Archive for August, 2016

The Bike Helmet Battle: Some Things never Change

Monday, August 29th, 2016

It’s been ten years since the Insider wrote a word about motorcycle and bicycle helmets. Shame on us. This Post provides a ten-year update and connects helmet use to workers’ compensation.

To review the bidding:

We “tackled” motorcycle helmets after Ben Roethlisberger, quarterback of the Pittsburgh Steelers (who, at the time, were reigning Super Bowl champions), had been seriously injured when, sans helmet, he drove head on into the side of a Chrysler New Yorker making a left turn in front of him in downtown Pittsburgh. Big Ben suffered serious facial and head injuries. He could easily have been killed. We ended that Post with this:

As a diehard New England Patriot fan, I really want to see Ben Roethlisberger on the field challenging my team for all he’s worth. So, I hope he makes a miraculously speedy recovery and is his old self by the start of training camp. But what would be really great, better than any football game, is if Big Ben, as soon as he’s sitting up and able to mouth coherent speech, were to make a big-time television public service announcement. A TV spot in which he would tell every kid and every football fan in America that he was wrong, that he was stupid, that he is not immortal and that he will never, ever again ride a motorcycle without wearing the best helmet made in the universe.

That didn’t happen. Quite the opposite, actually. For when media asked Mr. Super Bowl Superman if he would continue riding his bike (well, make that his new bike) and, if so, would he wear a helmet, he said “Yes” to the first and “No” to the second. It was at that moment that I knew we had lost the motorcycle helmet game in America.

With respect to bicycle helmets we reported on a New York City study (unfortunately no longer available) analyzing the 225 bicycle accident deaths that occurred over the most recent ten year period in the City. The study provided compelling evidence of life-saving properties of bicycle helmets. This from that Post:

  • Almost three-quarters of fatal crashes (74%) involved a head injury.
  • Nearly all bicyclists who died (97%) were not wearing a helmet.
  • Helmet use among those bicyclists with serious injuries was low (13%), but it was even lower among bicyclists killed (3%).
  • Only one fatal crash with a motor vehicle occurred when a bicyclist was in a marked bike lane.
  • Nearly all bicyclist deaths (92%) occurred as a result of crashes with motor vehicles.
  • Large vehicles (trucks, buses) were involved in almost one-third (32%) of fatal crashes, but they make up approximately 15% of vehicles on NYC roadways.
  • Most fatal crashes (89%) occurred at or near intersections.
  • Nearly all (94%) fatalities involved human error.
  • Most bicyclists who died were males (91%), and men aged 45–54 had the highest death rate (8.1 per million) of any age group.

So, where are we now?

According to the Insurance Institute for Highway Safety:

Currently, 19 states and the District of Columbia have laws requiring all motorcyclists to wear a helmet, known as universal helmet laws (Insider Note: in 2006, it was 20 states and the District of Columbia). Laws requiring only some motorcyclists to wear a helmet are in place in 28 states. There is no motorcycle helmet use law in three states (Illinois, Iowa and New Hampshire).

Regarding bicycles helmets, no state requires an adult to wear one, although 21 states and the District of Columbia require young riders to wear them.

Now, into this cranial hodgepodge of helmet laws ride researchers from the University of Arizona. Writing in the American Journal of Surgery, they report on their study, the largest ever done regarding the efficacy of bicycle helmets. This from the study’s Abstract:

Methods

We performed analysis of the 2012 NTDB abstracted information of all patients with an intracranial hemorrhage after bicycle related accidents. Regression analysis was performed.

Results

A total of 6,267 patients were included. 25.1%(n=1,573) of bicycle riders were helmeted. Overall 52.4%(n=3,284) patients had severe TBI (Traumatic Brain Injury), and the mortality rate was 2.8%(n=176). Helmeted bicycle riders had 51% reduced odds of severe TBI (0.49 [0.43-0.55]; p<0.001) and 44% reduced odds of mortality (0.56; 95% CI, 0.34-0.78; p=0.010). Helmet use also reduced the odds of facial fractures by 31%(0.69; 95% CI, 0.58-0.81; p<0.001).

Conclusion

Bicycle helmet use provides protection against severe TBI, reduces facial fractures, and saves lives even after sustaining an intracranial hemorrhage.

The good news from this study? In a bicycle accident you are more than 50% less likely to sustain a TBI, 44% less likely to die and 31% less likely sustain a facial fracture if you are wearing a helmet (Insider Note: Ask Ben Roethlisberger to describe the pain of a facial fracture).

The bad news? Despite the good news only 25% of bicyclists wear helmets. In ten years nothing has changed.

Does this have anything to do with workers’ compensation? According to Bureau of Labor Statistics data, if you’re one of the more than 73,000 bicycle messengers and couriers in the U.S. it might. And if you’re one of the more than 12,000 that navigate streets in southern California or one of the more than 5,000 that zip through Midtown Manhattan, or one of the 1,400 dodging traffic in Chicago’s Loop it might. Because, while all states require employers to provide helmets to their bicyclist employees, and while most states require employers to provide training that includes the benefits of helmets, no state requires the bicyclist to wear them. However, both New York City and Chicago have enacted local laws requiring employers to provide working cyclists helmets meeting either A.N.S.I. or Snell standards and further require the cyclists to wear them.  Although in the case of NYC, someone might want to pass the requirement on to the messenger and courier companies, the largest of which told me wearing a helmet is “totally up to the rider’s discretion.”

For now, we’re left with a mish-mash. Things are pretty much as they were back in 2006, along with the helmetless rider’s continuing mantra: “It’s all about the freedom of personal choice.” That may be true, but society, that’s you, I and everyone else, doesn’t have a choice about sending EMT Rescue Units to the scenes of cycle accidents and caring for those who sustain serious injury or death in the “Live Free Or Die” game.

 

 

August Health Wonk Review at Healthcare Economist

Thursday, August 18th, 2016

Health Wonk Review is on an abbreviated summer schedule – if you’ve missed your biweekly fix, the August edition is up: Jason Shafrin has posted Health Wonk Review: Short and Sweet Edition at Healthcare Economist. It’s a great edition – catch up on the policy news!

For more summer reading:

Our friends at Work Comp Psych Net have a helpful post offering guidance on when adjusters should refer claims for mental health evaluations.

Joe Paduda explains why Trump will be GREAT for workers’ comp!

HR Director Reminds Employees That Any Crying Done At Office Must Be Work-Related

Employer toolkit for the Zika virus

Insurers Offer Advice to Flood Victims in Southeast

From Risk & Insurance: In Support of Monitoring and Legislation to Collateralize Workers’ Comp

We were saddened to see the recent closure of Business Insurance and offer sincere thanks to the the many editors and writers who kept us informed over the decades. The editorial staff at Business Insurance have long been recognized as top tier so it’s a true loss to our industry!

OSHA penalties jump 78% this month

Wednesday, August 17th, 2016

Beginning this month, the Department of Labor (DOL) has increased the maximum penalties associated with violations of The Occupational Safety and Health Administration (OSHA) by 78%, the first such increase since 1990. Any citations issued by OSHA on or after August 1, 2016  will be subject to the new penalties if the related violations occurred after November 2, 2015. In addition, OSHA will adjust penalties to inflation annually, but will have a cap of 150 percent of the existing penalty amount.

Here’s a summary of the old vs the new penalties

OSHA-violations

The increase in penalties is not limited to OSHA; This is part of a sweeping modernization that passed in 2015: The Federal Civil Penalties Inflation Adjustment Act. Here’s a Fact Sheet for Inflation Adjustment Act Interim Final Rules.

In addition to OSHA, other penalty increases will affect:

  • Employee Benefits Security Administration (EBSA)
  • Mine Safety and Health Administration (MSHA)
  • Office of Workers’ Compensation Programs (OCWP)
  • Wage and Hour Division (WHD)

The US Department of Labor Blog talks about how the Inflation Adjustment Act was intended to strengthen the deterrent effect of penalties. In The Benefits of Penalties, Sharon Block notes that penalties had not been raised since a gallon of gas was $1.20 and a first class stamp was 25 cents.

“Adjusting our penalties can lead to significant benefits for workers and responsible employers who will have a more level playing field when competing with those who try to gain a competitive advantage by cutting corners on safety and other basic protections for American workers. As always, we at the Labor Department define success as encouraging employers to comply with the law, not by the amount of penalties we assess, so we stand ready to continue to provide technical assistance to all employers who want to do the right thing.”

This is sure to raise some consternation among the nation’s employers, particularly following the OSHA’s controversial new reporting rules. It would appear the the DOL is serious about putting some teeth in enforcement programs designed to protect workers.

Unfortunately, despite the steeper fines, the deterrence factor has historically been mitigated by the all-too-frequent subsequent slashing of fines after they have been levied. See this 2013 NPR Report: Enforcement Of Penalties Weak In Grain Bin Deaths, in which levied fines were negotiated down by 90% or more – a not unusual practice. These fines may be steep to small employers, but to large national, they are a cost of doing business.

BERKES: Employers have the right to challenge and negotiate citations and fines. And OSHA routinely relents. Those major fines – over a hundred grand – they dropped 80 percent of the time, according to an analysis of OSHA enforcement by NPR and the Center for Public Integrity. The agency discount ranged from 40 to 97 percent.

In all the grain deaths we identified, OSHA fines were cut on average more than half. This, Michaels suggests, is part of the process.

MICHAELS: We do everything we can within the current regulatory framework. We look at the individual characteristics of the case, the characteristics of the employer. We don’t think reducing a fine to, you know, $700,000 or $500,000 or $200,000 is going easy on this industry.

BERKES: But given the persistent death toll, it doesn’t seem fines are providing the deterrent effect they’re supposed to. As for criminal prosecutions.

Related resources

 

The GB Journal: Pithy, Trenchant and Chock Full Of Stuff You Can Use

Thursday, August 11th, 2016

In March of this year, friend and colleague Dr. Gary Anderberg, Senior VP of Claim Analytics for Gallagher Bassett Services, had another one of his good ideas: Publish concise and useful information for risk managers who don’t have a lot of spare time to wade through oodles of research. In Gary’s words:

The basic purpose of The GB Journal is to keep our clients informed on new developments that impact WC, A/L, G/L and property coverages. The idea is that most risk managers are more than a little pressed for time, so a neat synopsis with a link or two for those interested in more details, will be helpful. We also see this as a neat vehicle for generating useful conversations between our account managers and our clients concerning important issues. I try to keep the average item to about 350 to 400 words and no more than three items per issue. That’s no more than five minutes of reading time total.

And presto, his GB Journal was born.

GB 11 August

I love the tagline: We deal in conclusions, not opinions.

Gary says the Journal is for clients of GB, but anyone can subscribe. He’s the sole author and publishes every other Thursday. The current issue summarizes the Workers’ Compensation Research Institute’s recent analysis of eight state’s attempts to curb physician in-office dispensing and discusses the new term of the day, BoT – Burden of Treatment.

At the Insider, for years we’ve been doing something similar when Julie Ferguson posts her News Of Note, but we have no set schedule for that and don’t limit it to three items. Gary’s approach is different, but certainly worthwhile and effective.

I like what Gary is doing. It’s good for GB’s business, but it’s also good for the workers’ compensation community at large. If you’re not already a subscriber, I recommend you become one.