According to the Bureau of Labor Statistics, 5,190 people – more than 14 a day – died while doing their jobs in 2016. And, for every worker lost, countless loved ones, co-workers and friends are affected.
For more than 100 years, the National Safety Council has been a leader in workplace safety, and we believe we can eliminate preventable deaths in our lifetime. Workers’ Memorial Day on April 28 reminds us that we still have a long way to go. Despite all the advances that have been made in safety, for the first time in nearly a decade, workplace deaths have surpassed 5,000.
For more than 100 years, the National Safety Council has been a leader in workplace safety. We know that employers who show they care about the safety of their employees see improved morale, increased productivity, lower costs and, most importantly, fewer injuries.
The OSHA-NSC Alliance
The OSHA-NSC Alliance agreement aims to prevent workplace injuries, deaths and illnesses. As part of the agreement, OSHA and NSC partner to:
Develop compliance assistance tools and best practice documents
Convene, participate and exhibit at occupational safety and health forums and stakeholder meetings
Collaborate with other OSHA Alliance participants to address specific safety topics
Support and promote the Journey to Safety Excellence Campaign
10:00 in the morning is an expensive time of day for many organizations. There is a spike in injury frequency in the service/hospitality, construction/natural resources and healthcare industries, according to Pinnacol Assurance. The Colorado workers’ compensation insurer released trends based on five years of its claims data in four industries. The results can help employers in the industries take positive steps toward improved workers’ comp injury prevention.
Injury Frequency. While many injuries occur to newly hired workers, some industries were noteworthy for other spikes in injury frequency
Healthcare – 3 – 4 years after the hire date
Clerical/professional – more than 10 years after the hiring date
Also, in healthcare, 38% of injuries happen during the first year on the job, whether the worker is new to the organization OR new to the industry.
Danger Zone Times. A drop in blood sugar levels is speculated as a reason
for the increase in injuries at 10 a.m. in several industries. Additional times of frequency spikes include:
Service Hospitality: 9 p.m. saw a spike in the most expensive injuries
Clerical/professional: 8 – 11 a.m., with a significant spike at 2:00
Vulnerable Body Parts. The lower back is the most commonly injured body part in both the professional/clerical and construction/natural resources fields. It’s also the most expensive location for injuries in construction/natural resources. Other commonly injured and/or expensive body parts injured include
Service/hospitality: fingers, hands and lower back are most commonly injured. Lacerations, contusions, strains, sprains, and burns are the most expensive injuries.
Construction/natural resources: lower back, knee, foot, lower leg, and fingers are the most expensive body parts injured.
Healthcare: lower back, shoulder, knee, wrist, and ankle are the most expensive. Strains, strikes (needlesticks) and strains (lifting/carrying) are the most frequent causes of injuries, while animals are number 8 on the list of causes, due to home health care incidents.
Clerical/professional: lower back, knee, fingers, shoulder and wrist are the most commonly injured body parts. The most expensive injury types are contusions, strains, sprains, fractures and The most frequent causes of injures are strains from lifting, falls from ice/snow, falls on the same level, repetitive motion, and motor vehicle incidents.
“There is no such thing as an FDA-approved compound medication.” That statement from myMatrixx Chief Clinical Officer Phil Walls underscores one of the main criticisms of these medications; while the drugs within the mixtures may all be FDA-approved, the specific combinations have not been tested and verified.
Safety is just one concern, however. The other is cost; they generally are priced significantly higher than similar, FDA-approved drugs or the sum of their underlying medications.
Both the utilization and the average cost of compounded medications in the workers’ compensation system has decreased in recent years. However, there are still pockets of excessive use. Stakeholders need to maintain a steady and continued focus on efforts to curb the unnecessary use of these pharmaceuticals.
Compounds are a mixture of drugs intended for a specific patient’s use. According to an FDA report, they are beneficial only in limited circumstances; such as when other medications have failed, a patient is allergic to some of the inactive ingredients or has difficulty swallowing.
The federal agency inspected compounding facilities and noted the following “troubling conditions” that could lead to widespread harm of patients:
Toaster ovens used for sterilization.
Pet beds near sterile compounding areas.
Operators are handling sterile drug products with exposed skin, which sheds particles and bacteria, among many others.
Compounded medications are not considered first-line therapy for pain or other common conditions of injured workers according to industry guidelines, such as evidence-based medicine guidelines from Work Loss Data Institute, American College of Occupational and Environmental Medicine, and many other state-specific guidelines.
Compounds are available in many applications but are used in workers’ compensation most often as topical products for pain management. Usually, compounded medications are excluded from workers’ compensation formularies, and require prior authorization before they are dispensed to an injured worker.
An important role of the claims management team is to coordinate with employers and defense interests to make sure quickly reporting workplace injuries is a top priority of your organization. It is easier for claims to be evaluated and decisions regarding primary liability to be made in an effective and efficient manner when injuries are quickly reported. There are many steps claims management teams can make to develop important work injury compliance steps, which includes the use of evolving technology.
Emphasis the Importance of Reporting Workplace Injuries
There are several steps that employers can make to ensure workers’ compensation claims are reported in a timely manner. This starts with developing a culture of understanding on the part of the employees. This goes beyond making sure the proper posters are displayed in the workplace:
Provide documentation on how work injuries should be reported and the information needed to make a report of injury; an
Ensure that the employer has a contact person to make sure the First Report of Injury is filed timely with the workers’ compensation insurer. In some instances, employers and their staff are unsure how the process generally works. Making sure these persons understand the process is important.
All workers’ compensation insurance carriers and third-party administrators can provide information to their insured on these processes.
An estimated 16 million workers use workers’ compensation (WC) insurance annually in California. Many recent policy changes might have affected access to care for injured workers. For this report, the authors assess the various dimensions of access to care in the evolving policy environment to ensure that injured workers have adequate access to needed medical care and the opportunity to achieve better health outcomes. Access to care is an important domain to monitor, especially among vulnerable populations, as patients with better access to care systems are more likely to receive comprehensive, higher-quality care and are therefore more likely to experience better outcomes.
The key objective of this report is to describe access to medical care among injured workers in the state of California, as mandated by Labor Code Section 5307.2. The authors analyze administrative and medical service bill data to examine changes over time for measures related to access to care for injured workers. The authors aim to highlight potential access-to-care barriers in the WC system and to understand whether changes in the WC system may be increasing access for injured workers.
Overall, there were increases in claims, bill lines, and spending per provider. Although these increases were moderate to large in number, many of the differences were not statistically significant. These results suggest a concentration of treatment for injured workers, in which a relatively smaller number of providers furnished care to injured workers. Increasing concentration could offer opportunities for specialization in the treatment of work-related injuries. On the other hand, increasing concentration could lead to future access barriers related to scheduling.
Fewer providers provided care to California WC patients in 2014 than in 2010.
The specialties with the largest declines from 2010 to 2014 in WC-participating providers were family medicine/general practice, chiropractic medicine, and pharmacy providers. Most other specialties were relatively stable.
Over the same period, there was an increase in the number of WC injuries.
Utilization and payments per provider
The average number of claims per provider increased from 2010 to 2014.
Payments per provider increased by $8,813, on average, from 2010 to 2014.
The observed increases in average claims per provider, bill lines per provider, and payments per provider were likely driven by changes in very large practices or health systems treating many injured workers.
You are all probably aware of many of the standard strategies that can be employed to ensure timely return to work during and after recovery from an occupational injury or illness.
Technology Can Make Return to Work More Efficient
But are there any newer technologies and approaches that can facilitate this process to make it more effective and expedited?
In a previous article, I discussed the critical need for an advanced form of “job description,” which we refer to as a digital job profile (DJP) containing a comprehensive physical demands analysis(PDA). It bears repeating that the digital job profile is the cornerstone to understanding the explicit, quantitative demands of a job, and is utilized by all stakeholders in the claim management continuum. How can we return an individual to modified or full duty without knowing exactly what the job requirements are?
Psychological Component Can Play Greater Role Than Biological
Many of you are aware of the biopsychosocial model of injury or illness. In short, this is the recognition that non-physical factors highly impact functional restoration. In fact, many experts feel that the psychosocial components play a greater role than biological ones. You have undoubtedly noticed that the same type of injury may be devastating to one individual, while a more resilient person easily overcomes it. It is extremely helpful to predict whether your claimant is likely to be in the former or latter category. If the claimant is fragile from a psychosocial perspective, many mitigation strategies can be employed to prevent the delayed return to work/life activities that inevitably accompanies these comorbidities.
Fortunately, there are automated, online screening tools available that allow you to enter claimant responses to a brief series of questions, and provide you with an immediate, calculated psychosocial risk level (high, medium, low). These validated tools may also recommend various interventions derived from the response pattern of claimants to the questionnaire. Some folks will benefit from cognitive behavior therapy, and others from family counseling, vocational guidance or psychiatric assessment. Risk screening helps to identify the level of risk, as well as appropriate strategies to help individuals better cope with the added stress of an injury or illness.
If you or a loved one has ever been hurt or sick, you know well that healthcare and insurance systems are complicated; the challenges can seem endless and overwhelming.
Health navigation helps individuals and companies through these challenges. It includes clinical services, of course, but it’s much more than that. Knowing what services are needed, where to get them, and in what timeframe are critical elements to getting on the right path to recovery.
Fundamental Premise of Health Navigation
People can’t always tell at the onset how serious an injury or illness is. So, sometimes they go to an ER when they could have gone to a doctor’s office, or they go to a doctor’s office when they could have cared for themselves. Other times people underestimate or don’t recognize symptoms, and look back wishing they had realized how serious something really was – this regret can make them more likely to overreact the next time they are confronted with a health concern.
The fundamental premise of health navigation is getting people the care they need when and where they need it, which removes burdensome guesswork. A best-in-class health navigation provider should:
Have clinicians which navigate people to the right level of care at the right time, in the right place.
Have systems to help people determine the severity of each case and the best course of action for treatment.
Provide the needed care or guide patients in self-care whenever possible.
Make a referral when further care is required
People know overtreatments and over prescribing exist, but they don’t know how to tell when it is happening to them. What’s the best practice?
A combination of ibuprofen and acetaminophen does a better job of relieving acute pain than opioids. Despite clear evidence that the combination of the less dangerous medications provides equal or greater pain relief, many physicians still prescribe opioids for injured workers with pain.
This statement was just one point made in a recent session at the Workers’ Compensation Institute’s Annual Conference in Orlando presented by:
Marcos A. Iglesias, Chief Medical Officer of Broadspire
Mark Pew, senior VP for Product Development & Marketing at Preferred Medical.
The opioid epidemic in the U.S. has been well documented in recent years. Researchers say Americans consume more opioids than any other country, regardless of the myriad physical and psychological problems associated with their unnecessary use.
While stakeholders in the workers’ compensation system have made progress in curbing the unnecessary use of opioids in recent years, it will take a concerted effort of educating providers as well as employees about chronic pain, and effective treatment alternatives said Iglesias and Pew.
Findings released by the Society for Internal Medicine on a one-year comparison of patients with chronic low back pain who were treated with either opioids or ibuprofen included:
No difference in function
Those given opioids had statistically worse pain control
Shoulder pain is one the most common musculoskeletal problems in workers’ compensation, second only to low back pain. In fact, it is even more prevalent in some industries. Like low back pain, shoulder pain has been shown to respond well to conservative care, especially physically therapy.
Strenuous work, including heavy lifting over a long period of time, carrying, pulling, or pushing can cause shoulder pain and problems. The type of repetitive overhead arm motion that warehouse workers, flight attendants and construction workers perform also contributes to shoulder issues.
Symptoms include pain at rest and when lifting and lowering the arm or with specific movements. Some patients feel weakness when lifting or rotating the shoulder or experience a crackling sensation when moving the shoulder in certain positions. Limited range of motion and/or pain associated with internal and external rotation and forward flexion can indicate a partial thickness tear of the rotator cuff. Another symptom is painful abduction, which is the movement away from the median plane of the body. Full-thickness tears are indicated by weakness of external rotation and abduction.
Until recently, surgery was the common approach to rotator cuff tears and similar shoulder injuries. Now, guided by research, clinicians are adopting more conservative methods. This usually involves a combination of physical therapy and temporarily modifying activity, such as avoiding heavy lifting or sustained overhead use of the arms.
If the hard hat has sustained an impact, dispose of it immediately, even if the damage is not visible.
By Don Rust
Protecting employees from potential head injuries is a key element of a safety program in virtually all industries. The primary reasons for an organization to require hard hats in the work environment is to help protect employees from head trauma from objects falling from above; bumping into fixed objects, such as pipes or beams; or contact with electrical hazards. Head protection also can serve to help protect employees from splashes, rain, high heat, and exposure to ultraviolet light.
In this article, we will discuss many of the frequently asked questions related to hard hats.
When Is a Hard Hat Required?
OSHA requires, in 29 CFR 1910.135, that if the following hazardous conditions are present, then head protection is required:
Objects might fall from above and strike employees on the head
There is potential for employees to bump their heads against fixed objects, such as exposed pipes or beams
There is a possibility of accidental head contact with electrical hazards
Other countries or organizations may have additional requirements, but most regulations are hazard based and start with a thorough workplace hazard assessment.
What Industry Standard or Approval Do Hard Hats Need?
This can vary by country or global region because there are various standards in place. In North America, the current standards are the American National Standards Institute (ANSI) Standard for Head Protection, Z89.1 (current version is 2009) and the Canadian Standards Association (CSA) Industrial Protective Headwear, Z94.1 (current version is 2005). These two standards share the “Type” and “Class” descriptors, which makes it easier to ensure that the right hard hats are selected for your application. However, as you will see below, the tests are slightly different, so a hard hat manufacturer must test to all standards that it chooses to meet, based upon the markets in which it wants to sell.