Lynch Ryan's weblog about workers' compensation, risk management, business insurance, workplace health & safety, occupational medicine, injured workers, insurance webtools & technology and related topics

November 29, 2004

DOL report on work-related multiple-fatality incidents

The Department of Labor's Monthly Labor Review features an 18-page report about work-related multiple-fatality incidents (pdf). While 9 out of every 10 work-related accidents that result in death involve a single fatality, between the study years of 1995 and 1999, 10 percent of the fatal events involved multiple deaths.

There were 1,109 incidents resulting in 2.949 deaths during the study years. Almost three quarters of these incidents involved two fatalities per event, but the nine worst catastrophes claimed a total of 266 workers’ lives. Nearly two-fifths of these multiple-fatality accidents involved transportation; homicides accounted for another one fifth of all such events.

The article presents side-by-side comparisons of by-exposure and by-industry data for multiple fatality events and all fatal events. This first-time study is an interesting way of viewing the data on fatalities because the data do not always track with the results for single-fatality events.

The data is not always what "conventional wisdom" might assume. Some workers that have a high proportion of overall fatalities, such as fishers and loggers, do not have a similarly high proportion of multiple-fatality events; other professions that might be expected to have a have a high proportion of multiple-fatality events, such as construction workers and miners, do not. While these occupations represent a high proportion of single-fatality incidents, they have a smaller proportion of multiple-fatality incidents. Yet while other occupations may have a low fatality rate overall, such as managerial and professional occupations, they have a significant proportion of multiple-fatality events when compared to overall fatalities for those professions. For example, the study reports:

"While managerial and professional specialty occupations account for one-ninth of overall occupational fatalities, they make up one-fifth of multiple-fatality transportation incidents and one-third of multiple-fatality homicides and suicides. For example, the legal profession, with a fatality rate a mere fraction of the overall rate, is very safe. Nevertheless, 14 multiple-fatality incidents involving 20 fatalities account for more than a quarter of the 74 work-related fatal injuries to lawyers, mainly air crashes in which workers in other occupations also died."

The report presents a snapshot of data from a different vantage, and as such, may be valuable to risk management and prevention efforts. The report concludes:

"First, multiple-fatality incidents occur in varying degrees in almost all event or exposure categories, but in some they make up larger or smaller shares of the category’s overall fatalities. Second, except in the case of murder-suicides, very rarely does the fatal event or exposure differ among the individual victims of the same multiple-fatality incident. Third, most multiple-fatality incidents involve workers in the same or similar industries and occupations. Finally, multiple-fatality incidents are a unique phenomenon: in most major respects, the fatal events or exposures underlying the circumstances under which they occur and the kinds of jobs in which they are most prevalent often do not reflect the fatal injury experience as a whole."

Posted by Julie Ferguson at 10:52 AM Link to, Comment (0), or E-mail this post
November 25, 2004

Thanksgiving and how to avoid too much of a good thing

Happy Thanksgiving to all our readers, particularly those for whom the day is business as usual - police, firefighters, healthcare workers, soldiers, waiters, cooks, utilities workers - for thousands of workers, it's just another day at the office. Hats off to all the workers who keep things running well and safely so the rest of us can enjoy the day!

Whether you’re working or relaxing, you may want to be on your guard. Conventional wisdom holds that turkey makes you tired, although a scientific explanation for post-feast drowsiness would lay the blame on the entire dinner rather than just the turkey. Too much of a good thing is common risk today so we offer a few tips on how to avoid overeating when you chow down on your Thanksgiving feast. But if you succumb to that extra piece of pumpkin pie and feel the ill effects later, you may want to learn more about heartburn.

Wherever you spend the day, take care in your travels. It's easy to be in too much of a hurry, to be distracted, or to have one too many drinks - be sure to drive safely.

Bon Appetit!

Posted by Julie Ferguson at 9:26 AM Link to, Comment (0), or E-mail this post
November 24, 2004

Here Comes the Judge!

Did you ever consider how easy it might be for a workers compensation judge to file claim after claim and even retire on workers compensation benefits? After all, who knows the ins and outs of compensability better than a judge? And who is in a better position to locate attorneys and doctors to support even the most dubious claim?

A fascinating article by John Hill and Dorothy Korber in the Sacramento Bee reveals that 15% of workers compensation judges in California have filed claims for workers compensation benefits. Workers comp judges in that legendary state are six times more likely to file claims than judges in other state departments. And in a number of these cases, the judges hired the same attorneys – and used the same doctors -- who appear regularly in their courts. In addition, the claims are ultimately heard before their colleagues on the bench!

One judge has tried for three years to achieve a 100% disability rating, based upon neurological problems involving his feet and hands. Of course, these problems primarily stem from his diabetes, but he has found a doctor to support his claim that the problems were triggered by his work as a judge.
In another situation, a retired judge has put in a claim for “focal hand dystonia” – otherwise known as writer’s cramp. I guess that years of hand drafting findings have resulted in permanent damage to his hand. (I suppose I should consider filing the same claim myself, even though I switched to a keyboard years ago…)

We are not suggesting that judges are immune from work-related injuries. However, we all have concerns if judges play “inside baseball” in the pursuit of marginal claims. When judges take advantage of their intricate knowledge of how workers compensation operates, and when they hire attorneys who appear before them to pursue their claims, public trust erodes. This compelling article raises a number of issues that bear contemplation, as we pick up the knife and fork to carve the Thanksgiving turkey.

Special thanks to our colleague Peter Rousmaniere for pointing the way to this article.

Posted by Jon Coppelman at 9:49 AM Link to, Comment (0), or E-mail this post
November 22, 2004

America's Cold War Energy Workers - Help on the way?

In late September, we wrote about the government's pitiful efforts to compensate workers who became ill after working in our atomic energy program during the cold war. In 2000, Congress had passed The Energy Employees Occupational Illness Compensation Program Act (EEOICPA).

We wrote about the cooperation required between the Energy Department (DOE), the Department of Labor (DOL) and the National Institute of Occupational Safety and Health (NIOSH) to make the program work.

After four years of failure by these departments to get compensation to deserving workers who had been made ill working on our nuclear energy program, the DOL seemed to have made progress, but the DOE just couldn't get out of its own way. Whatever the reasons, it was not getting the job done, and sick workers were paying for it.

Last month, Congress decided to use some common sense and did the right thing for the workers. It took responsibility away from the underperforming DOE and gave it to the DOL.

Congress also eased the criteria for qualifying for benefits; workers no longer have to have cancer to get paid; exposure to any hazardous substance now qualifies. Moreover, the payment process has been streamlined.

A comparison of DOE and DOL performance shows that this is a very good thing. In the four years of the program's history, DOE had managed to make payments of only $700 thousand, while DOL had paid out $937 million. Clearly, a change had to be made.

DOL will now decide if the employee's illness was caused by workplace toxins. And DOL officilas will determine the amount to be paid and see that payment is made.

We think that this is a good step and, as we wrote in September, perhaps our country can now get about the business of compensating the truly deserving among us.

Posted by Tom Lynch at 11:33 PM Link to, Comment (0), or E-mail this post

DuPont safety resources and preventable injuries

For years, DuPont has been a leader in workplace safety. They were the original "zero injury" culture, holding to a philosophy that all injuries are preventable.

The first and most basic safety principle at DuPont is that all injuries are preventable. This may seem a startling idea in the context of a lot of plant operations, but we have lived and worked with this core belief for more than 150 years. In fact, our performance demonstrates that this principle is workable. We have plants with more than 2,000 employees who have worked for more than 10 years without a lost time injury. That's injury prevention! We are able to prevent injuries because of the fundamental belief that injuries are, by their nature, preventable.

We agree with the concept of all injuries being preventable, and encourage organizations to build a zero-injury culture. Many companies promote a zero defect culture when it comes to product parts or processes - we think employee well being deserves the same quality commitment.

Why not take some lessons from the masters? DuPont Safety Resources is a site that offers a variety of articles and resources, as well as a free newsletter. And those of you who frequent Workers Comp Insider know that we have a soft spot for calculators and interactive tools. Try the Dupont Safety Calculator to estimate your organizations annual direct and indirect injury costs. There's also a Contractor Safety Assessment Form to help you assess how your organization is managing the increased risk associated with the use of contractors.

Posted by Julie Ferguson at 7:57 AM Link to, Comment (0), or E-mail this post
November 18, 2004

Prolonged PC use may cause glaucoma

Does heavy computer use increase the risk for glaucoma? Yes, according to a study by the University of Japan at Toho. The study was conducted with 10,000 office workers who are heavy computer users:

“… the researchers found that those who were short-sighted and sat in front of computer screens for long hours were at significantly higher risk of developing/having glaucoma - their chances of developing glaucoma were double (compared to non-computer screen watching people).

In the study, out of 500 short-sighted people who spent long hours in front of the computer screen, 350 either had glaucoma or showed symptoms for the onset of glaucoma.”

Glaucoma is a disease of the optic nerve that can cause blindness. It can progress rapidly before any symptoms are evident. People who have risk factors for developing glaucoma should be tested regularly. Are risk managers paying enough attention to eyestrain and eye safety when it comes to office workers? Does your firm have an "eye ergonomics" program? Here are some online resources to get you strated.

Vision Health Management: Visual Ergonomics in the Workplace
10 tips for avoiding eyestrain
A dozen things you should know about eyestrain
CCOHS: Eye discomfort in the workplace
NIH: Eye exercises and stretches
BBC: Eye problems
OSHA: computer monitors

Posted by Julie Ferguson at 8:48 AM Link to, Comment (1), or E-mail this post
November 16, 2004

When Injured Workers Meet Tired Doctors

Yesterday's posting on the impact of fatigue on medical treatment raises some interesting issues for workers compensation. The first line of defense for injured employees is the emergency room. You don't need an appointment. It's open 24/7. No injury is too severe or, for that matter, too minor. Supervisors routinely send injured employees to the nearest emergency room for treatment. That makes sense, doesn't it?

But what happens if the doctor examining your employee has been up for 24 hours? How accurate is the diagnosis? How competent is the treatment provided? How alert is the doctor to nuances that might ultimately determine whether the course of treatment results in rapid recovery or a period of prolonged disability?

Beyond that, what kind of a mood would a sleep-deprived doctor be in? Would this doctor treat your employee with patience and respect, or might he or she possibly alienate the employee simply by being in a bad mood brought on by a lack of sleep?

LynchRyan tries to place employers in the best possible position to manage workers compensation costs. We train employers to take charge of injured employees from the moment of injury, through initial and follow up treatment, through the prudent use of modified duty up to full recovery. This is a great system, but it's dependent upon the provision of excellent medical care.

Which brings us back to the emergency room as the first line of defense. We are not suggesting that emergency rooms be avoided. We do recommend, however, that supervisors meet face to face with injured employees as soon as feasible after initial treatment. The supervisor should make sure that the employee is confident in the quality of medical treatment. If there is any question about the emergency services provided or the diagnosis itself, the supervisor should set up a follow up appointment with an occupational specialist - a specialist who in all likelihood will have benefited from something we all need -- a good night's sleep.

Posted by Jon Coppelman at 10:14 AM Link to, Comment (0), or E-mail this post
November 15, 2004

Interns' Medical Errors Affected by Work Schedules

Insurance Journal reports on a study in the October 28, 2004, issue of the New England Journal of Medicine on the link between medical intern work schedules and medical errors. Surprisingly to me, the Brigham and Young research is one of the first studies of its kind, and while the study focuses on patient safety, it is but a short step to think of the implications of sleep deprivation for self injury, as well. The study reports:

The rate of serious medical errors committed by first-year doctors in training in two intensive care units (ICUs) at a Boston hospital fell significantly when traditional 30-hour-in-a-row extended work shifts were eliminated and when interns' continuous work schedule was limited to 16 hours, according to two complementary studies funded by the National Institute for Occupational Safety and Health (NIOSH) and the Agency for Healthcare Research (AHRQ).

Interns made 36 percent more serious medical errors, including five times as many serious diagnostic errors, on the traditional schedule than on an intervention schedule that limited scheduled work shifts to 16 hours and reduced scheduled weekly work from approximately 80 hours to 63. The rate of serious medication errors was 21 percent greater on the traditional schedule than on the new schedule.

It would almost seem to be a no-brainer to link extended work hours to mistakes, stress, and self-injury - yet extened hours have been a time-honored and accepted practice in the medical field.

Here are more resources on extended hours in the medical profession:

NIOSH aggregates 52 research reports in a 50-page booklet entitled Overtime and Extended Work Shifts: Recent Findings on Illnesses, Injuries, and Health Behaviors (PDF). For additional research, visit the Harvard Work Hours and Health Study site with links to studies and educational materials regarding extended hours and sleepiness. It is also a place for medical personnel to report medical errors, needlestick injuries, and motor vehicle crash incidents related to sleep deprivation or long work hours.

Posted by Julie Ferguson at 8:44 AM Link to, Comment (0), or E-mail this post
November 10, 2004

Are older workers at greater risk for specific injuries?

The Ohio Bureau of Workers Compensation has published an interesting paper on the relationship between age and injury. We are all aware that many people are working longer and retiring later. Does this put employers at risk for higher workers compensation costs for their aging workforce? Are there specific injuries that occur to workers as they get older? The Ohio study, backed up by research from the Workers Compensation Research Institute, does not project significantly higher costs for workers comp due to the aging workforce. But a close look at the numbers reveals areas of concern.

The Ohio study of claims between 1998 and 2002 reveals intriguing differences between the injuries of younger and older workers. Younger workers are injured more often, with the predominant injuries involving lower back strains. If frequency is greater among younger workers, severity increases with age. This is pretty much what you would expect. It simply takes longer for an older worker to recover full function after an injury, and for many workers who have spent decades performing physically demanding work, returning to productive employment may prove very difficult indeed..

There are a couple of findings in the study that are truly compelling. The primary cost driver for both younger and older workers is lower back strain. However, the number one injury in terms of indemnity cost for workers between the ages of 50 and 70 is rotator cuff sprain. Among younger workers, rotator cuff sprains are not even in the top 10. There is also a higher rate of knee injuries (degenerated meniscus) among the older workers.

The study recommends that employers take steps to ensure that the tasks performed by older workers are limited to the area “between mid thigh and mid chest.” The study recommends that older workers avoid frequent bending and lifting, to limit pressure on the knees. They also recommend that older workers avoid work that is above the shoulder. Indeed, it may well be that frequent reaching above the shoulder is a key factor in the relatively high incidence of rotator cuff problems among older workers.

There are no easy answers here. Savvy managers always keep a close eye on the way basic work is performed. They should pay particular attention to the stresses and strains on older workers as they move through the work day. If your older workers are bending and reaching frequently, especially reaching above the shoulder, there is cause for immediate concern.

Posted by Jon Coppelman at 12:59 PM Link to, Comment (0), or E-mail this post
November 8, 2004

Health & safety resources from Canada

Most U.S. risk managers and health & safety staff are no doubt familiar with the many online prevention resources available at OSHA, but some may be less familiar with resources available from our neighbors to the north. Canada's Center for Occupational Heath & Safety (CCOHS) is available in English, French, and Spanish - an invaluable resource for employers with a multi-lingual work force. It's a vast site - one of the most useful sections can be found at OSH Answers, topic-specific health & safety information.

The Workers' Compensation Board of British Coolumbia also provides a wealth of resources at its online Health & Safety Center. The site includes in-depth resources for a variety of specific industries ranging form heavy industries like forestry and petroleum to lighter industries like performing arts and tourism. In addition, the site features free downloadable stickers and hazard alert posters. I'm always partial to interactive *toys* so I found the push, pull, carry and the what does an accident really cost calculators rather intriguing.

Posted by Julie Ferguson at 11:43 PM Link to, Comment (0), or E-mail this post
November 7, 2004

Environment, health & safety benchmark survey

Wondering how your health & safety department compares with those in other organizations? An environemnt, health & safety (EHS) benchmarks survey, recently released by the Bureau of National Affairs reports on a number of trends, including salaries, outsourcing trends, budgets and expenditures, and areas of responsibilities. The survey was conducted in conjunction with the National Association for Environmental Management. A free report on the EHS survey highlights is available in PDF. Among the findings:

  • More than half the EHS managers will have earnings of between $70,000 and $101,000 in 2004
  • There is about one EHS staffer for every 300 employees in the work force
  • The per worker median budgeted expenditure was $268, with roughly half of the respondents indicating projected outlays of $106 to $790 per employee.
  • Nearly 6 out of 10 respondents reported responsibility for EPA compliance, but fewer reported responsibility for OSHA compliance; nearly 25% reported that they had no responsibility for OSHA compliance.

Posted by Julie Ferguson at 11:30 AM Link to, Comment (0), or E-mail this post
November 5, 2004

More on the ADA

Michael Fox from Jottings by an Employer's Lawyer points us to a useful resource from the EEOC: How to Comply with the Americans with Disabilities Act: A Guide for Restaurants and Other Food Service Employers. And if ADA compliance has slipped off your radar screen lately, you may want to read Michael's report about a recent $1.3 million jury judgment in a Louisiana disability case which involved the ADA.

And speaking of the ADA, Rafael Gely at LaborProf Blog pointed us to the National Bureau of Economic Research's Digest. The current issue of the Digest features an article entitled Did the ADA Reduce Employment of the Disabled? This study refutes the notion that declines in employment of the disabled in the 1990s is related to the ADA as has been suggested:

"Jolls and Prescott infer that, apart from a short-term effect of the ADA's requirement of special accommodations, the ADA was not causally linked to declining disabled employment over much of the 1990s. This conclusion, based on the relative effects of the ADA across states with different pre-ADA state-level regimes, stands in contrast to recent empirical work using national-level data. In light of their findings, Jolls and Prescott conclude that that the apparent negative employment effect of the ADA through much of the 1990s plausibly reflects not the impact of the ADA itself, but rather other contemporaneous changes disproportionately affecting individuals with disabilities."

Posted by Julie Ferguson at 1:16 AM Link to, Comment (0), or E-mail this post
November 4, 2004

Middle Manager Discriminates, Senior Managers Pay

Can senior managers be held liable if a middle manager lies about the reasons for terminating an employee? You bet they can. In a recent federal case outlined in the Boston Globe, a court awarded $827,000 to a 62 year old former branch manager at Hertz Equipment Rental Corp. The fired manager had transformed a money-losing branch to profitability, but was fired by senior managers for “gross misconduct,” based upon the recommendation of a middle manager. [NOTE: The full Circuit Court of Appeals ruling reveals a more complicated situation than that described in the news article. Read the ruling here.]

The firing involved basic operations and equipment maintenance. Senior managers said they fired the employee, who happened to be their oldest manager by several decades, because he failed to have some crane equipment painted in accordance with the regular maintenance schedule. However, the employee’s direct supervisor did not tell the executives the reasons they weren't painted: The equipment was rented out to customers and couldn’t be painted at the time. Indeed, the middle manager and the fired employee discussed the issue and agreed that the painting could wait until the equipment was returned.

This is a situation where the intention to discriminate apparently resided only with the middle manager, not with the senior managers. The detailed ruling reveals that senior managers thought the termination was based solely upon inadequate performance; they had no awareness of the age bias of the middle manager.

According to the article, the decision was significant because it effectively held the employer liable for what top executives did not know, underscoring the basic principle that employers are responsible for what takes place in the workplace.

From the LynchRyan perspective, there is no greater asset in a company than a positive work culture. Managers should treat subordinates well, regardless of age or other circumstances. These same managers need to be straight with senior management. Every termination is full of risk. If you hold the pen, review the situation in detail and make sure that your action is backed up by documented facts. You don’t want to wind up in a courtroom where the expense of lawyers and the time consuming reconstruction of events means that win, lose or draw, you lose.

Posted by Jon Coppelman at 9:31 AM Link to, Comment (0), or E-mail this post
November 3, 2004

Workers compensation state News Roundup OR, AZ, MO

Oregon: Attempt to dismantle SAIF defeated
Voters cast a resounding no vote on Measure 38, a proposal to dismantle SAIF Corp.
The high-profile campaign to abolish SAIF Corp., the state-owned worker's compensation insurer, was failing by a wide margin in early election returns. Liberty Northwest, the private insurer that bankrolled the campaign, conceded that Measure 38 was doomed in a written statement issued shortly after 8 p.m. Tuesday.


Arizona: WCRI profiles workers comp system

The Workers Compensation Research Institute recently issued a profile of the Arizona workers compensation system.
... notable features of Arizona's workers' compensation system included a lifetime entitlement to medical and indemnity benefits - payments to replace lost wages - and the active role of the state agency in educating and assisting system participants and reducing litigation.
However, injured workers were subject to some of the lowest weekly benefit levels in the country.

Missouri: Rate of increase declines for Missouri workers' comp premiums
Safer workplaces appear to be slowing the premium increases for workers' compensation insurance in Missouri, Department of Insurance Director Scott Lakin said Wednesday.
Based on rate changes for this year filed by 206 insurers, the overall market rate has increased 2 percent this year, compared with 15 percent last year, Lakin said in a written release.

Posted by Julie Ferguson at 10:02 AM Link to, Comment (0), or E-mail this post