Sit Up and Take Note: The Truth about Ergonomics

Sit Up and Take Note: The Truth about Ergonomics

Article originally published on Medcor Health Blog

 

Does your back hurt? Are you experiencing neck pain? Do you find yourself complaining of hand, arm, knee, or muscle aches? If so, you may be suffering from a musculoskeletal disorder (MSD). Discomfort/pain, numbness, tingling, stiffness, burning, cramping, and swelling of bones, joints, muscles, tendons, and ligaments can be symptoms of MSDs. If work or leisure activities are causing discomfort – it is time to become more ergonomically aware.

 

MSDs are conditions of muscles (sprains/strains), tendons (inflammation), ligaments, joints (arthritis), and nerves that are often associated with exposures to ergonomic risk factors, including: awkward postures, repetition, force, contact stress, and vibration.1 Age, sex, obesity, and health conditions (i.e., diabetes, rheumatoid arthritis, and hypothyroidism) can also play a factor.

 

 

Truth: Being Aware Of Ergonomic Risk Factors Can Significantly Reduce Your Chance Of Developing MSDs

 

Being aware of ergonomic risk factors can significantly reduce your chance of developing MSDs which have costly and disabling effects for many Americans. An estimated 126.6 million Americans aged 18 and older suffer from MSDs – that is one in two adults.2 Costs related to MSDs involve treatment (medical visits, prescriptions), lost wages, and work-related injuries, estimated to exceed $200 billion annually.3

 

MSDs often result in chronic complaints, disability, issues with mobility and decreased quality of life and are the second largest contributor to disability worldwide. Frequently, MSDs result in work-related injuries impacting worker’s compensation costs, absenteeism, and productivity.

 

 

Truth: One-Third Of Million Nonfatal Workplace Injuries/Illnesses Result In Days Away From Work

 

The U.S. Bureau of Labor Statistics reported that approximately 2.8 million nonfatal workplace injuries/illnesses occurred in 2017, one third of those resulted in days away from work. MSDs represented 32% of those injuries.4

 

Employers and workers share in the responsibility to help reduce risk factors by understanding ergonomics, taking actions to decrease those risks, and promoting best work practices throughout the organization. Ergonomics involves everyone.

 

 

Truth: Ergonomics Help The Job Fit The Worker

 

Ergonomics includes engineering, administrative, and personal controls to help the job fit the worker, rather than trying to have the worker fit the job.5

 

Engineering controls include: workspace design, reducing the weight of loads or applying lift-assist devices, automating processes, and re-designing tools to promote neutral postures.6

 

Administrative controls focus on establishing work practices to reduce the risk of injury and encompass actions such as job rotation, managing over-time, providing adequate staffing, reviewing injury logs, performing accident investigations, promoting near-miss reporting, providing employee education on MSDs/risk factors, encouraging early reporting of work-related injuries/illnesses, implementing break and stretching schedules, discussing work load and job satisfaction with employees, and maintaining equipment and tools.7 Providing ergonomic friendly accessories, such as: adjustable table/chairs, lumbar supports, footrests, arm supports, document holders, sit/stand work stations can each promote the job fitting the worker.

 

 

Personal Controls

 

Lastly, personal controls include the appropriate use of personal protective equipment (PPE), being mindful of posturing, alternating between sitting and standing, reporting of work injuries at the first sign of discomfort, participating in ergonomic stretches/micro-breaks and safety committees.8 Everyone should be mindful of posturing (feet flat on the floor or footrest, back supported, elbows close to body, avoid slouching, keep neutral postures), avoid awkward positions (bending the neck, static postures, placing wrists at extreme angles, working above shoulder height, stooping/crouching), reduce unnecessary movements, limit carrying heavy loads, avoid excessive bending and twisting, avoid over reaching, and keep frequently used items within a safe reach zone.9

 

Implementing ergonomic awareness and promoting a culture of safety and overall total worker health will reduce the risk of work-related injuries, increase productivity and job satisfaction, decrease costs associated with worker’s compensation and health premiums. The truth is, awareness goes a long way in preventing injury.

 

This article is not meant to diagnose or treat any condition. Always consult your primary care provider for healthcare instructions.

 

 

Author Ashley Clay, MSPAS, PA-C, Medcor Provider. Medcor helps employers reduce the costs of workers’ compensation and general health care by providing injury triage services and operating worksite health and wellness clinics. Medcor’s services are available 24/7 nationwide for worksites of any size in any industry. Headquartered in McHenry, Illinois, the company operates 174 clinics and provides triage services to over 90,000 worksites across all 50 states and US territories. Medcor’s triage methods are covered by U.S. & foreign patents, including U.S. No. 7,668,733; 7,716,070; & 7,720,692; other patents pending. Medcor is privately held. Learn more at www.medcor.com.

 

  1. Occupational Safety and Health Administration, “Ergonomics: Overview,” accessed March 15, 2019, https://www.osha.gov/SLTC/ergonomics/index.html.
  2. Bone and Joint Initiative USA, “The Impact of Musculoskeletal Disorders on Americans—Opportunities for Action,” Executive Summary of The Burden of Musculoskeletal Diseases in the United States: Prevalence, Societal and Economic Cost, third edition.
  3. Ibid.
  4. United States Bureau of Labor Statistics, “2017 Survey of Occupational Injuries and Illnesses Charts Package,” https://www.bls.gov/iif/osch0062.pdf.
  5. Occupational Safety and Health Administration, “Ergonomics: Overview,” accessed March 15, 2019, https://www.osha.gov/SLTC/ergonomics/index.html.
  6. Occupational Safety and Health Administration, “Ergonomics: Solutions to Control Hazards,” accessed March 15, 2019, https://www.osha.gov/SLTC/ergonomics/controlhazards.html.
  7. Ibid.
  8. Ibid.
  9. Washington State Department of Labor and Industries, “Ergonomics Principles for Reducing Awkward Postures,” accessed March 15, 2019, http://www.lni.wa.gov/Safety/SprainsStrains/AwkwardPostures/ReducingAwkwardPostures.pdf.

21st Century Skepticism in Science and Effects on Medical Care

thomas glimp

Dr. Thomas Glimp, Medcor Chief Medical Officer

We live in an age of scientific enlightenment. Science, through technology, has made remarkable advances in the 20th and early 21st centuries.

 

Health advances over the same time include sanitation and hygiene with cleaner water and food, advanced imaging technologies using ionizing radiation and nuclear magnetic resonance, minimally invasive surgical techniques, organ transplantation, the discovery of DNA and sequencing of the human genome, the relationship of the genome to heritability and disease with great promise for  future  health, the discovery and mass production of antibiotics and widespread vaccination. Because of these and other health innovations, the average U.S. life expectancy increased from 47 years to 77 years in the 20th century.

 

Most bacteria are still susceptible to at least one or a few antibiotics, but we are getting uncomfortably close to the abyss.

 

In spite of these advancements, there is a skepticism of science in general and of medicine in particular. Skepticism can complicate daily medical management. Let’s look at an example:

 

 

Antibiotic Abuse

 

There, I’ve said it – abuse. Not overuse, but abuse. Antibiotics, one of the most important discoveries in the history of medicine are abused and, as a result, are losing their life-saving power.

 

Antibiotics are substances produced by microorganisms, including molds, that inhibit or kill competing microbes. Alexander Fleming accidentally discovered penicillin, the first antibiotic, in 1928. Fleming saw that staph bacteria growing in a petri dish were inhibited by a green mold (Penicillium notatum) contaminant. Through further testing, he found that “juice” produced by this mold inhibited or killed any number of pathogenic bacteria. Penicillium “mold juice” ultimately became the first antibiotic, penicillin. During World War II the U.S. War Production Board recognized the strategic value of penicillin and made its production a priority under the direction of Albert Elder,  known  as  the  “Penicillin  Czar.” I mention Elder for this quote:

 

You are urged to impress upon every worker in your plant that penicillin produced today will be saving the life of someone in a few days or curing the disease of someone now incapacitated.[1]

 

While true then, we have squandered the value of penicillin and many more antibiotics today. How do bacteria become resistant to antibiotics?  It’s all about selection pressure. The CDC explains it well:

 

Every time a person takes antibiotics, sensitive bacteria (bacteria that antibiotics can still attack) are killed, but resistant bacteria are left to grow and multiply. This is how repeated use of antibiotics can increase the number of drug-resistant bacteria.[2]

 

This is true whether the person given antibiotics has a bacterial or viral infection. The overuse of antibiotics promotes resistant bacteria, even if the infection is not bacterial. The “bathing” of our population in unnecessary antibiotics for medical illnesses that are not or only rarely bacterial – colds, bronchitis, sinusitis, etc. – has led to resistance and a tragic loss of antibiotic effectiveness. You have undoubtedly heard about “MRSA” – Methicillin Resistant Staph Aureus. You are just as likely to have not heard about VASA, VRE and the hundreds of other highly resistant bacteria for which there are few antibiotic choices. In just the past year, resistance was reported to the last remaining antibiotic, colistin, to which no resistance had previously been described. Fortunately, most bacteria are still susceptible to at least one or a few antibiotics, but we are getting uncomfortably close to the abyss.

 

There is a delicate balance between clinical need and preventing resistance. To prevent resistance, antibiotic use must be thoughtful and frugal. The world is lacking that balance.

 

There are three culprits:

 

  • agricultural use of antibiotics in livestock feed
  • overuse of antibiotics through free access in much of the world
  • over-prescription of antibiotics by medical providers.

 

Our focus at Medcor has been on appropriate antibiotic prescribing practices or “Antibiotic Stewardship.” Our perennial campaign is comprised of patient education materials, including handouts and posters, specific provider support through education, monitoring of prescription practices, and feedback.

 

A world with effective antibiotics sounds like a place we’d all like, but there are considerable obstacles to antibiotic stewardship, not the least of which is skepticism.  When it comes to antibiotics, physicians and other medical providers seem to have little credibility with patients.  Providers seem unable to convince patients that not every infection can be successfully treated with antibiotics and further that indiscriminate antibiotic use is unnecessary and unwise. In a study published in the British Journal of General Practice, antibiotic prescribing volume was a strong predictor of “doctor satisfaction” and “practice satisfaction.” In this study, 55% of physicians reported pressure to prescribe antibiotics, 45% had prescribed antibiotics for a viral Infection knowing that they would be ineffective, and 44% admitted that they had prescribed antibiotics in order to get a patient to leave. The authors calculated that a 25% reduction in antibiotic prescription would result in a 3-6 percentile decrease in national satisfaction ranking.[3]

 

There is a clash between what is right for patients and what is desired by patients. It is borne of the skepticism surrounding what is right.

 

 

The Point

 

So, what’s the point of this exercise? It’s to give you a better idea of the surprising pressures, born of skepticism, under which healthcare providers operate today and the complex realities of medical practice. Who would predict that dedication to evidence-based care would meet with patient resistance and poor impressions of provider performance? Overcoming skepticism is not easy, nor does the pressure relent. Toward the goal of better health for all, it is up to all involved in healthcare to show grit – passion plus perseverance wielding science as a weapon.

 

[1] Quoted In John Parascandola. “The Introduction of Antibiotics into Therapeutics in Sickness and Health in America: Readings in the History of Medicine and Public Health Third Edition Revised, ed. Judith Walzer Leavitt and Ronald L. Numbers (Madison University of Wisconsin Press 1997), 106

[2] Centers for Disease Control and Prevention, “Antibiotic Resistance Questions and Answers” last modified May 29, 2018. https://www.cdc.gov/antibiotic-use/community/about/antibiotic-resistance-faqs.html

[3]  Mark Ashworth et al., “Antibiotic prescribing and patient satisfaction in primary care in England: Cross-sectional analysis of national patient survey data and prescribing data” The British Journal of General Practice: The Journal of the Royal College of General Practitioners 66, no 642 (2016 ): e40-e46. doi: 10.3399/bjgp15X688105.

 

 

 

Author Thomas Glimp, MD, Chief Medical Officer, Medcor. Dr. Glimp, MD joined Medcor in 1994. Tom is board certified in internal medicine and in emergency medicine. Dr. Glimp’s clinical affairs team provides standards, scope, guidelines and protocols, quality assurance, and other support for Medcor’s clinical services and staff. Medcor helps employers reduce the costs of workers’ compensation and general health care by providing injury triage services and operating worksite health and wellness clinics. Medcor’s services are available 24/7 nationwide for worksites of any size in any industry.

Create an Effective Wellness Program with 6 Milestones

Create an Effective Wellness Program with 6 Milestones Many small and medium-size companies wish to create an effective wellness program like their larger competitors, but due to budget concerns and lack of personnel in the Human Resources Department, have not started their own wellness program. It is not as difficult as one might think.

 

Here are some guidelines on how to create an effective wellness program:

 

 

Management Support of Wellness is Step One 

 

Gaining management support for the implementation of a wellness program is the first step. As senior management is all about the financial success of the company, explaining how the wellness program will improve the company’s financial picture is a good place to start. Read the study on wellness programs completed by the Wellness Council of America. Explain how for every $1 spent on wellness programs, there was a $3 reduction in the cost of the health insurance program. If management is still not sold after learning the wellness program has an ROI of 3 for 1, an article published in Forbes states “According to the Centers for Disease Control, more than 75% of the employers’ health care costs and productivity losses are related to employee lifestyle choices.”
 

There is a similar correlation in workers compensation cost as healthier employees have fewer accidents, and when they do have an accident, they return to work sooner. This was supported by a combined 56 studies on worksite wellness programs. Per the American Journal of Health Promotion, there was a 32% reduction in workers compensation.
 

 

Form a Wellness Committee

 

After gaining the support and participation of senior management in the creation of a wellness program, form a wellness committee. Whether electing to utilize an outside company that has a wellness program already structured that can be implemented quickly or deciding to build your own company wellness program, the involvement of additional personnel from various departments will expand the ideas and ensures the success of the wellness program. Broad representation of the wellness committee will be drawn from human resources, finance, risk management, safety, union, senior management, and production. You can also invite volunteers from any department within the company. The wider the variety of specialties the better.
 

 

Establish Wellness Benchmarks

 

The goals and objectives of the wellness program should be the first order of business for the wellness committee. By establishing benchmarks, you will be able to measure the success of the wellness program. The primary reason companies abandon wellness programs is the failure to have benchmarks showing the success of the wellness program. Some benchmarks that can be considered include:

 

  1. absenteeism
  2. health care cost
  3. employee retention rate
  4. employee participation (percentage) in the wellness program
  5. reduction in the number of workers compensation claims
  6. reduction in overall workers compensation cost

 

 

Employee Involvement Is Essential

 

The wellness program should not be based solely on the ideas of the wellness committee. Employee interest and involvement are essential to the success of the wellness program. Obtain the input of the employees themselves in what they want to see in the wellness program. An anonymous survey, whether online or on paper, can be used to obtain employee input. Some categories that can be considered for inclusion in the survey for the wellness program include:

 

  1. diet and nutrition
  2. weight loss solo and weight loss groups
  3. exercise equipment
  4. walking solo /walking groups
  5. muscle toning
  6. reduction in blood pressure
  7. reduction in cholesterol level
  8. reduction in body mass index (BMI)
  9. cessation of smoking
  10. cessation of illicit drugs
  11. cessation of alcohol abuse
  12. healthier food options in company cafeteria/snack machines
  13. on-site flu shots
  14. hand sanitizers and other sanitizing items in a public area
  15. ergonomics at work and home
  16. seat belt use
  17. safe driving
  18. pamphlets and posters reminding employees of health topics ( pamphlets on cancer screenings)
  19. vision screenings provided on-site (mandatory for all employees who drive on duty)
  20. yoga classes before/after work hours

 

In addition to these topics, leave three or four blank lines on your survey for the employees to suggest their own wellness topics and concerns they would like to know more about or to have assistance with.
 

 

Implement and Promote Wellness Quickly

 

Once you have established the employees’ wellness program interest, implement and promote quickly to increase your odds of creating a successful wellness program. This can be done in a variety of ways including:

 

  1. provide non-smokers with a $5 per week credit on their health insurance program
  2. provide employees with a BMI under 30 with a $3 per week credit on their health insurance program
  3. a $6 per week credit for the employees with a BMI under 26
  4. provide pamphlets on wellness topics
  5. have posters on wellness issues
  6. offer “lunch and learn” on wellness topics
  7. organize group walks before work/after work/lunch time
  8. have wellness calendars
  9. schedule on-site flu clinic (ask a nearby medical clinic for a group rate discount or inquire if the health insurance carrier will pay for it)

 

 

Give Enough Time to Realize Impact

 

After implementation of the wellness program, it is important to give the program enough time to have an impact. The above-mentioned benchmarks should be established on the first day of the wellness program, and the results measured after one, two and, three years. Evaluate what has worked and what has not. A repeat survey asking the employees who participated their impression of the wellness program is a good way to get additional feedback. Also, a survey for the employees who have not participated in the wellness program asking why they do not participate can provide insights on ways to improve the wellness program.
 

By establishing and creating a successful wellness program, you will improve the financial picture of your company, reduce absenteeism, reduce work comp claims, reduce health insurance claims and improve employee morale. It will also reduce your workload if you deal with human resources issues or workers compensation.

 

 

 

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and 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. She is the co-author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact:.

Contact: RShafer@ReduceYourWorkersComp.com.

Workers’ Comp Roundup Blog: https://blog.reduceyourworkerscomp.com/

 

©2018 Amaxx LLC. All rights reserved under International Copyright Law.

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

Workers’ Comp Wellness: 6 Tips for Better Sleep

Workers’ Comp Wellness: 6 Tips for Better SleepGetting sustaining and plentiful sleep is among the top wellness lifestyle practices and guiding health principles. According to a recent poll by the National Sleep Foundation, 65% of Americans say they are more effective when they get enough sleep.  If sleep is key to helping us be more effective, shouldn’t we put effort into making sure we get enough quality sleep?

 

There are many actions you can take to improve both your sleep quantity and quality. Your bedroom environment is a great place to start. Researchers and experts from the Division of Sleep Medicine at Harvard Medical School and the National Sleep Foundation share the following advice to improve your sleep.

 

 

Routine and Consistency

 

Your body has an internal “clock” that regulates your sleep. Going to bed and waking up at the same time each day will help improve your sleep and waking hours. By doing relaxing things before bed like taking a bath or reading a book, you help cue your body to prepare for sleep. On the other hand, doing stressful activities before bed can increase your alertness and make it difficult to fall asleep.

 

 

Temperature

 

Our body temperature naturally decreases as we begin to fall asleep and the air temperature in the room can affect sleep quality. If it’s too hot, our natural dip in body temperature can be affected, causing restlessness. While the most favorable temperature varies from person to person, research suggests that a temperature around 65 degrees is best for quality sleep.

 

 

Light

 

As darkness settles, our bodies pro­ duce the hormone melatonin to help us prepare for sleep. Artificial light can hinder this process and trigger our brains to stay awake. Inspect your room for sources of light and consider using darkening curtains or shades to block out light. Make it a habit to keep light-producing electronics like cell phones, tablets, and TVs out of the bedroom.

 

 

Sound

 

Noise can disturb your sleep, even in subtle ways that you do not remember upon waking. It is important to create a quiet and constant bedroom environment to get quality sleep. White noise can help drown out sounds that disturb sleep like doors shutting or cars passing by. A fan, air purifier, or even a white noise app and speaker can provide a consistent background sound. Avoid using a TV as your noise filter since the sounds and light constantly change.

 

 

Smell

 

The air you breathe can positively or negatively affect your sleep. Studies suggest that the smell of lavender can have relaxing effects (even to the point of lowering blood pressure and heart rate). Using lavender essential oils or lavender scented candles before bed may help prepare you for a good night’s sleep.

 

Conversely,  allergens can prevent or interrupt a good night’s sleep. To reduce allergens in your environment, wash bed sheets in hot water once a week and blankets regularly. Also, use an air purifier that removes allergens, and keep windows closed when pollen counts are high.

 

 

Food

 

Some research suggests that foods containing the amino acid tryptophan can make you drowsy, helping prepare you for sleep. Turkey, eggs, chicken, fish, and nuts are common sources. But remember: Eating big meals or foods that upset your stomach before your regular bedtime can cause you discom­ fort and make it hard for you to sleep. So can alcohol (which has both sedative and stimulant effects) and true stimulants like caffeine.

 

Sleep is essential to our health and productivity. Make a conscious effort to establish bedtime routines and create an environment that improves your sleep quality. Talk with household members and seek their support. For more sleep tips and research, visit the National Sleep Foundation website and the Healthy Sleep website from Harvard here:

 

http://sleepfoundation.org/bedroom/

http://healthysleep.med.harvard.edu/healthy/

 

 

 

pete arens medcorAuthor Pete Arens, Medcor, Wellness Manager. Medcor helps employers reduce the costs of workers’ compensation and general health care by providing injury triage services and operating worksite health and wellness clinics. Medcor’s services are available 24/7 nationwide for worksites of any size in any industry. Headquartered in McHenry, Illinois, the company operates 174 clinics and provides triage services to over 90,000 worksites across all 50 states and US territories. Medcor’s triage methods are covered by U.S. & foreign patents, including U.S. No. 7,668,733; 7,716,070; & 7,720,692; other patents pending. Medcor is privately held. Learn more at www.medcor.com.

Put It in Writing: Crafting Effective Written Job Offers

Put It in Writing: Crafting Effective Written Job OffersOne of the goals of every workers’ compensation program should be to get the employee back to work following an injury.  When returning the employee to work, interested stakeholders and those seeking to reduce workers’ compensation costs should seek to do so by finding employment at the date of injury employer.  When seeking to return that person to work, it is important to have an effectively written job offer.  Failure to do so can cause delay and be met with ongoing and unnecessary litigation costs.

 

 

Understanding Written Job Offer Requirements

 

The requirements of a written job offer are outlined in greater detail in statute and regulation.  There are also other factors to consider based on developed case law.  Members of the claims management team and employer representatives should understand these jurisdictional specific requirements and carefully follow them.  Always consult with an attorney when there are questions.

 

 

Back to the Basics: Preparing an Effective Written Offer

 

It is referred to in workers’ compensation as a “written job offer” because the most important requirement is that the offer for future employment following a work injury must be in writing.  The nature of that written (paper copy versus e-mail) may also be subject to judicial interpretation.  The result is the best offers are on a piece of paper and either directly handed to the employee or sent via certified mail/receipt request to ensure it was delivered.  There is developing case law that suggests the offer can also be sent via email or tax.

 

There are also other basic requirements.  These often include the following:

 

  • The job offer must be suitable: There are varieties of issues to consider in this element.  The offer must be something that is available at the date of injury employer at a wage commensurate with ability and skill;

 

  • The job offer must be defined: These standards are often outlined in statute/regulation with supporting case law interpretations.  General factors to include are that it be a part of an approved vocational rehabilitation plan, within the employee restrictions and produces an economic status as close as possible to the employee’s pre-injury condition;

 

  • The job offer must be offered at the right time: It is important to understand if this job offer can be made before an employee reaches maximum medical improvement.  This is an essential requirement in many jurisdictions with “timing” requirements; and

 

  • The job offer must include detailed information: Important parts of any job offer should include a job title, wages and hours, physical demands of the position (detailed description of the work one would perform) and whether the employee is capable of performing this job with success given their physical and vocational limitations.  This is often subject to a battle of vocational experts.

 

 

Failure to Accept an Appropriate Written Job Offer

 

The failure of an employee to accept or reject a valid written job offer can have significant implications for a workers’ compensation program.  In many jurisdictions, this can include discontinuance of, or complete future forfeiture of one’s wage loss and vocational rehabilitation benefits.  Most states do not limit an employee’s ability to receive future medical care and treatment based on the rejection or failure to accept a valid written offer.  An attorney knowledgeable in a jurisdiction’s workers’ compensation law can provide a legal opinion on these matters.

 

 

Conclusions

 

Members of the claims management team and other interested stakeholders should seek creative ways to place an injured worker back to work to reduce workers’ compensation program costs.  One such tool is preparing and giving an injured worker an effectively written job offer.  When preparing this written offer, it is important to ensure it is received by the employee and meets the legal requirements of a workers’ compensation act.

 

 

 

Michael Stack - AmaxxAuthor Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center .

 

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: https://blog.reduceyourworkerscomp.com/

 

©2018 Amaxx LLC. All rights reserved under International Copyright Law.

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

6 Tips to Battle Workers’ Comp Comorbidities

Proactive workers’ compensation claim management teams are constantly seeking opportunities to reduce workers’ compensation costs and promote efficiencies.  One such area to address these concerns is battling comorbidities and developing a healthier workforce.  Doing so in an effective matter will reduce the cost of claims and significantly benefit your program.

 

 

What Are Comorbidities?

 

From a medical point of view, a “comorbidity” is a medical condition that exists along with other injuries or ailments.  An example of this in the context of a workers’ compensation claim is a claimant suffering from a work-related injury who has another medical condition.  Common examples include high blood pressure, diabetes, cancer or mental health conditions.  Modern medicine even classifies smoking and use of tobacco as a comorbid condition.

 

It is important for members of the claims management team to identify claimants who have a comorbid condition.  This is because they may often require additional medical care and treatment, or there could be an aggravation of the underlying condition as the result of the work injury.  The ramifications of this include prolonged disability, increased medical care and treatment, addiction to prescription pain medication or permanent and total disability.

 

 

Dealing with the Immediate Issues

 

Once a claim handler is aware of an injured worker with a comorbid condition, it is important to position the matter to avoid future long-term exposures.  In the short-term, members of the claims management team need to monitor claims with care.  This includes a number of actions to keep on top of the claim:

 

  • Frequent contact with the employee to monitor progress and evaluate for referral to defense counsel;

 

  • Determine if or when the employee should be seen for an independent medical examination. Depending on the nature of the claim and comorbid condition, this may require the use of multiple medical experts.  This is frequently common in claims involving an underlying psychological and/or psychiatric condition; and

 

  • Opportunities to put the claim into litigation, as necessary.

 

 

Techniques for Successful Claim Management

 

It is also important to work with interested stakeholders to seek solutions that will develop a healthier workforce to mitigate future claims. Examples of being proactive in this area include:

 

  • Developing a smoking cessation and tobacco dependence program. It is well-documented that workers’ compensation claims involving a smoker/tobacco user cost significantly more when compared to their non-tobacco using counterparts.  While fewer Americans are using tobacco, a certain segment of the workforce continues to use these products;

 

  • Encourage employers to offer gym memberships (free or reduced) and other weight loss programs. Other options include encouraging people to take regular breaks to stretch and move around.  This is also an opportunity for employers to seek out medical insurance programs that offer discounts for members who undergo biometric testing; and

 

  • Increasing the level of education workers have regarding their eating habits. This includes the development of relationships with organizations and registered dieticians who provide information on better food selection, preparation and consumption.

 

 

Conclusions

 

Having an effective workers’ compensation program goes beyond knowing the law and working your claim files in an effective matter.  Proactive claim management teams need to address the underlying issues of a claim such as claimants with comorbid conditions to reduce costs in a program.  This includes addressing issues present on a file and promoting a healthier workplace to mitigate the risk of expensive future claims.

 

 

Michael Stack - AmaxxAuthor Michael Stack, CEO Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center. .

 

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: https://blog.reduceyourworkerscomp.com/

 

©2017 Amaxx LLC. All rights reserved under International Copyright Law.

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

Top 3 Pitfalls When Implementing Wellness In The Workplace

Numerous studies demonstrate the benefits of wellness programs and their positive impact of reducing workers’ compensation costs.  While they can reduce costs in a program of any size, it is important to be aware of some common pitfalls organizations face when implementing wellness programs.

 

 

A Common Hypothetical

 

The owner of the Acme Widget Company attends a workers’ compensation seminar and learns about the benefits of wellness programs in the workplace.  After returning, he installs a basketball hoop and buys a ball for employee’s to use while on their lunch break.  Postings about the basketball hoop were posted in common spaces and the owner strongly encouraged all employees play during their break times.

 

After the installation, the employees were excited.  A “one on one” league soon formed and the owner administered it.  Shortly thereafter, John Doe, the chief widget engineer, injured his knee why playing.  Is the injury compensable?

 

In Hemmler v. WCAB-Clarks Summit State Hospital, 569 A.2d 395 (Pa. Cmwlth. 1990), the following injury was found to be compensable.  Like anything, these cases are fact dependent.  Central to the court’s review were the following issues:

 

  • Did the injury take place while the employee was engaged in the furtherance of the employer’s business or affairs?

 

  • Was the injury caused by a condition of the employer’s premises that was a required part of the employee’s employment at the time of the injury?

 

 

Avoiding Work Comp Issues While Promoting Wellness

 

Promoting wellness within the workplace can create a double-edged sword for employers.  Liability will not be ignored in many instances even though the concept of healthy living and better health are a noble cause.  Proactive stakeholders can take the following steps to avoid liability from injuries suffered when employees engage in wellness-related programming.

 

In reviewing cases that involve injuries while engaging in workplace wellness programs, courts will generally examine whether the activity in question “furthers” the business or affairs of the employer.  Because wellness programs reduce workers’ compensation costs, courts have found the requisite connection between the work activities and an injury to uphold compensability and force the payment of various workers’ compensation benefits in certain instances.

 

  • Avoid dictating specific wellness activities during the workday: Courts have consistently found that direct employer mandates in the form of exercise can make injuries compensable.  Making generic or benign statements about wellness and not prescribing its preferred form of exercise or activity and reduce exposure in workers’ compensation matters.

 

  • Mandated performance of wellness activities. It is important to give employees the option to participate in wellness or other health program activities.  It is important to note that when managers and supervisors require or otherwise pressure employees to participate, resulting injuries are compensable under a workers’ compensation act.  Interested stakeholders seeking to minimize their exposure may consider using a third-party service provider to promote and provide information to employees about a wellness program.

 

  • Avoid hosting wellness program activities during the workday or while someone is scheduled to work. Wellness events and engaging in healthy activities is something that should take place every day.  An interested stakeholder can minimize their exposure by encouraging employees to engage in wellness activities during their personal time and away from the employers premise.

 

 

Conclusions

 

Encouraging wellness within the workplace has many positive benefits.  This should not be overshadowed by the risks of employees sustaining injuries while engaging in these activities, and employers should be encouraged to implement wellness in the workplace.

 

However, the diligent risk manager should be aware of common pitfalls and implement a wellness program in a manner that avoids unnecessary risks and promotes a better bottom line.

 

 

Michael Stack - AmaxxAuthor Michael Stack, CEO Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center. .

 

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: https://blog.reduceyourworkerscomp.com/

 

©2017 Amaxx LLC. All rights reserved under International Copyright Law.

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

Smoking, Depression, and Substance Abuse Wellness Programs in Workers’ Comp

wellness in workers compensationIt has been proven many times that employers can reduce their workers’ compensation costs by investing in a wellness program.  Notwithstanding the imperial data that demonstrates the effectiveness of these programs, many interested stakeholders are resistant to them based on the perceived cost or other imaginary barriers when it comes to improving the health of their workforce.  Instead of focusing on these hurdles, thought leaders within the industry should focus on the bigger picture to reduce costs in their programs.

 

 

Smoking Cessation Programs

 

Notwithstanding nationwide efforts to curb smoking, tobacco use remains a popular habit in millions of Americans.  It is well-documented that smoking and the use of its other forms, including smokeless tobacco have significant negative health consequences.  These include many common issues Americans struggle with such as cancer, heart disease and other respiratory problems.  The use of tobacco also reduces the effectiveness of physical rehabilitation and healing following a work-injury.

 

Access to smoking cessation programs is now more affordable following the passage of the Affordable Care Act (ACA).  Under the ACA, all qualifying individual and group health plans are required to include these programs as an “essential health benefit.”  This means that health plans must allow participants access to programs and services with no copay.

 

Changes in health care have also had a positive impact on people who remain without insurances.  In many instances, employers have taken the initiative to provide their employees, regardless of health instance coverage, access to programs that assist people kick the habit.  This also includes access to patches, gum and other devices that promote smoking cessation.

 

 

Depression and Mental Health Awareness

 

Americans as a who have also become more sensitive to mental health related issues.  This includes greater access to care and parity of coverage when compared to treatment to physical ailments and injuries.  The essence of the awakening and change in attitudes is better resources for employees to receive the care they need.

 

While Americans now have more options when it comes to purchasing health insurance, many remain without.  This has led to opportunities for proactive employers to provide resources when it comes to psychological and psychiatric issues.  This includes:

 

  • Training for employees on how to recognize a coworker suffering from a mental health related issue;

 

  • Greater access to mental health care and services, including treatment by specialists; and

 

  • Easily accessible outreach programs such as supportive and non-judgmental telephonic services for thoughts struggling with mental health needs.

 

 

Substance Abuse Prevention and Treatment

 

Use and abuse of substances, included those that are legal, can have a negative impact on the workplace.  This includes decreased productivity, diminished service of customers and injury.  Failure to address these issues in the context of a workers’ compensation program can only hurt the bottom line and dramatically increase costs.

 

Proactive employers need to take this issue seriously.  This starts with the implementation of a substance abuse policy that is consistently applied.  It must also apply to all employees, regardless of their position within a company.

 

It is also important for employers to assist employees who may use and abuses these substances.  This includes the following methods to implement:

 

  • Reporting of substance abuse issues within the workplace via confidential means;

 

  • Drug testing that is performed in a manner consistent with state and federal laws; and

 

  • Resources such as help lines and other medical/mental health professionals who can assist employees impacted by use/abuse issues.

 

 

Conclusions

 

There are many benefits to any workers’ compensation program when interested stakeholders look for creative and cost-effective measures to improve employee wellness.  They not only cut down on the frequency or injuries within the workplace, but they have many other benefits.  Among these include an increase in morale and reduce turnover.  The bottom line also includes lower workers’ compensation program costs.

 

 

 

Michael Stack - AmaxxAuthor Michael Stack, Principal, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center. .

 

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: https://blog.reduceyourworkerscomp.com/

 

©2017 Amaxx LLC. All rights reserved under International Copyright Law.

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

3 Times to Consider the ADA in Workers’ Compensation

Workers’ compensation claims professionals and other interested stakeholders face many challenges in their programs.  One important challenge is running a program that is consistent with the applicable workers’ compensation act and not conflicting with the Americans With Disabilities (ADA) Act.  Failing to understand this matter can result in serious legal consequences and impact your bottom line.

 

 

What is the ADA?

 

The ADA is codified under 42 U.S.C. §12101, and is an important civil rights law that prohibits discrimination based on disability.  It was enacted in 1990 and laid the groundwork for greater inclusion of persons with disabilities in American society, which includes those suffering from a work-related injury.

 

There are many legal nuances to this law, so it is important to consult an attorney if you have questions.  Areas of concern as outlined by the U.S. Equal Employment Opportunity Commission (EEOC) include:

 

  • Whether a person with an occupational injury has a disability as defined by the ADA;

 

  • Disability-related questions and medical examinations relating to occupational injury and workers’ compensation claims;

 

  • Hiring practices concerning a person with a history of occupational injury, return to work of persons with occupational injury, and application of the direct threat standard;

 

  • Reasonable accommodation for persons with disability-related occupational injuries;

 

  • Light duty issues; and

 

  • Exclusive remedy provisions in workers’ compensation laws.

 

 

3 Times to Consider the ADA in Workers’ Compensation

 

Employers and other interested stakeholders need to understand the value anyone with a disability has and how it can impact the work environment in a positive manner.  Contrary to popular belief, people who may be disabled want to work as it provides a number of intangibles that benefit morale and self-worth.

 

Keeping this in mind, employers need to consider the following touchpoints in their hiring and workers’ compensation programs:

 

 

Pre-employment:

 

All hiring polices need to comply with the ADA and its mandate of non-discrimination.  Asking potential new hires about disabilities or work restrictions many result in legal action.  It is also important to keep in mind that a disability is not limited to physical barriers.  Various mental health conditions can qualified as a covered disability under the Act.

 

Issues concerning drug testing also come into play under the ADA.  As a general rule, employers can ask all applicants to submit to a drug test as part of the pre-employment process.

 

 

Post-work injury:

 

Employee’s suffering from a work injury can also be covered under the ADA.  A common misconception is the ADA only applies when an employee reaches MMI, this is incorrect. A person injured at work can immediately be considered a “qualified individual with a disability”. At the time of injury a referral to HR and a discussion, referred to as the “interactive process” regarding reasonable accommodations must occur.

 

Additional areas of concern include job search requirements, return-to-work/employment transitions and light duty.  Employers should work with various professionals within their organization when crafting a return-to-work plan and requires modified job duties or positions.  Additional considerations should also be given to time off from work to attend medical appointments, etc.

 

 

Post-injury Termination of Employment:

 

Problems also arise following a work injury when the employee’s position is eliminated or that individual is terminated.  It is important to document all steps that are taken and involve legal counsel.  Employers should also involve specialized counsel if they are requesting a global settlement of a workers’ compensation claim that involves a voluntary resignation of employment and release of all claims.  Issues to consider include a separate employment release and monetary consideration beyond what is paid for workers’ compensation benefits.

 

 

Conclusions

 

Workers’ compensation claims are complex and require an understanding of the law.  The ADA is an important consideration for those involved in handling claims and the myriad of associated issues.

 

 

Author Michael Stack, Principal, Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center. .

 

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: https://blog.reduceyourworkerscomp.com/

 

©2017 Amaxx LLC. All rights reserved under International Copyright Law.

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

Impact of OSHA’s New Electronic Recordkeeping Rule On Employers & Their TPAs

 

This Interview with Broadspire’s CEO Danielle Lisenbey was originally published in Crawford’s On the FrontLine Magazine – Spring 2017

 

The Occupational Safety and Health Administration (OSHA) implemented a final rule in 2017 requiring employers that must record workplace injuries and illnesses for OSHA to submit reports of such incidents electronically. For the first time, OSHA will post on its website establishment-specific data, rather than only aggregated industry data. The goal is to encourage employers to identify workplace hazards and improve their safety records. We ask Broadspire’s Danielle Lisenbey for her views.

 

 

What does OSHA’s new rule mean for employers and TPAs?

 

OSHA has long required employers to keep a log of certain workplace incidents that result in injury or illness. That basic recordkeeping requirement is not new, but what is new is that OSHA is now asking employers to submit certain forms electronically. That will greatly facilitate the administration’s ability to make employer specific data publicly available. Employers and their third-party administrators (TPAs), including Broadspire, will work closely to make sure the appropriate data is submitted to comply with all applicable OSHA rules. Our mantra as a TPA is “early reporting and early intervention lead to better outcomes.” The new OSHA rule ultimately ties into that.

 

 

Which industries are primarily affected by the new electronic tracking rule?

 

The new recordkeeping rule applies to a significant number of  employers. Under the final rule, employers with 250 or more employees that are required to maintain OSHA injury and illness records must submit their logs, summaries of injuries and illnesses, and  incident reports.

 

Employers with 20 to 249 employees in industries classified as having high rates of occupational injuries and illnesses must submit an electronic summary report. Industries on OSHA’s list include construction, manufacturing, healthcare, transportation and others – all of which are important sources of employment and productivity.

 

Industries that OSHA considers to have lower injury rates, which include insurance and financial services, and some retail businesses, are partially exempt from such reporting. The reality is, however, that OSHA’s new rule will cover a large number of U.S. employers and their workers.

 

 

How does Broadspire see this new rule benefiting employers and workers?

 

The intent of OSHA’s new final rule is to increase workplace safety and motivate employers to reduce injury and illness  for  their workers.  That is a noble goal and we not only support it; it is at the heart of our business.

 

Broadspire exists to help employers reduce claims frequency and severity. We believe that the more data an employer has, the better it can plan ahead and mitigate situations that can cause injury or illness. OSHA’s new rule will make more workplace data accessible, which will encourage employers to focus more attention on the causes of occupational injuries and illnesses. That’s a positive thing for  all concerned.

 

Workers will benefit because they will be healthier and safer. Employers will benefit from reduced downtime and increased productivity, which in turn will benefit communities through economic growth. Truly, improving workplace safety pays big dividends, well beyond an employer’s door.

 

 

What are the downsides or unintended consequences of the new OSHA rule?

 

Some observers have expressed concern that online publication of employer-specific reports could create cyber exposures, increase litigation and might even discourage some employers from tracking minor incidents to artificially improve their safety results. While public disclosure may not be the preferred method to motivate employers to improve safety, greater transparency and competitiveness are likely to accelerate changes.

 

It is our belief that the vast majority of employers required to report to OSHA will submit injury and illness reports fully and accurately. We also believe that the general population of employers will see the data points as helpful to keeping them focused on the big picture, which is to make workplaces safer. We certainly hope that OSHA has considered the implications of this final rule and will swiftly address any problems should they arise.

 

 

What is Broadspire doing to help prepare its clients to comply with the rule?

 

Broadspire is deeply invested in helping employers to improve their claim outcomes and to reduce the costs of workplace injury, illness and disability. Early access to data is key, and TPAs can step up and help employers build out their data sets.

 

Between the data and benchmarking that we provide, and the reports that OSHA intends to make available, the ultimate objective is to reduce loss costs for the employer and improve the care of the injured worker. It’s a win-win for both employer and employee. Compliance is a big part of what we do every day for our clients, and we are having ongoing conversations with our clients to ensure they submit the appropriate data to OSHA by the July 1, 2017, deadline.

 

Read more On the FrontLine Magazine.

 

 

Danielle Lisenbey, Broadspire President & CEO. As president and CEO, Lisenbey’s goal is to make Broadspire the number one choice for companies seeking claim, disability and medical management services to help increase their employee productivity and contain costs. On the road to excellence, however, Lisenbey knows you don’t have to sacrifice integrity for achievement. She believes in always doing the right thing. Although tough when called for, she prides herself on being fair and demonstrating integrity in everything that she does.  https://choosebroadspire.com/us/

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