been a huge problem in California.) Needless to add, she has much to say about the positive role of doctors in solving the disability problem.
“Delayed Recovery”
Finally, Dr. Christian focuses on what may be the single greatest cost driver in the entire workers compensation system: we often use the word “malingering,” — injured workers staying out of work longer than is medically necessary — but Dr. Christian has coined a more neutral and more compelling terminology: “delayed recovery.” Under delayed recovery, even though there is no medically necessary reason for people to be out of work, they do not return to work. These delays may stem from actions (or inactions) of the employee, the doctor, the employer or even the insurance carrier. And as injured workers drift on their own through the medical maze, they begin to lose their identity as workers. They often succumb to a “disability syndrome” and begin to believe that they are never going to be able to work again. Dr. Christian sees the need for a multi-disciplinary assessment, one that looks at more than just an injured body part. Through such an assessment, we can identify the people most at risk for delayed recovery and plan effective interventions so that the delays are minimized.
The Employer Role
Dr. Christian recognizes the importance of employer involvement, without which success in controlling losses will remain a distant goal. Educated employers know how to respond to injured workers. They secure first rate medical treatment and use temporary modified duty to accommodate medically necessary restrictions. Educated employers treat every injury with a sense of urgency, because they care about their people and because they understand the risks involved in a “delayed” recovery process.
Even though Dr. Christian’s brief paper is just the beginning of a working definition of disability management, there is plenty of food for thought for all of us. Every once in a while, we need to step back and refocus on the big picture. We need to redefine what we are trying to do in managing disabilities and the best ways for accomplishing our goals. Dr. Christian’s paper is an excellent starting point in this effort.

Older Workers Wanted: The Good News and the Bad

Wednesday, March 23rd, 2005

A feature article by Milt Freudenheim in the New York Times (registration required) touts new recruiting efforts by a number of nationally prominent companies to find older workers. In settings as varied as Borders bookstores, Home Depots, Pitney Bowes and Walmart, a serious effort is being made to lure people out of retirement by offering health benefits, flexible hours and computer training. Home Depot even offers a

Obesity and Workers Compensation

Tuesday, March 22nd, 2005

A little while back we blogged the conundrum of smokers, whose habit, while not illegal, does impact their over-all health and their ability to recover from injuries (whether work related or not). Today we