Top Workers Comp Cost Culprit Moves From Aging to Obesity

 

Top 10 Obese States
 
While reading through my local paper the other day, I came across an article of the most obese states in the USA.  They are ranked as follows:
 
  1. Mississippi
  2. Louisiana
  3. West Virginia
  4. Alabama
  5. Michigan
  6. Oklahoma
  7. Arkansas
  8. Indiana
  9. South Carolina
  10. Kentucky
 
The comorbidities of obesity are obviously well known, including diabetes, high blood pressure, sleep apnea, arthritis, and more. But how does this play in to work comp cases?
 
 
Top Culprit Moves From Aging to Obesity
 
In the not too distant past, aging was seen as the biggest culprit to a spike in cases.  These workers possibly were on the edge of retirement, now remaining in the workforce because their 401k tanked, their house lost value and was unable to sell, and so on. Workers in the retirement age were unfairly viewed as resistant to new change, resistant to new technology, and resistant to retire.  In addition to all of that, their bodies are riddled with both possibly occupational and certain non-occupational damage. Should an injury occur, the adjuster viewed them as looking for a way to fund their retirement by milking work comp wage loss and medical benefits until they finally filed for their pension.  After that they left the occupational scene in a flurry of litigation looking for high-dollar redemption in exchange for their years of pain and suffering while working for their employer. (WCx)
 
This blanket statement is no longer the top culprit amongst claims professionals.  Obesity has taken over as the top non-occupational factor that leads to adjuster headaches. While not entirely true in every case, the majority of obese individuals come with their own medical baggage, in the form of longer healing times, degenerative arthritic issues, diabetes, and the like. 
 
 
Biggest Medical Issue Non-Occupational Degenerative Condition in Joints
 
The biggest medical issue that comes with obesity are the non-occupational degenerative conditions, mostly seen within joints.  Obese workers may have more wear and tear in their ankles, knees, hips, back, and shoulders, and any injury in this area that is acute in nature will be affected be underlying degenerative arthritis that is exacerbated or accelerated by the mechanism of injury. 
 
 
Difficult to Determine What is Pre-Existing
 
This makes the case difficult for the adjuster, who is trying to weed out what damage is occupational in nature, and what is not.  Even if this worker has no prior record of treatment, the mere existence of arthritis in these joints will complicate any case, extending healing times due to more extensive surgeries. Workers are confused why their claims are denied due to arthritis, when they have never had any treatment for this condition before.  Typically, they do have reason to complain because the adjuster doesn’t take the time to explain to the claimant why their doctor said that some of their injury is work related, and some of it is not. 
 
 
Costs Can Skyrocket During Investigation and Litigation
 
In these situations, the cost of the accrued benefits can continue to climb.  Adjusters will perform an extensive medical background sweep looking for prior medical treatment, even if the claimant states they have never treated for this pain before.  As anyone in the field knows, this will take time.  And while this investigation is ongoing wage loss continues, medical expenses climb, and litigation will usually result. Then when that litigation happens, it will move slowly from one court date to the next, adding attorney expenses to the overall cost of the claim.
 
Every case, however, for an obese worker is not denied.  I have seen cases where the worker’s MRI of their knee looks clean, absent of any arthritic condition except for the meniscus tear that the work injury caused.  Everyone heals differently.  I have seen cases where a worker labeled “obese” has had a quicker turnaround time from injury to return to work post-surgery than someone not only non-obese, but years younger as well.  I credit this to overall personal attitude, genetics, and the dedication to listening to what the doctors and physical therapists are telling them to avoid and what to do instead.  Using proper body mechanics and lifting mechanisms help as well, providing a way for a worker post-surgery to return to gainful employment while on restriction, which gets them up and around and off the couch.  (WCx)
 
 
Every Case is Unique
 
Just because a worker is labeled obese by their physician or by the new media standards,  doesn’t mean their claim is doomed, or at least in certain denial.  It is true that the claim may take more investigation, especially on the medical record end, but when it is all said and done some cases are denied, and some are accepted.  No two cases are exactly the same.  The adjuster has to take the time to explain to the claimant what they need to do, and what records they need to help produce for the adjuster.  If everyone gets on the same page and does what they are supposed to do, then the claim will work itself out, whether it is indeed denied, or accepted as compensable.
 
 

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 author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: RShafer@ReduceYourWorkersComp.com.

 

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher.  www.reduceyourworkerscomp.com Contact mstack@reduceyourworkerscomp.com

 


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©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

Ohio BWC Unveils Workplace Wellness Program

Ohio Bureau of Workers Compensation (BWC) Administrator/CEO Stephen Buehrer recently announced the addition of a workplace wellness program to help employers meet the challenges related to rising incidences of obesity and chronic disease.


Over the next four years, the program will make $4 million available to employers to create programs to control escalating costs of workers’ compensation claims associated with these health risk factors.(WCxKit)


“Health factors like obesity and chronic disease can contribute to workplace injuries and slow the recovery of an injured worker,” said Buehrer. “By promoting wellness programs in the workplace, we are helping improve the quality of life for working Ohioans and their families, as well as helping reduce costs for Ohio’s employers.”


Participating employers will be awarded up to $15,000 over four years to implement wellness programs in their workplaces. BWC expects more than 600 employers will benefit from these grants, which will be awarded on a “first come, first serve” basis based on availability of funds.
 
 
 
Author Robert Elliott, executive vice president, Amaxx Risk 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. He is an editor and contributor to Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: Info@ReduceYourWorkersComp.com.
 
 
 
 
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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, contactInfo@ReduceYourWorkersComp.com.

Getting Employees and Employers to Take Obesity Seriously

David C. Radford, DC, MS

 
Obesity is a chronic disease that involves three simultaneously occurring interactions. These include a genetic predisposition that is estimated to contribute to about 30% of the problem. The other 70% includes the individual’s behavior and environment. Let us break this complex interplay down into these individual components and think about how, as employers, we can help reduce the incidence of this epidemic affecting more than a third of our nation, and driving our cost for healthcare into the unsustainable range. We know that smoking and tobacco costs our nation about $2 billion a year in lost time, decreased productivity, and cost of illness. Obesity is far more expensive, costing American business an estimated $13 billion dollars a year in lost time decreased productivity, and cost of illness, and the cost to our nation is approaching $300 billion. While obesity now affects more than a third of the entire US population, more than 50 percent of the injured workers with low back pain are obese. 
 
 
Advancements in human genetics and human genome-wide association approach have isolated 20 genes that are associated with obesity and type 2 diabetes. Alone, these genes only have a modest effect, but if we couple genetics with a poor diet and a sedentary lifestyle, we have the prescription that has led to our current healthcare disaster. Obesity results when body fat accumulates over time as a result of a chronic energy imbalance (calories consumed exceed calories expended). Obesity is a major health hazard in our nation and it is associated with several relatively common diseases such as Metabolic syndrome, leading to insulin resistance and Type 2 diabetes, hypertension, heart disease, Vitamin D deficiency, osteoarthritis of the lower extremities, gallbladder disease, and gout as well as several types of cancer. In women these cancers include endometrial, cervical, ovarian, breast, and colorectal. In men, obesity increases the incidence of prostate and colorectal cancers. In both men and women obesity contributes to sleep apnea, morning headaches, daytime sleepiness, and decreased productivity. (WCxKit)
 
 
Integrative medicine and cooperation between different types of healthcare providers is required to provide a solution. Patients need cost effective conservative primary care, using evidenced based methods for weight loss coupled with preventive medicine. Physicians, nurses, and dieticians need to work one on one to encourage patients to move towards a healthier life style. Treating obesity is a process that requires making lifestyle changes.
 
 
As a physician treating obesity and working to prevent chronic illness today, I have witnessed rapid and spectacular advances in medical research in the fields of biochemistry, physiology, biophysics and genomic medicine. We know the cause and cost of obesity and its consequences are not just taxing our resources, the increased incidence of obesity and its related problems are rapidly bankrupting our nation’s healthcare programs under Medicare and Medicaid. Obesity is driving the costs for private insurance through the roof. Physicians fees are not to blame. It is the high cost of managing the co-morbidities associated with obesity, which fuels the development of chronic diseases by the systemic inflammation that is caused by morbidity.
 
 
 
How do we get Employers and Employees to Address Obesity?

The question is how do we get employers and employees to buy into addressing obesity? There are preventable contributors of a chronic illness like obesity, and making changes to address obesity will lower our healthcare costs. What will motivate the person to lose weight? I like to use the BMI (body mass index) to start the discussion. Obesity is defined as a BMI greater than 30. I use serum biomarkers (objective laboratory tests) to monitor progress. These lab tests are covered by health insurance. Sitting with a patient and reviewing these results allow goals to be set and progress can be tracked. Seeing improvement in an objective measurement and positive feedback reinforce the goal.
 
 
Developing interest can be particularly difficult for those living in poverty.  As they face a far greater and more challenging environment. Access to a variety of fresh foods can be challenging, and payment vouchers for food often lead to bad nutritional choices. Returning to grassroots education at the community level through public health clinics will help. It is important that all county, state, and our federal government address this epidemic of obesity, as well as the Type 2 diabetes and Vitamin D deficiency. As these are related problems that increased the morbidity of obesity, and we all pay for this epidemic through higher taxation.
 
 
For the employed, the incentive that seems to hold great promise is a financial benefit for buying into preventive medicine. A financial incentive to lower the employee’s contribution to their insurance premium cost is a good starting point. Patient’s using a health savings account and having a higher deductible learn that some of the burden of care is their personal responsibility to themselves and their families.
 
 
An onsite exercise area or a negotiated group discount to local area health clubs will encourage greater activity. Group instruction to teach healthy eating pays off quickly, and employees may need some guidance to learn how to live a lifestyle that normalizes weight. The weight loss process starts by reducing the refined carbohydrates in the diet. These calories from simple starches, sugar, and high fructose corn syrup pack on the pounds. Eating plenty of fruits, vegetables, nuts, seeds, fresh and dried herbs and spices create a strong anti-inflammatory response in the body. The extra pounds of fat in obesity drive inflammation, good bacteria in the gut counteract this process, so that eating fermented foods that contain healthy live bacteria like yogurt and kefir are very beneficial. I have found patients with lactose intolerance, gluten intolerance, constipation, IBS or irritable bowel syndrome, yeast infections, allergies and even asthma benefit from a probiotic if they lack the good bacteria in the gut. (WCxKit)
 
 
Finally, we all need to make sure that we are getting enough vitamin D. Teaching our employees how to eat sensibly can be the first step in reducing our employees healthcare costs.
 
 
Dr. Radford is in private practice. He is a third generation Doctor of Chiropractic Medicine. He earned a Master’s Degree in Advanced Clinical Practice and he provides conservative primary care. He has treated work related injuries for more than 30 years. Dr. Radford has found that treating the co-morbidities that often accompany injured workers like obesity, medication overuse, and addiction lead to a more complete recovery. He was a founding member of the Cleveland Orthopaedic and Spine Hospital, Cleveland, Ohio.  Contact for more information at DCR8888@aol.com or phone: (440)-248-8888.
 
 
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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.

Obesity Drives the Cost of Work Injuries Sky High

If you were the producer of a Broadway show, would your hire a 300-pound ballerina? The idea seems absurd, but most employers shy away from hiring and retaining obese employees. (Obesity discrimination is illegal in Michigan, the District of Columbia, San Francisco, and Santa Cruz, CA). Obesity is not a disability that falls under the Americans with Disabilities Act (ADA) unless is has a proven physiological cause. We do not advocate obesity discrimination, but feel you should be aware that the more obese people you hire and employ, the higher the cost of your workers compensation insurance will be. This is also true in life insurance, one must fall into the appropriate body weight range to qualify for reasonably priced life insurance. Sad but true. And there may be ample justification for such increase in rates.
 

There are many ways to define obesity. To most people, a “fat person” is someone who weights 50 or 100 pounds more than they do.  Medically speaking, a person with a body mass index – BMI (a weight-to-height ratio, calculated by dividing one's weight in kilograms by the square of one's height in meters) of 18.5 to 24.9 is considered to be of normal weight, 25 to 29.9 is considered to be overweight, with 30 and above is considered obese. The doctor once told my husband he was obese which was very surprising because I don't view him as obese — a beer tummy maybe, but certainly not obese to my way of thinking.

 
In a often-cited Duke University study based on 100 full-time employees with a body mass index of 40, the impact of obesity on the cost of workers compensation is tremendous. Statistics show the impact on workers compensation cost of obese employees who are injured on the job including:
 
 
1.  Claims: Obese employees have twice as many workers compensation claims (11.65 claims vs. 5.8 claims for non-obese employees.)
 
2. Lost days from work: Obese employees lose 13 times more work days for their injury (183.63 days vs 14.19 days).
 
3. Medical cost: Obese employees medical cost is seven times higher ($51,901 vs. $7,503).
 
4. Indemnity Cost: Obese employees indemnity cost is 11 times higher ($59,178 vs. $5,396).
 
 
Another study by researchers at John Hopkins found similar results with a direct correlation between the number of injuries and the amount of obesity, with the odds of injury at work increasing with the waistline. The more obese the employee, the greater the odds the employee would be hurt on the job.
 
 
With nearly two-thirds of all American adults either overweight or obese, obesity is now being divided into subgroups with their own definitions including:
 
1.      Overweight – 1 to 29 pounds above normal
 
2.      Obese – 30 to 59 pounds overweight
 
3.      Severely obese – 60 to 99 pounds overweight
 
4.      Morbidly obese – at least 100 pounds overweight
 
5.      Super obese – 200 or more pounds overweight
 
 
Per the Center for Disease Control and Prevention, in 2007 about one-fourth (26 percent) of all employees were in the obese or a higher category. It is projected that by the year 2020, 40 percent of men and 43 percent of women will be classified as obese or higher. When you include the overweight people with the obese, by 2020 it is predicted that 70 percent of all employees will be overweight, with the number of overweight people continuing to grow (no pun intended).
 
 
What does this mean for workers compensation? Well, any one who has been involved with or who has handled their share of workers compensation claims know the injuries most common to obese employees involve their back, lower extremities (knees and ankles primarily), wrist (carpal tunnel claims and women with obesity “go hand-in-hand”) and hands. Obese employees generally hurt their back when trying to lift heavy weights or lift any weight improperly, and the obese employees hurt their backs, knees and ankles more severely when they slip and fall. Due to their obesity, obese employees have a significantly higher percentage of musculoskeletal injuries than non-obese employees.
 
 
The additional strain placed on the employee's musculoskeletal system by the additional weight is only one factor that delays the employee's recovery from an injury. Obese employee's often have other comorbidity problems besides their weight that delays their recovery from injury. Other medical issues among obese employee's interfering with their recovery include hypertension, heart disease and diabetes. open-ended According to the National Counsel on Compensation Insurance, these comorbidity issues can increase the cost of a work comp claim by an astounding 30 times.
 
 
As an employer, there are some steps you can take to reduce the cost of workers compensation related to obesity. The following are some approaches employers have taken to deal with this issue:
 
1.      Health insurance premium discounts for employees with a BMI of 18 to 25.
 
2.      A weight-reduction program offered through your human resources department.
 
3.      Encourage physical activity at work whether it is taking the steps instead of the elevator or parking at the far end of the parking lot.
 
4.      Use weight loss seminars from Weight Watchers or Jenny Craig.
 
5.      On-site or off site fitness centers with free membership or reduced price membership.
 
6.      A fitness program that includes healthy eating, health improvement seminars, exercise classes, and company sponsored athletic teams.
 
7.      Use of the company intranet to post weight loss guides, cooking light suggestions, and any topic on good health.
 
8.      A recognition program for employees who meet a weight-loss goal.
 
 
Encouraging your employees to be healthy pays off in lower workers compensation cost and provides for a healthier, happier work force.  Insurance companies – yes – the very same ones selling life insurance and workers compensation need to get in line to promote wellness, health and fitness just as much as any other employer. My daughter worked for an insurance company and the supervisor had a candy dish on her desks, ice-cream sundae Wednesday, birthday cakes often and pot luck Friday once a month. Ice Cream Sundae Wednesday? Ya think everyone was bringing in Frozen Yogurt?
 

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.

Wellness Programs Proven to Reduce Workers Comp Costs

The majority of quarter-million dollar and half-million dollar workers compensation claims have a secondary medical issue that complicates recovery and extends the length of time the employee is disabled. Personal medical problems such as obesity, smoking, poor physical condition and diabetes often complicate severe injuries, especially those involving surgical repair, making recovery more difficult, longer and expensive.
 
 
A 300-plus-pound employee who must lose 50 pounds before surgical repair of a herniated disc can easily add six months of temporary total disability benefits and six months of doctor visit to overall claim costs. In most jurisdictions, state workers compensation laws take the employee the way you hired them; often referred to as, “You touch it, you bought it.” That the employee has a pre-existing medical issue does not excuse the employer from having to pay all medical care for injury and indemnity benefits until the employee can return to work (or until indemnity benefits reaches the state maximum time limit for draw.)(WCxKit)
 
 
Obese employees with medical problems are not the only ones who increase workers compensation claim cost. A 6-foot-tall, 140-pound man smoking a pack of cigarettes each day will find a fractured ankle (or any other bone) takes much longer to heal in a smoker than in a non-smoker. Cervical and lumbar fusions often fail in the heavy smoker as the two bones do not grow together. A failed fusion in a person who smokes can add from months to a year to the life of the workers compensation claim, and increase the employee’s permanent impairment rating.
 
 
Most employers totally separate their health insurance program from their workers compensation insurance program with the human resources/benefits department handling the health insurance program and the risk management department dealing with the workers comp insurance program. If your health insurance and workers comp programs are handled separately, we recommend the two departments work together to institute a wellness program, or to improve the existing wellness program, for the simple reason that healthier employees have fewer insurance and workers compensation claims.
 
 
If you are thinking, “Okay, I understand that unhealthy employees take longer to recover from their work comp injuries, but how does a wellness program create fewer workers comp claims?” the answer is employees who are not in good physical condition are much more prone to strains and sprains than employees who are physically fit. For example, picking up and moving a 50-pound object does not create a problem for the physically fit employee who has muscles that are properly toned. The same 50-pound object creates a herniated disc in the employee who does not have developed back muscles to support the spine.
 
 
A study completed by the John Hopkins University Medical Center of employees at eight aluminum plants found that 85 percent of those injured were overweight or obese. There is also the often-cited Duke University study that documented obese employees have twice the number of injury claims per 100 employees as non-obese employees, lose 13 times as many work days, with indemnity cost being 11 times higher, and medical cost being seven times higher.
(For more detail look http://www.dukehealth.org/health_library/news/10044.The savings in this one area of wellness will greatly exceed the cost of the wellness program.)
 
 
One study showed that for every $1 spent on wellness programs, there was an overall reduction in medical care cost of $3 to $4. That is a return on investment that can not be ignored. By eliminating employee’s unhealthy habits, both parties benefit. Not only does the employer benefit by lower insurance cost, but the employer also benefits from higher productivity, as the employee is on the job working, not at home recovering from an illness or an injury.
 
 
By having an integrated, comprehensive wellness program you are taking a holistic approach to the employee's health and the impact it has on the employer. With the ever-rising cost of medical care, whether for health insurance claims or workers compensation claims, the need for a strong wellness program in your company will continue to grow.(WCxKit)
 
 
We recommend you do your employees and your company a big favor by starting or by improving your wellness program. There are a tremendous amount of resources on the Internet on wellness programs. We are also here to assist you in any way we can, so please contact us in regard to your questions about wellness programs.

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.

Dr. Alice Martinson on Loss Control and Musculoskeletal Injury Prevention

I interviewed Alice Martinson, MD about soft tissues injuries, one of her passions after almost 40 years as a board-certified orthopaedic surgeon, 25 of which were as a Naval Medical Officer.


You mentioned loss control was of interest — which areas in particular are of interest?

What I'm most interested in is loss control through the prevention of musculoskeletal injury. I have seen so many work-related injuries in my long career that I know did not have to happen if folks had used common sense. After seeing the same injury pattern happen over and over again when it does not have to happen, I have come to believe that if I know of simple prevention strategies, I should pass them on whenever I can. Nothing discourages me more than to see an individual's personal and economic future compromised by a preventable injury.
 
 
How can employers benefit from having a loss control program in that area?
 
Musculoskeletal injuries are far and away the most common work-related injuries – particularly back injuries. For a company to focus on employee output while overlooking employee safety is self-defeating, because lost work days and medical costs directly affect the bottom line. (WCxKit)
 
 
What type of loss control is used for prevention of musculoskeletal injuries —  like low back — is it ergonomics, job matching, physical demands job descriptions, others?
 
I'm glad you asked about assessment of job demands. That is probably the most overlooked aspect of loss prevention. Far too many company leaders have no real idea of the physical demands made on their employees. Careful job analysis will be eye-opening for a great many of them, and it will also let a prospective employee know more accurately what is expected in the jobs they are taking on. In my view the easiest and most effective loss prevention strategy is job matching. It is pretty hard to do properly when the actual physical requirements of the jobs are not appreciated. A good example of this would be hospital nursing or radiologic technician job descriptions. They carefully spell out the intellectual and administrative roles these folks are supposed to play, but nowhere in the ones I have read is it mentioned that the job requires moving many patients who are physically impaired or unpredictable.
 
 
Some hospitals have finally come to understand the risks their professionals undertake in these jobs and have established "lifting teams." The following links are to the press release and to the published study of the consequences of one such effort: https://www.miamivalleyhospital.org/mvhdefault.aspx?id=10770 and www.innovations.ahrq.gov/content.aspx?id=1813.
 
Ergonomic analysis is a logical follow-on to job demand assessment. Once you see clearly the actual nature of the jobs that need doing, it is usually not hard to figure out a way to get them done better and more safely – that's what ergonomics is in a nutshell.
 
 
The reports from the hospital cited above clearly demonstrate that what makes any loss prevention strategy effective is commitment to the goals and principles of maintaining a healthy, safe workforce. If, however, the incentives are concentrated just at the worker-supervisor interface, those incentives inevitably turn to suppression of work injury reports as employees get the message  injuries "are not tolerated.” As in all other leadership challenges, enthusiasm and sustained attention to detail are the keys to successful implementation of loss prevention strategies, and those things HAVE to come from the top down.
 
 
Are there specific injuries that can be avoided?
 
The most fruitful area to start in is prevention of low back injuries. The first and most obvious loss prevention strategy is to match the employees' capabilities to their assignments. Pre-employment screening, except in highly-selected cases, is not cost effective. Keep it simple. A woman who is 5' 2" can no more safely lift a 70-pound object of irregular shape than she can fly. Yet in the past month I have evaluated several cases where that is exactly how she was injured, because that is what her job required her to do. The same can be said about morbidly obese individuals. Almost all of them have some degree of lumbar spine pathology, and if they are required to lift large heavy objects, it is only a matter of time before they will get a compensable back injury, because the bulk of their bodies does not allow them to use the proper lifting mechanics.
 
 
The situation of morbidly obese employees in general is another area where prevention can be fruitful. Osteoarthritis of the knees is virtually universal in long-standing obesity. If such a person is placed in a job requiring frequent squatting or climbing of stairs and ladders, they will develop knee pain and one or more surgical procedures is sure to follow. Somewhat akin to the knee injuries are shoulder injuries. Morbidly obese individuals cannot arise from a chair without using their arms. Shoulders were not designed to be weight-bearing joints, so when they are used for that purpose, they break down. Large rotator cuff tears and shoulder arthritis will develop, and if a shoulder becomes painful in the course of work that stresses that joint, the problem will end up being compensable as well. (WCxKit)
 
 
Please understand – I am not saying that obese individuals should not be hired or that they do not make good employees. Nonetheless, it is in everyone's best interest that the individual's capabilities match the job and the risks he or she is being assigned to undertake. Most companies of any size have employee assistance programs for those who are having problems with abuse of tobacco and other substances. Obesity is the abuse of food. Developing a meaningful incentive program to support and encourage obese employees in the weight loss process  pays off many times over by improving employee health, minimizing lost time from work, cutting down on both workers compensation and health insurance costs, and preventing a lot of personal misery. Besides – it is the right thing to do.
 

Author: Alice M Martinson, MD has practiced for 40 years as a board-certified orthopaedic surgeon, 25 of which were as a Naval Medical Officer. Relying on her extensive military experience with injury evaluation, she performs IMEs and consults on loss control issues. Contact: 870-480-7475 or docalice@aol.com. Go to our Directory to read more about Doc Alice. See LowerWC.com  for more information. Contact: info@reduceyourworkerscomp.com.

Read more by Dr. Alice Martinson: The Role of Chronic Soft Tissue Overload Syndrome and Lower Workers Comp Costs   and: An MD Explains How Stretching Helps Relieve Postural Strain Complaints in the Upper Back.

 

 
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.

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