Posts Tagged ‘Disability’

The Best Health Care in the World: Part Five: A recap, a few questions, a conclusion and a modest proposal

Monday, March 31st, 2008

This series is meant to paint a realistic, well-sourced and objective portrait of American health care early in the 21st century as compared with that of our 29 partners in the Organization for Economic Cooperation and Development (OECD, all of us comprising the most developed democracies in the world), and to examine how workers’ compensation fits into that mix. We’ve done a lot of the former and some of the latter. Now it’s time to finish the job.
First, a bullet-point recap. In Parts One through Four we saw that:

  • American per capita health care spending is two and a half times the average in the OECD and 25% higher than our closest competitor, Switzerland.
  • American per capita health care spending on pharmaceuticals is double that of the average in the OECD.
  • We perform more sophisticated testing and surgeries than any other country.
  • Our physicians earn double the compensation of their OECD counterparts.
  • Our hospital stays are 25% shorter and our doctor visits 42% fewer than other OECD citizens.
  • Despite all the spending, we don’t live longer and are no healthier than the average among OECD countries.
  • There has been explosive growth in the incidence of Type 2 Diabetes, much of it caused by an epidemic of obesity, and 27% of the per capita increase in our spending on health care since 1987 is attributable to obesity.
  • At nearly 31%, the percentage of obese adults in the US is the highest in the OECD and 25% higher than Mexico, the country that wins obesity’s OECD silver medal, yet we been unable either to halt or reverse the growth of obesity in America.
  • Thirty-one percent of our total health care expenditures go toward insurance administrative costs, far more than any other OECD country.

Meanwhile, over on the workers’ comp side of things…
It is indisputable that health care costs in America far exceed those for any other OECD country and have been sharply and steadily rising over the last 20 years. Bleak as that portrait is, the situation with health care costs in workers compensation is even more dire:

  • Since 1996, worker’ compensation medical treatment costs, representing only 3% – 4% of total US spending on health care, have been rising at twice the rate of those sharply and steadily rising group health costs.
  • We spend significantly more to treat worker injuries than similar injuries in group health, principally because of over-utilization of medical services.
  • Pharmaceutical costs, representing 18% of total incurred losses at the fifth service year, are a large chunk of the ice beneath the water line, the costs that are often hidden and unknowable (When have you ever seen prescription drugs itemized on a loss run?). If you are an employer, ask yourself these questions: Do you have any idea of the prescription drugs your injured workers are taking? Do you have any idea of the extent to which your injured workers are being prescribed narcotics, such as OxyContin, Actiq, Fentora, Duragesic, even Vicodin? If not, you need to have an immediate talk with your insurer and your Pharmacy Benefit Manager. It’s that important.

None of us can do much about the ridiculous costs of health care in America today. To quote Hercule Poirot, the problem is “a many-headed Hydra.” But employers and insurers can do something about the ridiculous costs of health care in workers’ compensation. What, you say?
At the end of this five-part series, here is a conclusion and a modest proposal, which to many will seem trite, even pedestrian, but 24 years working with more than 4,000 clients guarantees it works:
Conclusion: medical costs grow as indemnity costs grow, because injured workers stay out of work longer than is medically necessary.
The modest proposal: A caring, aggressive, systemic, performance-oriented and measured program that focuses on a) preventing injuries from occurring in the first place and b) if injuries do occur despite your best efforts, bringing injured employees back to work in some medically approved capacity of temporary modified duty as quickly as possible. This early return to work will keep injured workers connected to the workplace and the ingrained routine of getting up, getting dressed and going to work every day. Absent that, the injured worker will stay at home where he or she will create a new routine of staying out of work and making up his or her own, stay-at-home modified duty program. If I were injured and could not go to work because my employer had nothing for me to do, that’s what I would do, and so would you. And that does not have to happen.
It’s a lot of work, but it’s as simple as that.
I’ve enjoyed writing this series. I hope it’s given you something to think about.

Return to work and disabled vets

Wednesday, March 12th, 2008

The Iraq and Afghanistan theaters of war represent the largest deployment of civilian soldiers since WWII. Of the 1.5 million troops that have served, approximately one in every four is a National Guard member or a Reservist. While the Uniformed Services Employment and Reemployment Rights Act offers legal job protections, the road back will not be an easy one for many veterans. Many have suffered profound and life-changing physical injuries; many also face less obvious wounds – Iraq and Afghanistan Veterans of America estimate that about one in three Iraq veterans will face a serious psychological injury, such as depression, anxiety, or PTSD:

These psychological injuries exact a severe toll on military families. Rates of marital stress, substance abuse, and suicide have all increased. Twenty percent of married troops in Iraq say they are planning a divorce. Tens of thousands of Iraq and Afghanistan veterans have been treated for drug or alcohol abuse. And the current Army suicide rate is the highest it has been in 26 years. One of the goals of any disability program is to help the injured party to recover and to return to their normal lives, including return to work. This is true whether the injury occurred in the workplace, at home, or on the battlefield. Work is not only vital for economic security, for most of us it is also a core part of our identity, an integral part of our lives. A good return to work program can be restorative on a financial, emotional, and psychological plane. Both in the short term and over the longer term, employers will play a vital role in helping veterans readjust to civilian life. This requires that employers have awareness of the many challenges that veterans face and the willingness to provide the resources to support a successful transition.
Enter the Workplace Warrior Think Tank, a coming together of The Disability Management Employer Coalition, several of the nation’s premier insurers, employers, and military and veteran participants with the purpose of helping veterans to ease the transition from the war to the workplace. The group examined challenges and opportunities facing returning employees and identified employer-based resources and strategies. The end product is a useful guide for employers, Workplace Warriors: The Corporate Response to Deployment and Reintegration Highlighting Best Practices in Human Resources and Disability Management (PDF). The guide includes a list of best practice recommendations to help returning vets reintegrate in the workplace. These include such things as celebrating the employee’s return to the workplace, recapping changes that occurred while he/she was gone, and training supervisors to be aware of certain red flags that might indicate a problem. The group also emphasizes that the availability of effective EAP services can be critical to successfully helping veterans to face the many psychological problems that are common in the aftermath of war service.
It’s great to hear about the efforts of the think tank and their recommendations for employers – please help to distribute the guide and raise the issue because as the report notes, “Repercussions and delayed effects of the war experience will be felt in the workplace for decades to come.” Hopefully, this will be the first step in many by leaders in our industry to dedicate resources and attention to this important issue.
For more information and resources:
The Corporate Response to Deployment and Reintegration – this is the full report from Workplace Warriors, available through DMEC.
Wounded Warriors is a blog that collects veterans coverage from the McClatchy Washington Bureau, McClatchy Newspapers, and other sources. It’s a good source of news for items that affect returning vets and their families.
Resources for returning veterans and their families – from the Substance Abuse and Mental Health Administration.
Veterans and Military Health – from MedlinePlus
Iraq and Afghanistan Veterans of America – since 2004, the nation’s first and largest group dedicated to the Troops and Veterans of the wars in Iraq and Afghanistan, and the civilian supporters of those Troops and Veterans.

Your Government at Work – Worker injury research you can actually use

Monday, November 19th, 2007

A cornerstone of Lynch Ryan’s work for more than twenty years, a long-held mantra, has been that employees who work for good employers — employers who care for their workers and show it by the way they treat them — report all work injuries when they happen, get expeditious treatment and return to work faster. Moreover, their injuries cost significantly less than those of employees who work for less caring employers. A major driver for low workers’ compensation costs is the quality of the relationship between employer and employee.
We’ve seen this in our consulting work time and again, but it’s nice to have independent research confirm the mantra.
In the mid-1960s, the Department of Labor’s Employment and Training Administration (at that time called the Office of Manpower, Automation, and Training ) wanted to understand specific issues pertaining to the U.S. labor market, such as retirement, the return of housewives to the labor force, and the school-to-work transition. To do that it began conducting longitudinal studies, studies that look at a random group of like people to see how they develop over time. The Office began four such studies following groups of young men, older men, young women and, no, not “older” women, but rather “mature” women. The studies were originally targeted for five years, but, because they were yielding a mountain of data, they were extended until 1983, allowing other agencies to piggy-back along to glean even more information about how these first baby-boomers and World War II veterans were maturing in post-war America.
Because of the success of these studies, the Bureau of Labor Statistics decided to conduct an even more ambitious project, and in 1979 it launched the “National Longitudinal Survey of Youth 1979,” (NLSY79)
NLSY79 randomly selected and interviewed a cohort of 12,686 young Americans, 14 to 22 years old, all born between January 1,1957 and December 31, 1965, and it has been interviewing them regularly ever since, for nearly three decades now. As of 2004, there were 7661 people still in the survey group. These people have provided profound and relevant data about the aging of the last of the eighty million American baby-boomers.
What does this have to do with workers’ compensation? Actually, quite a lot.
Until I read Joe Paduda’s recent blog post, I was unaware that any researchers had ever mined the NLSY79 data for workers’ compensation insights. Thanks to Joe I have been enlightened. Thank you, Joseph.
In 2005, Darius Lakdawalla, Robert Reville and Seth Seabury of the Rand Institute for Civil Justice published “How Does Health Insurance Affect Workers’ Compensation Filing” (this is a Working Paper, meaning it has not been formally peer-reviewed). Using NLSY79 data, they confirmed Biddle and Roberts 2003 Michigan study (purchase required), which found that only about 55% of workers sustaining lost time injuries ever file claims for benefits, as well as an Oregon state-sponsored study of the 2002 Oregon Population Survey suggesting that 54% of workers reporting workplace injuries filed claims. They also found that unionized workers were more likely to file claims following work injuries.
Moreover, the Rand researchers found that workers without health insurance are about 15% less likely to file a claim than injured workers with health coverage.
A still more surprising finding may be that workers at companies that merely offer health insurance benefits are 50% more likely to file a claim after suffering a work injury than workers at companies that do not offer health insurance benefits.
However – and here is the major finding for me – lost time, as well as the cost of lost time for these workers who file more claims is about 20% less than for the workers who are not offered health insurance.
Finally, other types of fringe benefits – like paid vacation days – also seem to be associated with higher filing rates. For example, when both health insurance offers and paid vacations are present in the same employer, both variables are significant (at the 95% confidence level) and both have coefficients around .10 for claim filing.
What does this tell us? Well, for me it reinforces our mantra. These employees may report more injuries, but, as the NLSY79 data show, they return to work faster and their injuries cost significantly less than do the injuries of employees who work for employers who do not provide these benefits. Quod est demonstrandum.
The Rand study is compelling and instructive, but you do have to know a few things about statistical research to get the most out of it. Nonetheless, it should provide fuel for further workers’ compensation research using the NLSY79 treasure chest of demographic data. This stuff is too good to sit on a shelf gathering dust.

Justice for Judge Joyce?

Tuesday, August 21st, 2007

For unadulterated audacity and out and out gall, Michael Joyce, a Pennsylvania Superior Court Judge, may currently hold the lead in this year’s gold medal competition.
Scanning Insurance Journal Online today, we learned that last Wednesday, federal prosecutors indicted Judge Joyce for mail fraud and money laundering, claiming that he cheated the Erie Insurance Group and State Farm Insurance out of $440,000, a charge the judge denies as he protests his innocence.
Judge Joyce came to our attention not for what he is accused of doing, but for how he is alleged to have done it. According to the indictment, Judge Joyce, while parked in his Mercedes-Benz sedan in 2001, was rear-ended by an SUV traveling about 5 mph. That’s right, five miles per hour – I’ve crested middle age and I still can run that fast.
Following this horrendoma of a crash, no police or medics were called to the scene, yet the Judge asserted that the impact rendered him unable to exercise or play golf for more than a year. He was paid $390,000 by his insurer, the Erie Group, and $50,000 by State Farm, which insured the poor SUV driver.
Unfortunately for Judge Joyce, the indictment alleges that, not only was he playing 18- hole rounds of golf shortly after the “accident,” but he was doing it on vacation in Jamaica. It also claims that he was scuba diving, inline skating (I’ve never gotten the hang of that) and working out in his local Gym. The man must be a medical and physical marvel.
At any rate, Judge Joyce has announced that, infirmities and indictments notwithstanding, he will continue his run for a second ten-year term in this fall’s coming election.
The state’s Supreme Court last Friday suspended Judge Joyce, with pay, “to protect and preserve the integrity of the Unified Judicial System, etc…”
And what, you may ask, did Judge Joyce do with his new-found wealth? Well, according to the indictment, he used it to buy a motorcycle and make down payments on a house and an airplane, which, of course, he intended to fly. We know that, because on the application for his pilot’s license he asserted that he had no injuries or physical problems that would preclude his flying up, up and away, which he then did about 50 times.
There is terrible injustice here. We’ll let the courts decide whether it has been done to the Judge, or by him.

Workplace disabilities are on the rise

Wednesday, May 16th, 2007

Unhealthy worker lifestyles and an aging work force may portend trouble on the horizon for the nation’s employers. A recent article in The Wall Street Journal points to the disturbing trend of long-term worker disabilities that are accelerating at a rapid pace. This comes at a time when employers may be facing labor shortages with the impending retirement of the large boomer population.
The WSJ article uses data from The 2006 CDA Long-Term Disability Claims Review (PDF), an annual study issued by the Council for Disability Awareness. Some of the salient points from the study:

  • More than 500,000 individuals received long-term disability insurance payments from CDA member companies in 2006 – 4.4% more than 2005.
    CDA member companies paid in excess of $7.2 billion in long-term disability insurance claims in 2006, a 7.5% increase over benefits paid in 2005.

  • 33% of individuals receiving long-term disability insurance benefits did not qualify for Social Security Disability Insurance, and 95% of reported disabilities were not work-related.
  • 6.8 million disabled workers received payments through SSDI in 2006, 4.4% more than in 2005 and 51% more than the 4.5 million disabled workers receiving payments in 1997.
  • The rate of disability for women workers is growing faster than that of their male counterparts. Since 1997 the number of women covered under SSDI has grown from 16% to 47% of covered workers compared to a 9.9% growth rate for men, while the rate of disability for women workers has grown more than 60% compared to 32% for male.

For the last two decades, there have been numerous attempts to cobble the various disability programs together and serve them under one roof: 24-hour coverage, disability management, and absence management, to name a few. Often, for all but the largest self-insured employers, these attempts have been less than successful due to complex state-by-state regulatory environments, in-house management silos that administer programs differently (risk management vs human resources), and differences in program incentives, disincentives, and benefit structures. One area where workers comp has made huge progress and serves as a model for non-work related disability programs is in the area of return-to-work programs. For many, migrating RTW to disability has been slow going – often because it is a voluntary employee financed benefit, so the urgency hasn’t always been there. But with the converging forces of aging workers, a less healthy population (increased obesity, diabetes), and a tight labor pool, the sense of urgency may be growing.
The WSJ article discusses the ways that many large employers are making workplace accommodations to retain workers:

“American Express says it has altered the company cafeteria at its Greensboro, N.C., call center to accommodate wheelchair-bound workers, enabling them to access microwaves and bus their trays on carts. Company employees who rely on public transportation because of medical reasons, such as paratransit transportation, can get flexible work schedules to accommodate their needs.
At General Motors Corp., a joint program with the United Auto Workers union helps disabled workers find new positions within the company that are more amenable to a worker’s ailment. Under this so-called Adapt program, disabled workers meet with company doctors, ergonomic representatives and others who review the employee’s disability and try to match that to available jobs. Workers who install windshields, for instance, but who develop problems that restrict how high they can raise their arm, could be moved to door installation instead, since that job doesn’t require workers lift their arms above their shoulders, GM says.”

These types of creative programs are always easier for the big guys to effect than the smaller employers, given the law of large numbers, but the large employers can also serve as laboratories for what works well and what doesn’t. And the climate may be right for moving the needle a little further in terms of a unified approach to disability management and stay at work/return to work programs.

News roundup: Premium rates, ADA, disability awareness, OHIO privatization, and more

Wednesday, October 26th, 2005

RIMS Benchmark Survey: downturn in commercial rates
Commercial insurance renewal premiums in the third quarter were down by more than 5% from rates in the same quarter last year, although the survey notes that workers comp was the only major line to drop by less than 5%, with an average reduction of 3.75%. However, for many respondents, the effects of hurricane season hadn’t yet been factored into prices.
ADA protects persons “associated with” the disabled
Diane Pfadenhauer discusses a less widely recognized provision of the Americans With Disabilities Act that extends legal protections to those individuals who are associated with a disabled person.
October is Disability Awareness Month
According to the Society for Human Resource Managers (SHRM), there are 33 million people in the United States with disabilities and the unemployment rate for this population is 44%. SHRM notes that many employers fear high costs associated with making accommodations for workers with disabilities, but 38% of employers have not had to spend any money on accommodations and an additional 17% have spent less than $500.
For a whole different outlook on disability, you may want to see a film called Murderball about a team of quadriplegic rugby players. Some time back, Larry King featured a very compelling interview with a few of the charismatic team members – what an inspiration!
Ohio: many oppose privatization of workers comp
Despite the recent investment scandals, it seems that many employers, attorneys, and unions are unified in opposition to the idea of privatizing the state workers’ compensation system. Ohio is one of a diminishing number of monopolistic states. The current Bureau of Workers Compensation system was established in 1995 with a nine-member Workers’ Compensation Oversight Commission. Since then, it has been credited with speeding up claims and reducing premiums by an average of more than 30%.
The Best-laid Disaster Plans Are Merely Works in Progress
Workforce features an article offering an overview of problems and issues that HR departments faced in the aftermath of the Katrina disaster. The article profiles the experiences of three large employers – Entergy, Sodexho USA, and McDonalds – and some of the creative problem-solving that was required to locate and retain workers, communicate with workers despite the collapse of the communication infrastructure, arrange payments and administer benefit programs, and assist workers and their families in resolving various psycho-social issues.
12 picks for America’s Safest Companies of 2005
Occupational Hazards recognizes a dozen companies that set their own standards for safety excellence, exceeding OSHA and EPA regulations and industry norms. Safety efforts in these companies were generally characterized by high employee involvement and superior management commitment.
Insider View of the Vioxx trials in NJ
Robert Ambrogi and J. Craig Williams from Law.com’s arsenal of law bloggers offer first hand accounts from inside the courtroom at the VIOXX trial underway in New Jersey.
Also. from Legal Talk Network’s Workers Comp Matters:
Latex allergies in the workplace with Sandra Jutras, a career clinical nurse who developed a serious level one latex allergy; Attorney Jim Brady, and Dr. Gail Lenehan, national advocate and member of the Massachusetts Nurses Association’s Congress on Occupational Health and Safety.
Medicare set-aside allocations – Jean Feldman of CHOICE Medical Management discusses the complex issue of workers compensation Medicare set-aside allocations.
Making a difference
We can all sometimes get bogged down in the status quo and wonder if it’s still worth it to try to effect a change. It’s good to be reminded how one person can make an enormous difference – rest in peace, Rosa Parks. The LA Times has a wonderful tribute to this remarkable woman. (free registration required)

9/11 news roundup: health, insurance, and disability-related issues

Saturday, September 11th, 2004

Most Ground Zero Volunteers Still Waiting For Workers’ Comp
From Adjuster.com: “A study of workers’ compensation claims from the cleanup at the World Trade Center site after the Sept. 11 attacks found that about 90 percent of the 10,182 claims for workers’ comp have been resolved. In contrast, less than a third, or 31 percent, of the 588 volunteer claims were resolved as of June 30, 2004, the Government Accountability Office, the investigative arm of Congress, found.
Sept. 11 attacks didn’t bankrupt U.S. insurers: Study
Business Insurance reports on a forthcoming study from Ball State University in Muncie on the effects of 9/11 on the insurance industry that states that the impact on the insurance industry was less than anticipated, partly due to the federal compensation fund. .
Breathing and mental health problems widespread among Ground Zero rescue and recovery workers
Preliminary data from screenings conducted at The Mount Sinai Medical Center show that both upper and lower respiratory problems and mental health difficulties are widespread among rescue and recovery workers who dug through the ruins of the World Trade Center in the days following its destruction in the attack of September 11, 2001.
An analysis of the screenings of 1,138 workers and volunteers who responded to the World Trade Center disaster found that nearly three-quarters of them experienced new or worsened upper respiratory problems at some point while working at Ground Zero. And half of those examined had upper and/or lower respiratory symptoms that persisted up to the time of their examinations, an average of eight months after their WTC efforts ended. In addition, more than half of the Ground Zero workers who were examined had persistent psychological symptoms.
(via Pulse).
9/11 Impact on Marsh & McLennan Cos. Nothing Short of Devastation
Claims Journal features an interview with Marsh & McLennan Companies Chairman and CEO Jeff Greenberg reflecting on the lingering aftermath of the loss of 295 employees in terms of both the human and the business impact.
Additional stories:
Lingering 9/11 anger finds its outlet in courts
Court declines to hear appeal of 9-11 Workers’ Comp benefit case
No answers for kin of Mexican 9/11 victims
WTC rescue workers still ailing, study finds
Terrorism insurance is now common
World Trade Center Health Registry
Cantor Fitzgerald sues al-Qaeda over Sept. 11
The Port Authority of New York and New Jersey to join 9/11 lawsuit against Saudis
The miracle survivors – coping with recovery
Workers Comp and terror: the long shadow

How a workplace injury transformed a life

Thursday, September 9th, 2004

This past Monday, Sean George marched in Pittsburgh’s annual Labor Day parade. While such an event may seem pedestrian, the circumstances that led to it are anything but. A steamfitter and a survivor, George shares the story of his horrific workplace injury with workers and insurers in the hopes that his experience might change the lives of others for the better and help prevent other workers from suffering work injuries. The story of the gas explosion that killed his cousin and put him on a path of pain, depression, addiction, and ultimately, recovery, is a compelling one. It’s terrific that he shares the details of his personal experience — it’s a reminder to all of us that work safety is not an academic exercise; it’s flesh and blood.
Some time ago, we posted another survivor story, that of Candace Carnahan who lost her leg — and who nearly lost her life — when she became caught in a conveyor belt. She was 21 at the time of the injury. While work injuries and deaths can happen to anyone at any age, young and inexperienced workers are particularly vulnerable. Like George, she now devotes her energy to spreading the message of work safety.
We pass on George’s story in the same spirit that he shared it — with the hope that it might influence at least one person — a worker, a supervisor, an employer, or an insurer — to help prevent a work injury today.
Thanks to Jordan Barab at Confined Space for pointing us to this story.

Workers Comp and Terror: The Long Shadow

Thursday, May 13th, 2004

An article by Anthony DePalma in today’s New York Times (registration required) outlines the onging saga of workers’ compensation claims stemming from the attacks on 9/11. In the immediate aftermath of the attacks, most of the approximately 3,000 fatalities probably involved workers comp: these people were working. They died at work. (Death benefits in New York are capped at a relatively paltry $50,000.) But what about the survivors? What about the first responders? And in ever-widening circles, what about people who suffered post traumatic stress simply by their proximity to the horrifying events?

In the 9/11 aftermath there have been nearly 8,000 claims filed with the New York State Workers’ Compensation Board. While the events themselves were unique, when it comes to workers compensation, it’s business as usual. Claimants must be able to prove a causal relationship between the 9/11 disaster and their disabilities. A number of the claimants with respitory problems are offended that insurers are not forthcoming with benefits. They tried to help after the horrendous events. They breathed the chemical-laden air. Over time, they developed chronic breathing problems, what is now referred to as “World Trade Center cough.” They believe their injuries — and the link between the injuries and their permanent disabilities — is obvious. But in the world of workers comp, one person’s “obvious” is another’s “ambiguous.”

DePalma describes the Brooklyn courtroom where the compensability of claims stemming from 9/11 is determined. He provides the example of a former subway conductor who handed out bottled water immediately following the collapse of the towers and then worked at the 34th street station, keeping order on the platform. Despite wearing a mask, he breathed in the dust and debris brought into the station by incoming trains. In the following months, his breathing became more labored. In August 2002 he suffered a massive heart attack and was unable to return to work.

Should he collect workers compensation? Company lawyers have brought up his long-time smoking habit as a potential factor in the heart attack. How can you distinguish between the work and non-work related factors in this situation? A lot of money is at stake. Ultimately, it will have nothing to do with the iconic stature of the 9/11 events. It’s simply a matter of the judge determining whether or not there is a disability, and whether the disability is work related.

Post-Traumatic Stress

One of the fundamental lessons of workers comp is that people respond to adversity in different ways. Two people witness the same event: one moves on with life, the other suffers from lingering post-traumatic stress and is unable to function in any work environment. The former continues to earn a living; the latter may collect disability payments for being unable to work. And the “one size fits all” workers comp system has to make sense of it all.

What is striking about the 9/11 situation is the scale of the event. It does indeed cast a long shadow. It has been described as the “largest acute environmental disaster” in New York history. Despite the magnitude, workers compensation will play out as it usually does: in a court of law, with the presentation of evidence on both sides. Workers comp may be “no fault,” but it is by no means “no friction.” It is a constant drama of human suffering, of medical interpretation, of “expert” testimony, of point and counterpoint. What is taking place in the Brooklyn courtroom plays out in a similar manner every day across America.

Reducing medically unnecessary disability

Sunday, April 18th, 2004

Any regular visitor to Workers Comp Insider would know that we are not ones to minimize the seriousness of workplace injuries, and we bemoan the frequency with which work injuries occur. Essentially, we believe that if American businesses can aspire to total quality management and zero defect philosophies for parts and processes, they can do at least as well for their greatest asset, their people. Prevention is a key mandate that all of us in the industry should and must embrace.
That being said, a good part of our focus as a company has been on teaching employers how to respond to and manage work injuries if and when they do occur, with the twin goals of fostering maximum recovery for the employee and minimum cost for the employer. These are goals that should not be mutually exclusive if approached thoughtfully and with care, through good management, communication, and planning.

I was reminded, recently, of a survey of occupational doctors on the topic of lost time that was conducted by Dr. Jennifer Christian. In this survey, occupational physicians were asked to assess how many of the work-related injuries they treat typically require more than a day or two away from work for medical reasons. Most physicians placed this number at less than 10 percent; more than half of the responding physicians placed the figure at less than 5 percent.

So with an occupational medicine consensus being that between five and ten percent of all work injuries require time away from work for medical reasons – or one injury in 10 or 20 – why is it that, on average, about one injury in four, or 24 percent, results in absence from work long enough to become a lost-time claim? (Most states have a three to seven day waiting period before compensabilty benefits begin.)

So the question is, why do so many work injuries result in medically unnecessary time away from work?