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NEWSLETTERS
NEWSLETTERS
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561-683-8383
February 2009 |
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In this issue
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Large Scaffolding Company Embraces Change |
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Ten Costly Return-to-Work Mistakes in 2009 |
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Poor health drives trucker injuries
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Large Scaffolding Company Embraces Change
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Insured
The scaffolding company employs over 50 people with locations in two states.
Situation
The company experienced a substantial increase in claims activity in one year, going from $45,039 to $107,606. The majority of these claims were longstanding and many proved to be fraudulent in nature. The company hired an external risk management firm and paid a significant amount of money in fees with few results.
Assessment
CWCAs met with the management team. The company had no formal injury management program. Fraudulent claims were rampant throughout the organization. Employees were hired on good faith or referral without any pre-screening measures; often hired for jobs for which they were not physically qualified. There was no relationship with a medical facility for treatment of injuries. Employees were kept out of work until they could perform their job at full duty. There was no one person in the organization responsible for claims or hiring.
Solution
The CWCAs immediately implemented an injury management program, working to close outstanding claims and mitigate any damages. They established a sound pre-employment screening process, including conditional offers of employment, physicals and CORI checks. The CWCAs worked with the company to develop a relationship with a local occupational health facility to manage all pre-employment screenings and workers compensation injuries. The occupational health facility performed worksite visits to develop a customized physical to ensure the company was hiring the right employees for the job. To reduce indemnity claims and return injured employees to full duty as soon as possible, a Back-on-the-Job program was established. A newly formed in-house injury management team supervises program implementation.
Result
By controlling costs, the CWCAs were able to reduce reserves by $103,000. Claims were reduced by 35% in one year. Furthermore, the CWCAs found five recoveries not properly recorded by the insurance company, resulting in a 2-point Mod reduction and a 2-point ARAP reduction. In making sound hiring choices, the company was able to do more work with fewer people. Through the pre-hire screenings, the company has eliminated a handful of prospective employees who either could not meet the physical requirements of the position or who were scared away by the process. The Back-on-the-Job program is so successful they have extended it to all non-work-related injuries as well. With the creation of the injury management team, the company is better able to manage injuries, has reorganized and reassigned a number of employees to more appropriate positions, and has hired a fulltime safety manager.
In addition to these costs savings, they have opportunities to bid on much better jobs because of all their efforts.
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Ten Costly Return-to-Work Mistakes in 2009
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The deepening recession coupled with the sweeping changes in the newly enacted ADA Amendments Act (ADAAA) and the Family and Medical Leave Act (FMLA), have changed the economic and legal landscape in 2009. As the news continues to bring announcements of mass layoffs and weakening financial conditions, returning injured employees to work might not seem like a priority. Yet it has become more important than ever to have a strong Return-to-Work (RTW) focus.
Here are ten mistakes in RTW that could cost you in 2009. While some are the same as previous years, several are new reflecting the ADAAA and FMLA changes.
1. Failure to recognize the increase in number of employees covered by the ADAAA
For employers covered by the ADAAA (those who have 15 or more employees), more employees will satisfy the definition of disability and be entitled to reasonable accommodations, including those employees who have suffered on-the-job injuries. Employers covered by the ADAAA must make disability determinations without consideration of mitigating measures such as medication, hearing aids and assistive technology.
The ADAAAs stated goal is to shift the focus from whether an employee is disabled to whether employers are complying with their obligations under the law. When faced with litigation, employers, in many cases, will no longer be able to argue over whether the worker is covered by the ADA. Employers will need to have an interactive process with disabled workers, wherein the employer discusses with the workers the reasonable accommodations that will allow them to perform their essential job duties. They will need to make sure managers know their obligations to provide reasonable accommodations and do not reject requests without appropriate analysis.
As a federal law, the ADA supersedes state Workers Compensation laws, and therefore, its directives provide the floor level protection for disabled individuals. State Workers Compensation laws can provide more protection, but not less.
Properly structured, RTW programs can decrease the ADA exposure.
2. Insist employees be released to full duty before returning to work
Considerable evidence exists about the value of RTW programs that provide a means for employees to transition back into their full duty jobs with responsibilities and tasks modified for short periods of time. Insisting on a return to full duty increases Workers Comp costs and heightens the possibility that the injured employee will fall prey to a disability syndrome the failure to return to work when it is medically possible.
For employers covered by the ADAAA the criterion is the essential functions of the job. Not all job functions are essential. Courts consider job descriptions and performance evaluations in determining what functions are essential to a job. Employers should review and update these documents to ensure that the essential functions for each position are accurately described.
3. Cut the budget for RTW
Employers seeking to cut expenses may target RTW programs. Yet, cutting or delaying such programs can result in higher costs both now and in the future. The longer an employee is out on injury leave, the higher the cost, adversely affecting claim reserves and ultimately the Experience Modification Factor as well as increasing the likelihood of litigation.
Furthermore with todays sharply reduced workforces, employees are often working beyond full capacity and cannot absorb the excess work of an absent co-worker. A troubling message is sent to valued employees, both injured and healthy, damaging an already vulnerable morale.
4. Believe that RTW can not address musculoskeletal injuries such as back pain
Low back pain is the most prevalent and most costly work-related condition, yet only a small fraction of workers with acute back pain progress to chronic disability. A recent study concluded that workers who were not offered an accommodation such as light duty or reduced hours to facilitate the return to work in the first three weeks were almost twice as likely to develop a chronic disability. These findings suggest that employer offer of accommodations to facilitate working in the first few weeks after injury may play an important role in chronic disability prevention.
5. Be deterred from setting up transitional assignments because the employee may get hurt again
Employer and employee fear of re-injury often hampers RTW efforts. This of course is a risk, but an even greater risk is having the employee stay at home and develop a disability attitude that extends the absence and drives up costs. Explain why it is important to return to work and the steps that are being taken to ensure the employees safety. Be sure job assignments meet the medical restrictions set by the treating physician and stay in touch with the employees as to their comfort level with the assignment.
6. Dont distinguish light duty from transitional work from reasonable accommodation
RTW assignments are best described as transitional tasks. Limited in duration such tasks help the injured worker return to full productivity by being progressively adjusted in line with medically documented changes in the employees ability. Under the ADAAA, it is permissible for an employer to reserve light-duty jobs for those with work-related disabilities and these jobs should be distinct from transitional tasks. The ADAAA also stipulates that reasonable accommodations include, but are not limited to making existing facilities used by employees readily accessible, job restructuring, part-time or modified work schedules, reassignment to a vacant position, acquisition or modification of equipment or devices, appropriate adjustment or modifications of examinations, training materials or policies, the provision of qualified readers or interpreters, and other similar accommodations for individuals with disabilities.
7. Rely on the physician to guide the RTW process
While physicians are medical experts they do not have essential information about workplace policies, job demands and the availability of transitional work. Moreover, if a physicians training is not specifically in the treatment of occupational injuries they may not adhere to evidence-based guidelines. The employer must be proactive and take the lead role with both the physician and the injured worker.
8. Dont understand the laws governing mandatory comprehensive medical exams before returning to work
This is one of the most confusing aspects of RTW with the ADAAA, the FMLA and state Workers Compensation laws having different and sometimes conflicting requirements. Understanding the laws and how they apply to your specific circumstance is critical.
9. Dont establish consequences for failure to comply with RTW requirements
Whats important here is to understand the difference between disciplining and cutting off benefits. If an employee is covered by the FMLA and cannot perform one or more of the essential functions of his or her job, that employee may refuse transitional assignments and take FMLA leave. However, the FMLA only creates an entitlement to unpaid leave, and therefore, in most cases, the Workers Compensation indemnity payments may discontinue with the refusal to return to work. The employee retains the right to reinstatement to the position held when FMLA leave was taken.
10. Believe Workers Compensation settlements resolve ADA liabilities
Under the ADAA, more injured employees will qualify as "Qualified Individual with a Disability" and as such can assert their right under the ADA to a reasonable accommodation, irrespective of any Workers' Compensation settlement. During settlement negotiations, close coordination is necessary between the company's legal, risk management, and HR departments to ensure that each office is able to accomplish its mandate without compromising the employee's rights. |
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Poor health drives trucker injuries
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According to the large Truck Crash Causation Study 2006 report, which analyzes multi-year data of a large number of crashes involving trucks, 88% of the critical reasons for accidents are attributed to drivers as opposed to vehicle failure, weather and other conditions. And of that number, 15% fell into the category of non-performance issues such as drivers falling asleep, having a heart attack, or being disabled by some other physical impairment.
Why the high number of non-performance incidents? According to a recent Associated Press story by Emily Fredrix, the answer is quite simpletruckers are too fat, eat badly, dont exercise regularly, smoke too much and dont get enough sleep. The result: truck drivers account for 15% of the nations work-related deaths, and she cites poor health as a major factor.
"As many as half of drivers are regular smokers, compared to about one-fifth of all Americans, writes Fredrix. Many truckers are obese, and only about one in 10 get regular aerobic exercise ... Sleep apnea, which is linked to obesity, is rampant too. An industry study a few years ago found 28% of drivers had it; that compares with about 4% in the general population who have the disorder."
Along with being a danger on the road, many truckers have become a danger to themselves. According to a report by OSHA, strains, sprains and various other muscular-skeletal injuries make up 50% of all common trucker injuries, ranging from off-loading cargo to the simple act of stepping in and out of the cab.
Exacerbating the problem are companies that lack a program for injured drivers to receive proper medical treatment from an experienced occupational medicine professional. Also absent is a well-thought-out return-to-work or modified duty plan.
According to one experts report, only one out of every three back injuries is receiving proper medical treatment. Treatment is being administered differently in various parts of the country, instead of a national observance of the evidenced-based guidelines as set forth by the American College of Occupational and Environmental Medicine or others. With proper treatment of muscular-skeletal injuries not only does the driver benefit but also the employers, who can ill afford to lose experienced workers.
More than any other industry, the trucking industry, because of the physical unfitness of its employees, has an adverse impact on Workers Compensation costs. The result is more truckers going out on medical leave, or leaving the industry early due to their injuries. This doesnt bode well for an industry that has few young people waiting in the wings.
Ultimately, the burden falls on the employer to be more pro-active in taking part in the wellness of their drivers, to make sure they get proper medical treatment and to help keep their drivers in shape. To their credit, many employers are taking the initiative and implementing work-based wellness programs that include screenings for such issues as sleep apnea, high-cholesterol and high-blood pressure monitoring, and weight-loss programs. According to one survey, the result has been a very favorable ROI resulting in a drop in Workers Compensation claims.
The results often speak for themselves. Con-Way Freight of Ann Arbor, Michigan experienced a 75-80% reduction in lost workdays after it implemented a wellness program. Other experts cite a $3.14 return for every $1.00 invested in a well-executed wellness program.
There can be no denying that the trucking industry keeps the nation moving. This can never be overlooked, nor should it be. But when drivers are out for an extended medical leave and cant fulfill their duties because they fell asleep at the wheel and had an accident, or are injured in a crash because they cant get the seat belt around their middle or have a stroke because of one too many fast-food stops, then no one wins. Not the customer, not the employer, and certainly not the driver.
Being cognizant of the physical health of the trucker should be of major importance to every employer. We cant always control the danger thats outside the cab, but with the proper medical strategy in place to assist the driver in maintaining good health and keeping him on the job, we can control that potential danger prevalent inside the cab.
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