NOTE: This article appeared in Utility Products magazine, which serves the utility industry — it is reprinted with permission. It details Medcor’s work onsite at wind farm construction projects. These large utility construction projects can involve hundreds of employees working over many miles for many months. The article provides general information about onsite health care, regardless of who the provider is, but also highlights some of Medcor’s specific value. Medcor has many years of experience serving the utility and construction industries and has developed specific protocols and systems for that on-site environment.
By Kate Woldhuis
During the American Wind Energy Association’s WINDPOWER 2011 Conference and Exhibition in May, Occupational Safety and Health Administration (OSHA) announced its National Emphasis Program would target safety inspections at wind farms. Because systematic inspections of safety compliance at wind farms nationwide are probably going to begin in 2012, it has become paramount for safety managers to build on existing safety knowledge and work within the workplace to promote the development of compliance requirements by the end of 2011. Many safety managers have brought in third-party contractors to support worksite health and safety goals, so they are free to focus on maintaining compliance.
Choosing the correct onsite provider, however, can be a complex task. Parties to a wind farm project must be able to support onsite health and safety initiatives, as well as understand the law and new focus of OSHA so that these projects don’t face increased costs, litigation, fines or penalties.(WCxKit)
Onsite health care firms provide first aid care for workers, which is a beneficial service for both employers and their workers. Wind farms, in particular, face the common challenge of providing their employees with access to medical services. In emergencies, the ramifications of injuries might become magnified because of their commonly rural locations. Even in non-emergency situations, employees and employers alike enjoy the convenience of staying onsite rather than leaving work for 4-8 hours for one doctor’s appointment, leading to hundreds of hours of lost productivity over the length of the project.
Onsite services generally help employers reduce OSHA recordables and lost time, allowing companies to realize significant gains in productivity and their bottom lines. David Grogg, construction manager with Duke Energy, utilized onsite health care services at two wind farm construction projects in Wyoming. In addition to providing medical response to emergencies and core health services, he appreciated the flexibility it provided.
“Helping with safety orientations and providing a service to the team of people—a majority of whom are working miles away from town and don’t have the support structure to tend to their health needs all the time—kept the workforce in place so that they’re there and productive. That’s very valuable to us,” Grogg said.
Whether its in-house or outsourced, and if the onsite provider has the right experience and expertise, they can also support safety initiatives and monitor injury trends—freeing safety managers to focus on preventive measures, maintaining compliance, investigations and other core responsibilities. For the onsite medical team to provide immediate care to workers, the team must have the resources and experience to understand how to overcome obstacles specific to a worksite—including rugged terrain, extreme weather conditions, high-angle or confined space rescues, and hazardous materials. They must also be able to support compliance with applicable regulations and coordinate with local emergency rescue personnel. This is a specialty; the average medical facility does not have the expertise, systems and protocols in place to provide such safety and compliance support.
One health company that does specialize in onsite health services for wind farms and supports OSHA compliance and safety is Medcor Inc. Headquartered near Chicago, Medcor provides onsite health services to wind farms and other remote utility projects—including pipelines and highways, as well as “turn-arounds” and other services for power companies. The company also serves hundreds of more traditional businesses throughout the nation. Medcor has developed proprietary software systems and clinical guidelines specifically for onsite settings and supports its staff with physician medical directors, a 24/7 call center, off-road response vehicles and mobile clinics to ensure rapid deployment and effective services.
Medcor’s onsite staffs assigned to utility or construction projects have extensive experience as paramedics, registered nurses, and fire and rescue members, and have safety training up to and including OSHA 500-level certifications—so they can conduct OSHA safety training, environmental safety training (i.e., HAZWOPER) and other customized safety courses specific to their client’s environment. As such, the onsite medical staff is able to closely integrate into safety programs and practices at wind farms.
In other capacities, onsite medical staffs work closely with safety managers, conducting daily meetings to review daily safety initiatives, developing strategies for preventing injuries, etc., so that safety managers are able to focus on safety leadership. As another example, Medcor’s medical professionals walk the site each day to become familiar with the workers, their jobs and the potential hazards and work-related injuries that could occur. In addition, based on injury data and experiences in the field, these medical professionals are suited to conduct trend analyses and make safety suggestions based on their findings, which further improves the site’s safety record.
Luke Wright, operations director at Medcor, specializes in onsite health services at wind farm operations. Wright described an incident last year at a wind farm construction site involving an injury high inside a tower: “Our onsite medic worked closely with local fire and rescue to extricate the patient. In the process, our medic learned that the local fire department did not have the best equipment or techniques for that situation combining high angle and confined space. During the post-incident review, she recommended they use back boards designed for vertical extraction instead of typical horizontal boards.” Wright went on to explain other safety observations that were made throughout the course of the project, including changing the type of safety goggles being used, enforcing stricter safety belt rules and providing instruction on proper use of fall protection.
“Onsite providers offer a different type of service than the safety managers,” Grogg said. “They’re there for keeping workers out of trouble on all aspects. Medcor supplements safety and is more focused on tending to the emergency response plans and tending to health care needs. The greatest value was recognized at my last project when a person fell and Medcor took leadership in working with first responders to help provide the best care possible before they were able to get there.”(WCxKit)
Many managers like Grogg have found success in outsourcing health and safety support. Contracting third party health and safety professionals to work onsite allows safety professionals to be better positioned to meet the challenges of compliance to safety regulations, provide access to health care for employees and develop more effective safety programs. The wind energy industry is developing, and, with stricter OSHA regulations being enforced in the coming years, safety professionals will need to be free to focus on the changes.
Kate Woldhuis is a business development analyst at Medcor, Inc. She received a Bachelors’ Degree in Journalism and minored in Environmental Studies at Northern Illinois University and has written several articles regarding green energy and sustainable living for various publications. As a business development analyst, Ms. Woldhuis works with companies operating within a wide variety of industries to promote onsite health, wellness and safety initiatives, as well as strategizes onsite development opportunities to potential clients.
Medcor provides telemedicine services to nearly 90,000 worksites in all 50 states and operates 174 on-site workplace clinics. Medcor also provides safety services at construction sites, wind farms, utility and power companies, and government agencies through its subsidiary, Brown Services, LLC. For additional information contact csmith@medcor.com www.MedCor.com
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact
The first question from most employers when an employee suffers an injury is: How long will he/she be off work? Estimating the length of time the employee will be off work is not a precise science, but thanks to the accumulation of millions of workers compensation claims and disability cases over the years, there is ample data available to provide a range of time to predict how long it will take the employee to recover from a specific injury.
A large third party administrator can now estimate disability for any type of injury. Using the disability guidelines available, they can even refine the predicted period of disability using criteria of:
1. Age
2. Preexisting unrelated medical conditions
3. Gender
4. CPT codes (description of the services provided by the doctor)
5. Zip codes
While it almost sounds like you can plug the data into the computer and the computer will spit out the exact number of days the employee will be recovering from their injury, it is more complicated than that. There are numerous other factors that come into play when determining the period of time it will take the employee to recover from the injury including:
1. The severity of the injury – for example a torn tendon can be a small partial tear, a larger tear or torn completely apart.
2. The pre-injury condition of the employee – the physically fit recover faster than the employees who have poor physical conditioning.
3. Other injuries – employees with only one injury in an accident recover faster than an employee with two or more injuries, for example one fracture bone as opposed to three broken bones.
4. The post injury treatment program – employees who have physical therapy, occupational therapy or a rehabilitation program recover faster than employees with the same injury, but without a post injury treatment program.
5. The personal habits of the employee – smoking, alcohol, and illicit drugs slow the recovery process.
6. The employee's stress level, sleeping habits and general health.
From the medical provider or adjuster’s standpoint, if asked to predict the length of time the employee will be recovering from an injury, they will turn to a source such as The Medical Disability Advisor for disability duration guideline tables to provide information about anatomical regions, diagnostic categories, medical specialists, job titles and ICD-9 Codes.
The data and the tables will provide general answers and assist in predicting the approximate length of disability. The period of disability should not be confused with the length of time the employee will be off work. In most cases, the injured employee can return to light duty or modified duty work before the period of disability is over. To determine if the employee can return to work before the employee is fully healed, the doctor will look at the employee's physical limitations, the necessary restrictions and the employee's ability to deal with the injury symptoms.
The physical limitations are often centered around the employee's ability to use their musculoskeletal system. The employee will be given limitations on how much force they can exert or weight they can safely move, or how long they can stand, sit, squat, bend, crawl, etc. The limitations are designed to stop the employee from using an injured body part in a way that will aggravate the injured part, slowing or even reversing the recovery process.
The restrictions are designed to protect the employee, co-workers, and the general public from further injury that might occur when an employee is unable to safely perform the functions of the job. For example, while an employee might be physically capable of returning to work, an employee taking pain medication that creates drowsiness should not be operating machinery or driving a vehicle.
For the doctor, one of the most difficult aspects of controlling the period of disability and the return to work, is the employee's ability to deal with the pain symptoms. Some employee's tolerate an injury and the pain associated with it better than others. And while pain can be very real, it is often used as a crutch by people who do not want to return to work. A lack of job satisfaction, available income from workers' comp or another source, the employee's ability to find another job, the desired standard of living and the need for health insurance or other employer provided benefits, often have an impact on the perceived level of pain and the length of the disability period. A simple, no cost way to deal with pain that will work sometimes is for the employer to call the employee and stress how much the employee is needed at work – making sure to let them know they are a necessary part of the workforce. (WCxKit)
Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing, publishing, pharmaceuticals, retail, hospitality, and manufacturing. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
Comorbidity is the presence of two or more medical conditions in a person at the same time. When an employee with a prior medical problem has an on-the job injury, the cost of the medical care and the length of time the employee will be off work is normally extended. This does not mean that workers compensation will pay for an employee's pre-existing medical problems, but it does mean that the pre-existing medical problems can complicate the medical care for the workers compensation injury.
When an employer takes an active interest in the medical status of its employees, it has a far reaching positive impact. Take for example the trucking company that did not have an overall
wellness program for its employees. It was not only paying more for the cost of health insurance, it was paying more for the cost of workers compensation insurance. And then the inevitable happened: a truck driver with several — not one or two health issues — but
several health issues got hurt on the job.(WCxKit)
The truck driver, who was driving a tanker truck, decided to check the level of the liquid in the tanker. The driver, 51, climbed up on the catwalk. To hold on, he took hold of a handle for that purpose, but lost his balance and started to fall. By holding on to the handle, he was able to prevent the fall, until all of his 297 pounds was on his arm and shoulder. Rip went the rotator cuff in his shoulder, pop went the handle as it was there for balancing, not to hold 297 pounds, and the trucker fell to the ground.
The doctor's immediate assessment was probable torn rotator cuff. The MRI confirmed a large rotator cuff tear in this very large guy. Normally, the doctor would schedule surgery, repair the rotator cuff, and send the employee to physical therapy for six to eight weeks, returning the employee to light duty in four weeks and returning the employee back to work full duty in eight to 10 weeks.
The obesity alone would not have been much of a factor for rotator cuff repair, but the issue that caused the
obesity was. The trucker liked beer. A lot of beer, which is how he got to 297 pounds. But the alcohol also brought on other comorbidity factors including hepatitis C and cirrhosis of the liver. The orthopedic doctor did what any other doctor would do, he delayed the surgery until the claimant could get surgical clearance from the gastroenterologist. The gastroenterologist could not see the claimant immediately and four weeks of temporary indemnity benefits were paid while the claimant waited the appointment with the gastroenterologist.
The gastroenterologist agreed to take the claimant off antiviral medications. The claimant's body needed at least three months to adjust to not having the antiviral medications and for his platelet count to recover adequately for the rotator cuff surgery. Another three months of indemnity benefits.
The rotator cuff surgery was completed, but then diabetes came into play (I should have mentioned earlier that the trucker was also a diabetic). Three weeks post surgery, the area around the surgical wound began to turn red. Due to hyperglycemia, brought on by the diabetes, cellulitis (infection) of the wound and surgical area developed. The driver went back to the hospital for another surgery to surgically remove the infection. Of course when the wound was opened, the rotator cuff had not healed due to cellulitis and had to be repaired again. The second rotator cuff surgery caused by the comorbidity of diabetes adds both additional medical cost and another three weeks of indemnity benefits, as all the recovery time between the first surgery and the second surgery is loss.
When you are immobile due to obesity and recovering from two surgeries, have hepatitis C, cirrhosis and diabetes, it is nothing unusual to develop edema (where the body retains excessive levels of fluid). When you are severely bloated, it is difficult to actively participate in physical therapy. With drugs for the edema, physical therapy was only delayed two weeks, but this was two extra weeks of indemnity benefits in addition to the medical cost of the doctor's visit and the pharmacy.
For brevity of this article, we will not discuss the hypertension and basilic vein clot/thrombosis and how they delayed the medical recovery that further extended the time the employee was drawing indemnity benefits. Also, for brevity we will not discuss the employee's anxiety, depression, panic attacks, insomnia, abdominal pain, jaundice, and weight loss issues as these conditions individually did not prolong the worker compensation claim, but collectively added to the medical cost as the primary doctor had to address the issues or refer the medical issues to other doctors.(WCxKit)
While few workers compensation claims have this many medical complications, the non-work related medical issues of your employees will interfere with the recovery from the on-the-job injury. You can reduce the cost of both health insurance and workers compensation insurance by encouraging your employees to individually maintain good health and by providing a wellness program.
Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing, publishing, pharmaceuticals, retail, hospitality, and manufacturing. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
A very interesting viewpoint was recently presented to us. What happens to employees permanently disabled by an injury at work? Obviously, they are not candidates for a
return-to-work program. That is to say, they reside in nursing homes or receive lifetime medical care at home due to the nature of their workplace injury.
While an employer has an interest in controlling these medical costs, providing care management services supports the injured employee and offers the family peace of mind. (WCxKit)
What "Care Managers" Do
It is very challenging to work with and protect the interests of chronically ill or disabled persons. A care manager
works with clients to:
1. Evaluate current and future needs.
2. Act as an advocate within the healthcare and social services system.
3. Coordinate care while protecting assets.
5. Be available when family cannot.
6. Speak with the client about subjects the family finds difficult to discuss.
7. Listen to the person’s plans, wants and needs.
8. Help them with unbiased recommendations so they may make informed decisions.
9. Has the skills and knowledge to properly determine problems and come up with solutions.
10. Has sizable resource they can call upon.
Quality Care Managers
Well-qualified care managers are registered nurses, master’s level social workers or vocational counselors with a background in the special needs of workers with semi- or permanent workplace disabilities from a workplace injury. They have a thorough knowledge of the workers compensation system, Medicare set-asides, and understand the intricacies of the social services and healthcare delivery system.
They have the skills to assess needs and interests, locate resources and oversee the best solutions from the most cost-effective resources.
Care Managers are usually employed by an established care management service company (like
Broadspire, a third-party administrator). As such they are extensively trained and supervised.
The services of a care management service company are not attached to any home health agency, insurance carrier or facility, so care managers are free to offer a totally objective assessment of every issue. The only objective is the happiness and well-being of the clients and their families.
Care managers perform an assessment on the client’s functional, physical and cognitive status, as well as their environment and financial/legal situation. Following the evaluation, they provide a detailed analysis of the client’s status and recommend cost-effective solutions.
Complete Care Coordination
As advocates, medical advisors and surrogate family members, care managers take on many roles. They interview and screen in-home caregivers or hire contractors for home modification; attend doctor office visits, plan outings and visit clients to celebrate special occasions..
If placement in a nursing home or extended care facility is needed, the care manager locates appropriate options, checks all credentials and tours the facility with the client. They also determine suitable payment options and coordinate all paperwork.
Ongoing Care
Your care manager maintains the relationship for as long as you wish. They will:
1. Be an advocate during hospital stays.
2. Help arrange social activities.
3. Coordinate benefits and audit medical bills.
4. Help with moves or transitions.
5. Supervise aspects of in-home and facility services.
Legal and Financial Assistance
It can be quite a challenge to successfully manage disbursements from trust funds, protect the beneficiary’s eligibility for government-provided care. Fiduciary and legal representatives serve as healthcare representatives, evaluating the client’s health, needs and benefits, coordinate healthcare, and protect everyone involved against legal liability arising from misuse of funds.
Fiduciary and Legal Representatives provide:
1. Coordinated resources, equipment, medical and social services.
2. Transition coaching to a more independent, productive life.
3. An evaluation of appropriateness for trust funds disbursements.
4. Assessments of medical needs with healthcare professionals.
5. An appropriate environment to reduce risk.
6. Identification of community services to supplement existing care.
7. Alternatives for care.
8. Assistance with Independent Education Plan (IEP) meetings.
Navigating the Healthcare and Social Services Systems
Working within a bureaucracy to help special needs individuals is complex and often overwhelming. Some states even require attendance at court appearances. Understanding the required documentation is often intimidating. (WCxKit)
Care managers have the expertise to organize the information needed, complete the required forms and even attend hearings for the client, thus avoiding missteps that could take months or even years to clear up. A care management service relieves the burden of staying compliant with the system’s guidelines.
Contributor: Broadspire provides workers compensation claims adjusting services and third-party administrative services. This service is available unbundled and bundled for Broadspire clients and companies that are not currently clients. For information contact 1-866-625-1662 or Broadspire_Info@choosebroadspire.com or www.ChooseBroadspire.com
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com.
Have you ever wondered how long an employee’s medical treatment will continue after an injury occurs? It would be great if there was a medical guide stating, “If employee has X type of injury, the recovery time is 29 days.” but unfortunately, there is no precise recovery time for each type of injury. The speed and extent of recovery for the same type of injury can vary significantly from employee to employee.
The speed of recovery from an injury varies depending on different factors including:
1. the degree of damage caused by the injury,
2. the age of the employee,
3. the physical condition of the employee prior to the injury (obese employees and employees who have poor physical conditioning have longer recovery times),
4. the occurrence of injury to another body part at the time of the accident,
5. the post injury treatment program (for example – many musculoskeletal injuries resolve faster for employees given physical therapy than for employees not given physical therapy),
6. the activity level of the employee post injury,
7. the nature and extent of any underlying pathologies,
8. the overall health of the employee
9. the personal habits of the employee (smoking, alcohol use, illicit drug use),
10.the stress level and the emotional state of the employee,
11.the employee's sleeping habits and general health habits
Even with all these caveats, the employer still can estimate with some degree of certainty the amount of time an employee will be off work for certain types of injuries. Some general guidelines for average disability recovery time would be: This information is provided in a generic context and may not to be used without independent medical verification by your doctor.
|
Simple fracture
|
6 to 8 weeks
|
|
Compound fracture
|
8 to 16 weeks
|
|
Fracture with surgical intervention
|
18 to 30 weeks
|
|
Simple sprains
|
6 to 10 weeks
|
|
Simple strains
|
4 to 6 weeks
|
|
Surgical recoveries
|
6 to 24 weeks
|
|
Burns, first degree
|
3 to 6 days
|
|
Burns, second degree
|
2 to 3 weeks
|
|
Burns, third degree
|
12 to 40 weeks, depending
on percent of body surface
|
|
Anterior Circulate Ligament (ACL)
|
3 to 4 months
|
|
Rotator cuff
|
3 to 4 months
|
|
Lumbar surgery
|
8 weeks to 6 months
|
|
Cervical surgery
|
6 weeks to 3 months
|
To determine the severity and seriousness of the injury, the medical provider often performs various test including x-rays, MRI (magnetic resonance imaging) and CT scans (computed tomography). The results of these tests can guide the claims adjuster and the employer on whether the employee should be out of work closer to the minimum time or the maximum amount of time on the schedule above. (WCxKit)
Medical management with a nurse case manager should be considered as soon as any of the above minimum periods are reached if the medical provider has not given an estimated release date. A nurse case manager should also be considered if the employee has any underlying pathologies exacerbating the injury or delaying the recovery. It is also recommended that a nurse case manager be utilized when the employee is non-compliant with the prescribed medical treatment, the employee has had multiple prior injury claims or the employee has a preexisting disability.
If it appears the full recovery from the disability is going to exceed the normal amount of time needed for disability recovery, the workers comp adjuster should request an independent medical evaluation be performed to verify the extended disability time and to determine (or verify) the medical course of action to bring the employee to the point of maximum medical improvement. (MMI)
The average disability recovery time should NOT be confused with the time the employee should be off work. The average disability recovery time is the amount of time from injury to maximum medical improvement. The time the employee should be off work is determined by the availability of modified duty or transitional duty and the time off work should be considerably shorter than the disability recovery time.(WCxKit)
There are some severe injuries where the recovery period can be a very long time or the injury is so severe that there will never be full recovery. Examples of this include:
1. Closed head injury
2. Brain stem injury
3. Spinal cord injury
4. Amputation of a major extremity
5. Loss of an eye
6. Loss of hearing
These types of severe injuries normally require the insurance carrier or third party administrator to report the claim to the reinsurer.
The total disability recovery time for an injury depends upon the severity of the injury and the medical condition of the employee prior to the injury. Anytime the employee's recovery from the injury is taking longer than the minimum amount of time needed, a nurse case manager or an independent medical evaluation should be considered. By properly monitoring the medical care, the employer and the adjuster will be able to know if the medical recovery is
Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. RShafer@ReduceYourWorkersComp.com
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com.
Occupational illness, also known as an occupational disease, is one of the least understood areas of workers compensation insurance.
An occupational disease is any chronic ailment that develops as a result of the work done by an employee.
An occupational disease is any illness occurring in a group of workers at a higher rate than it does in the general population.
Occupational diseases have existed at least from the time the Pyramids were built in Egypt. The stonecutters developed respiratory problems from breathing too much stone dust. It is believed that they had the earliest known cases of silicosis.
Workers compensation claims for occupational disease is a small part of the total number of workers comp claims, but can represent a disproportionate amount of the total cost of workers compensation. This is due to the chronic nature of these illnesses/diseases and the on-going need for medical care (often the employee's lifetime). Most occupational diseases do not occur as of a particular date, but develop over a period of time. The time frame can vary from immediate with the exposure to some toxic gases to decades for the development of cancers from the exposure to carcinogens. (WCxKitz)
The extended time frame results in a large number of the occupational diseases not being identified as such and many going unreported. It also creates a problem for the workers comp insurer – is the disease the person has a result of their employment, or is the cause and origin not related to the employment? Uncertainty in this area results in the need for in-depth medical research when a workers compensation claim is filed to determine whether or not employment is the reason the disease developed.
Types of Occupational Diseases
There are various types of occupational diseases, grouped a:
1. Skin diseases
2. Lung diseases
3. Musculoskeletal & repetitive motion
4. Exposure to harmful substances or environments
5. Other occupational diseases
Skin Diseases
Most occupational diseases of the skin are caused by exposure to chemicals or over exposure to the ultraviolet rays of the sun. Common occupational skin diseases include eczema and dermatitis from chemical exposure, and sunburn and skin cancer from over exposure to the sun's ultraviolet rays.
Occupational skin diseases are not limited to chemical manufacturers. Common occupations like printers and hairdressers can development occupational skin diseases. Construction workers, farm laborers and other outdoor workers are exposed to the risk of skin cancer from over exposure to the ultraviolet rays of the sun.
Lung Diseases
The most well known occupational diseases are the respiratory diseases affecting the lungs. They include:
1. Asbestosis among those who work with friable asbestos insulation and asbestos mine workers.
2. Coal miners pneumoconiosis also known as black lung disease among coal mine workers.
3. Byssinosis also known as brown lung disease among cotton textile workers.
4. Silicosis among those who work around silica dust.
5. Occupational asthma brought on by various work place irritants.
6. Chronic obstructive pulmonary disease by employees who smoke and are also exposed to certain gases and fumes in the workplace. Examples of this would be chefs and cooks who use cooking gas without proper ventilation
Musculoskeletal
The best known occupational disease in the musculoskeletal group would be carpal tunnel syndrome caused by repetitive motion of the wrist. It is common in painters, butchers, typists and others whose jobs entail the constant flexing of the wrist or who use improper ergonomic alignment of their arms and hands while working.
Tendonitis caused by the overuse of a body part is also a common musculoskeletal occupational disease. Like carpal tunnel syndrome, it is often caused by the employee using a poor technique to perform the work. It is common in many occupations but occurs most among workers engaged in fabrication, manufacturing and laborers.
Exposure to Harmful Substances
In addition to skin diseases and lung diseases, exposure to harmful or toxic substances can cause injury to other body parts. Exposure to carcinogens can cause cancer to develop in various body parts, plus carcinogens have been known to cause cardiovascular and cerebrovascular disease, and nervous system and renal disorders.
Other
There are other types of occupational diseases. Hearing loss is common among factory workers exposed to loud machinery for years, and jack-hammer operators in construction work. (WCxKitz)
Summary
Occupational diseases are caused by exposures related to the employee's work. Occupational diseases, while infrequent in comparison to traumatic injuries, normally have a higher average claim cost. By knowing and identifying the potential occupational diseases your employees can develop, your company can take the necessary precautions to prevent them from occurring and thus controlling workers compensation costs.
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Author Robert Elliott, executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Contact: Info@ReduceYourWorkersComp.com or 860-553-6604.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
Protecting the Bottom Line and Increasing Productivity
Integrated Disability Management (IDM) is a coordinated, consistent approach to an employer's disability benefits programs, including short-term disability (STD), long-term disability (LTD), workers' compensation, and Family Medical Leave Act (FMLA). In an Integrated Disability Management (IDM) program, employee absence due to illness or injury, whether work-related or not, is handled using the same claim reporting, claim management, medical case management and return-to-work protocols. Although many companys have thought of trying an IDM program, not as many have actually implemented such programs.
A fair number, I'd say up to 20%, run some sort of parallel program where they have either a single point of contact or a single claims administrator paying and coordinating short and long term disability. Salary continuation is often paid instead of lost wages, then at 12 -16 weeks (depending on the plan) short term disability takes over. There are many type of programs, each slightly different depending on the companies philosphy. For example, will there be wage replacement instead of workers compensation or not? Do they offer short and/or long term disability benefits or not? Etc.
The objective is to get the employee back to work as quickly and as effectively as possible, maximizing productivity, and mitigating costs. Three key areas must all work together to achieve success.
1. Potential benefits of integrated disability management
2. The key components of a successful program
3. The steps involved in an efficient implementation.
The Potential Benefits of an IDM Program
An effective IDM Program benefits an organization in several ways, including:
Reduced overall disability claim costs. But what is this figures comprised of?
The total cost of employee disability can be broken down into the following categories:
1. Direct Costs, such as wage replacement, medical expenses, benefits expenses and litigation costs.
2. Indirect (Hidden) Costs, including temporary employee replacements, overtime, lost productivity and reduced employee morale.
3. Administrative expenses to manage multiple programs, either internally, or through vendors.
4. Increased productivity resulting from shorter disability durations and quicker return to work. Studies show that the longer an employee is off work, the less likely he is to return.
5. Enhanced, consistent claim management processes for both occupational and non-occupational injuries and illnesses.
6 Integrated data collection, sharing and reporting across benefit lines and policy years.
7. Reduced chance to submit multiple claims and "double dip" due to single source claim reporting and management. (WCxKit)
8. Increased employee satisfaction from simplified claims services
9. Medical management of all disability lines. It's only one body, one person, so a medical director could potentially have great impact since the employee is using all benefits available. Thus medical managment could have a huge impact to help reduce these costs.
10. Modified duty and transitional work assignments with internal accounting. While having modified duty has a cost, NOT having one has an even higher cost - 100% loss of one employee's productivity plus replacement wages for another employee, plus workers comp, STD or LTD.
\Author Rebecca Shafer, President, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Contact: RShafer@ReduceYourWorkersComp.com or 860-553-6604.
FREE WC IQ Test: http://www.workerscompkit.com/intro/
Return to Work Calculator: http://www.reduceyourworkerscomp.com/transitional-duty-cost-calculator.php
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers' comp issues.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
Attitudes continue to be seen by disabled persons as the single biggest barrier to New Zealander’s living fully productive lives, e.g., access to education, having paid work and appropriate support, according to a report from the Disabled Persons Assembly (NZ) Inc.
The government’s $3 million commitment to promote positive perceptions about disabled persons and to target discrimination provides a real opportunity for change.
“Disabled persons must be central to the planning and design of any public awareness or social marketing program that aims to change behaviors,” said Ross Brereton CEO of DPA. (WCxKitz) DPA as a collective voice has the lived experience of disabled persons and looks forward to working with other disabled persons organizations and with the government on the public awareness program.
The employment rate for disabled persons is a little more than half the employment rate of non-disabled persons. This participation rate remains embarrassingly low and is unacceptable officials said.
Changes in the income tax rates, particularly the lowering of the $14,000 to $48,000 from 21% to 17.5% presents an opportunity to focus on meaningful employment for disabled persons so everyone can share in the economic gains in a significant way.
DPA said it warmly welcomes the investment of $2.3 million over the next three years to promote, protect and monitor the rights of disabled persons. (WCxKitz)
DPA added it is particularly pleased with the $750,000 available to the Convention Coalition responsible for independently monitoring the United Nations Convention on the Rights of Persons with Disabilities.
\Author Rebecca Shafer, Consultant / Attorney, President, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Contact: Info@ReduceYourWorkersComp.com or 860-553-6604.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
Protecting the Bottom Line and Increasing Productivity with a Successful IDM Program
As the use of integrated disability management increases, best practices, or keys to program success, are emerging. A careful review of the following issues can help you decide whether an IDM program is an option worth pursuing for your organization.
1. Senior Management Support
Implementing an IDM program can be a resource-intensive initiative, and senior management should be firmly behind it before any making any commitments. An IDM program needs to be part of the overall corporate culture.
2. Cross-Functional Team Approach
Integrated disability management requires interdepartmental cooperation and communication to be successful. Everyone must share the same goals and objectives in order for IDM to succeed! It is also important to designate an IDM program manager or advocate who will oversee the entire process.
3. Centralized Claim Reporting
A unified claim intake system for all disability claims (WC, short-term disability (STD), long-term disability (LTD) and Family and Medical Leave Act (FMLA), protects your company against potential duplicate claims, and it simplifies the reporting process for your employees.
4. Common Claim Management Protocols
Despite the differences in processing occupational and non-occupational disability claims, there should be common claim management guidelines such as:
a. 24 hour contact with employer
b. On-going contact with employee
c. Early intervention by nurse case manager or claim rep
d. Subrogation identification
e. Transitional work program
5. Consistent Non-Occupational and Occupational Return-To-Work Programs
Bureau of Labor Statistics indicate if an employee is off work for six months due to occupational injury or illness, there is only a 50 percent chance the worker will ever return to work. If the employee is off for one year, there is less than a 25 percent chance of returning to work, and after two years, there is virtually no chance of ever returning to work, due to a phenomenon called "psychological dis-employment" – the worker becomes "used to" not working and "enjoys" being at home – possibly collecting work comp or disability payments for an extended period of time.
A primary objective of IDM is to return an injured or ill employee to work and productivity as quickly as possible. This requires a strong commitment from management to a "return-to-work" culture, with formalized RTW program and resources, for both non-occupational and occupational injuries and illnesses.
6. Integrated Data Capture And Retrieval System
Integrated data allows you to benchmark and track the results of the IDM program. It also allows you to objectively report program results to senior management and your operating units, essential for their continued support and buy in. (workersxzcompxzkit)
7. Frequent, Clear Communications To Employees
Poor communication can be the undoing of an IDM program! Clearly communicating benefit policies and procedures will help avoid confusion among employees.
\Author Rebecca Shafer, Consultant/Attorney, President, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Contact: RShafer@ReduceYourWorkersComp.com.
FREE WC IQ Test: http://www.workerscompkit.com/intro/
WC Books: http://www.reduceyourworkerscomp.com/workers-comp-books-manuals.php
WC Calculator: http://www.reduceyourworkerscomp.com/calculator.php
TD Calculator: http://www.reduceyourworkerscomp.com/transitional-duty-cost-calculator.php
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers' comp issues.
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com
Subsequent injury funds, aka second injury funds, are designed to facilitate the hiring of employees who have pre-existing medical disabilities. The state government in approximately 20 states assumes financial responsibility for the cost of a workers' compensation claim when a partially disabled employee incurs a new injury increasing the level of disability in the employee.
The Subsequent Injury Fund (SIF) process varies by state, but in the typical SIF state, the SIF assumes liability for the cost of the work comp claim over and above what the insurance company would have paid on the claim if the employee did not have a previous medical disability.
A typical example is the potential employee with a 25% permanent partial disability rating to the body as a whole due to a prior back injury. An employer reviewing the potential employee's prior medical history will be reluctant to hire the potential employee knowing this potential employee has a higher probability of a high permanency rating if injured on the job. If the employer knows the SIF will be responsible for the first 25% of any future disability rating, the employer should (in theory) consider this employee on his work qualifications and not his work comp exposure.
To prevent insurers and self-insureds from over utilizing the SIF, most states have fairly stringent guidelines about what type of claim will qualify for SIF payment. Some of the restrictions the SIFs have
1. The employee must have a medical certified disability prior to the new work comp injury.
2. In some states the prior disability must be from a work comp injury. In other states the prior disability can be from disease, accident or congenital.
3. The pre-existing condition limited the employee's ability to do the job to some extent.
4. There must be a merger of the two conditions—the pre-existing disability and the new work comp injury.
5. The pre-existing disability and the impairment from the new work comp claim must be greater than the pre-existing disability alone.
6. Each SIF will have requirements on when it must be notified of the potential claim against the SIF.
7. All the SIFs either required a claim form to be completed or require a hearing before the work comp board before they accept a work claim for SIF payment.
8. In the majority of states, the SIFs will accept the claim if the new work comp injury increases the employee's overall level of disability to some extent. In a few states the second injury must increase the overall disability to the 50% whole body level or other set percentage level.
9. Some SIFs require both the prior disability level to be 20% or 25% and the increase in disability from the new work comp claim to be another 20% or 25%.
10. Some SIFs will only be liable for indemnity benefits while others SIFs will assume liability for both indemnity and medical benefits.
11. Most SIF's require the insurer or self-insured to have paid a year or two years of indemnity benefits, plus a predetermined dollar amount of medical expense before they become involved.
12. Most SIFs reserve the right for an independent medical examination of the employee/claimant if they have any questions about the employee's medical condition and disabilities.
The SIFs differ in how they process the SIF claims. In some states, the insurer or self-insured continue to process and handle the claims and submits documentation to the SIF for reimbursement. In other states the SIF takes over complete handling of the claim and deals directly with the employee/claimant.
Second Injury Funds normally pay the permanent partial disability rating for the number of weeks needed to equal the disability rating. In cases of permanent total disability, the SIF will pay the remaining weeks to reach the maximum number of weeks for total disability, or for life in those states that provide lifetime payments for permanent total disability. In a few states where the employee can negotiate a lump-sum settlement for their disability, the SIF will be active in the settlement negotiations.
The funding mechanism for the SIF also varies. In some states the SIF accesses each insurer and self-insured a percentage of the work comp premium they have collected in the previous year. In other states, the assessment is based on the total amount paid in claims by the insurers and self-insureds. A few states assess only the work comp claims that have a permanency award. (workersxzcompxzkit)
If your state has a SIF it would be in your best interest to get acquainted with the details of how it operates. It can be a major source of funding for severe claims where the employee had a prior disability. If you have questions about your SIF, please contact us.
Author R Shafer, J.D. Consultant, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, healthcare, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. She can be contacted at: RShafer@ReduceYourWorkersComp.com or 860-553-6604.
Podcast/Webcast: Occupational Health Strategies
Click Here:
WC Calculator: http://www.reduceyourworkerscomp.com/calculator.php
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers' comp issues.
© 2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ ReduceYourWorkersComp.com.
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Implementation and Rolling Out Your Program, Integrated Disability Management, Medical Cost Containment & Managed Care |
