Poor Employee Health is Significant Factor in Your Workers Comp Costs

Your Employees Health Has Huge Impact on Cost

 
Risk managers often look to their safety program, their return to work program, their medical management team and their claims adjusters to keep the cost of workers’ compensation under control.  These are all good approaches, but they can be undermined by the physical fitness of the work force.  Obesity is one of greatest drivers of the cost of workers’ compensation.
 
 
Duke University Study
 
The famous Duke University Medical Center Study published in the Archives of Internal Medicine in April, 2007 showed that obese employees with a body mass index (BMI) of 40 or greater have a major impact on the cost of workers compensation.  The findings of the Duke University Medical Center included:
 
·         Obese employee had work comp claims at twice the rate of non-obese employees
 
·         Obese employees lost 13 times as many days from work as the non-obese employees
 
·         Obese employees medical cost was nearly 7 times higher than the medical cost of the non-obese employees
 
·         Obese employees work comp indemnity cost was 11 times higher than the indemnity cost of the non-obese employees
 
 
Obesity Related Costs Exceed $13 Billion Per Year
 
According to a recent article in Best’s Review, obesity related cost to businesses exceeds $13 billion per year.  To control the workers’ compensation cost due to obesity, the risk manager should team up with the human resources manager to create a wellness program to improve the overall health of the employees, including the reduction in the level of obesity.
 
 
 
Wellness Program Can Reduce Obesity
 
There are numerous approaches an employer can incorporate into a wellness program to reduce obesity and the associated cost to both the health insurance program and workers’ compensation insurance.  Some of the methods include:
 
·         A fitness program that includes exercise classes, health assessments, smoking cessation, health seminars and company sponsored sport teams.
 
·         A nutrition program that teaches healthy eating habits including foods to incorporate in their diet and proper serving sizes
 
·         Providing wellness bonuses to employees who meet specific criteria (for example: BMI below 25, non-smoker, blood pressure within normal range)
 
·         Subsidizing the cost of weight loss programs like Weight Watchers, Nutrisystem and Jenny Craig.
 
·         Walking programs that reward the employees for the miles traveled or steps per day (measured by free pedometers supplied to the employee)
 
·         Dietary assistance by both replacing junk foods in snack machines with healthy alternatives and improving the cafeteria plan to eliminate calorie laden foods
 
·         Charging higher health insurance premiums to obese employees or health insurance premium discounts to employees who have a BMI of 25 or lower (one of the provisions of the Affordable Care Act passed in 2010 allows employers to charge obese employees more for their health insurance).
 
·         Personalized motivational programs designed to assist and encourage the employee in their efforts to lose weight
 
·         Web-based programs for employees to track their progress in their weight loss efforts
 
·         On-site fitness centers or subsidizing the cost of gym memberships for employees
 
Not only will the wellness program reduce the cost of workers’ compensation, the reduction in obesity will reduce the health insurance program cost.  The wellness program will significantly lower the impact chronic diseases have on the health insurance program cost.  The health insurance program will see a reduction in the cost of obesity related high blood pressure, diabetes, stroke, heart attack and arthritis.
 
 
Reduce Absenteeism, Increase Productivity
 
A wellness program will also benefit the employer by cutting down on the absenteeism rate, resulting in an overall increase in productivity.
 
There are numerous state government websites and other free websites that provide information for employers to create low cost wellness programs.  Our website includes articles on wellness programs.  Please contact us if we can assist you with creating or improving your wellness program.
 
 

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

 


WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com

VIEW SAMPLES PAGES

MODIFIED DUTY CALCULATOR:  www.LowerWC.com/transitional-duty-cost-calculator.php

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

 

©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.

New Toolkit for Workplace Health Programs Unveiled by U.S. Chamber of Commerce

 

The U.S. Chamber of Commerce recently released a new toolkit to help small and medium-sized employers plan, implement, and evaluate workplace health promotion programs.
 
 
Titled, “Workplace Wellness Programs: Promoting Better Health While Controlling Costs,” the toolkit provides practical suggestions for workplace wellness activities, and highlights ways to engage the community.[WCx]
 
 
 “The Chamber has been a leader in advocating for workplace wellness programs,” said Randy Johnson, senior vice president of Labor, Immigration, and Employee Benefits for the Chamber. “Effective wellness programs can include financial savings as well as less tangible results, such as improved employee morale. While policymakers debate various forms of health care legislation, there are many things employers and others can do to address rising health care costs while concurrently improving employee health. Promotion of wellness programs is certainly one of those, and the Chamber’s toolkit will help achieve this goal.”
 
 
 “There are some very simple, but effective initiatives that small businesses can pursue to foster a sense of community in the workplace, such as setting up after-hour clubs and creating contests between groups, or serving healthy foods on the premises,” added Johnson. “Wellness programs are a win-win for both the employer and employee.”[WCx]
 
 
For more information on workplace safety toolkits, visit: http://www.uschambersmallbusinessnation.com/toolkits/workplace-wellness-

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.

 

 


WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com

VIEW SAMPLES PAGES

MODIFIED DUTY CALCULATOR:  www.LowerWC.com/transitional-duty-cost-calculator.php

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

 

©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.

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Workplace Wellness and Recovery May Improve Productivity and Ensure Business Survival

 
A recent article titled Fuse Workplace Wellness Programs With Recovery, by Lisa Firestone, helps employers in this economy by explaining that maximum efficiency and productivity is essential for continued growth and even survival. Firestone is president and founder of Managed Care Advisors Inc., a woman-owned, employee benefits and disability management consulting and full service workers’ compensation case management company.
 
 
Firestone writes that more and more employers are engaging in worksite wellness programs that lower health care costs. “In fact, according to American Journal of Health Promotion every $1 invested in a corporate wellness program returns $4 in reduced health care costs and $5 in reduced absenteeism over a period of three to five years,” she writes. [WCx]
 
 
The complete article, which can be found here, indicates by targeting and improving employee population health risk factors, worksite wellness programs reduce absenteeism, increase productivity, reduce injuries and improve employee morale and loyalty. Though most wellness initiatives have been focused on reducing risk factors in a working population with the goal of lowering costs and improving productivity, Firestone writes “leaving out those employees who may very well be at greatest risk for long-term disability and significant and ongoing health care expenditures – workers’ compensation claimants. I am in no way downplaying the importance of prevention, or the advantages of a population-based worksite wellness program, in fact, quite the opposite. What I am suggesting is that there is great benefit to be gained for organizations that broaden the scope and focus of their wellness programs to include individuals recovering from work injuries or illnesses.”
 
 
Firestone includes these other points in her article:
1. Why not target the recovery period after a work-related injury as an opportune time to introduce or maintain wellness activities?
2. It is essential that the wellness program adapt with the employee and provide programming and support to meet the employee.
3. If your health insurance and work comp programs are handled separately try to get the two departments to work together to institute a wellness program.
4. There are significant resources and information readily available to assist in the implementation and management of effective wellness initiatives.[WCx]
 
 
Firestone has been involved in the health care industry for more than 30 years gaining recognition for her expertise in the areas of employee benefit program development, evaluation, and strategic planning. She can be reached at lfirestone@managedcareadvisors.com  www.MCACares.com

 

 

 

 

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.

 


WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com

VIEW SAMPLES PAGES

MODIFIED DUTY CALCULATOR:  www.LowerWC.com/transitional-duty-cost-calculator.php

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

 

©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.

Survey Says Consumers Want Employers to Do More with Health Plans

As U.S. companies continue to ask workers to shoulder a greater burden of the cost of health care, a recent survey from Aon Hewitt, The Futures Company and the National Business Group on Health, reveals that consumers want their employers to do more to help them improve their health and get the most from their employer-provided health and wellness plans.


Together with the National Business Group on Health and The Futures Company, Aon Hewitt surveyed more than 3,000 consumers (employees and their dependents) covered by employer health plans to determine their perspectives, behaviors and attitudes towards health and wellness.(WCxKit)


Under continued pressure to mitigate costs and adjust to new regulations, employers are continuing to carefully consider the future of their employer-provided health plans. However, as they adjust their plan design and wellness strategies, the survey finds that many employers are not aligning these strategies with the goals, needs and concerns of their employees.


While a majority of consumers (74 percent) are worried about being able to afford health care now and in the future, they understand that health improvement programs, along with well-designed employer-provided health benefit plans, can help them get healthier while also holding down costs. But, the survey reveals that workers really want four simple things -programs and communication that are easy to use, motivating and meaningful to them, but that also provide personalized information and ideas.


"Employers continue to face countless challenges when it comes to offering health plans that effectively meet the needs of workers and their families, while also managing rising costs," said Helen Darling, president and CEO of the National Business Group on Health. "We hear over and over that the key to ensuring real health improvement is employee engagement, so knowing what employees want and what will motivate them is essential to success. Consumers are telling us that the one-size-fits-all approach to health and wellness is not working for them. In order to help with their challenges and reduce costs, they want health programs that speak to their individual and families' health care needs."


Faced with rising health care costs and new regulations, more employers are introducing health care plans that require workers to take more responsibility for managing their health and the related costs. In fact, a recent Aon Hewitt report shows that 51 percent of employers now offer a Consumer Driven Health Plan (CDHP), up from just 9 percent in 2005.


The good news for employers is that consumers are willing to try CDHPs if the immediate cost savings are apparent. Among those with a choice, most employees (63 percent) select a CDHP because of the lower premium costs.


Additionally, 39 percent choose this plan option because their employer contributes to an associated account-Health Savings Account (HSA) or a Health Reimbursement Account (HRA). In fact, among those enrolled in a CDHP who have a choice, over 90 percent will definitely or probably re-enroll. While CDHPs are, in part, intended to encourage workers to take a more active role in their health, the survey findings indicate that they are having a mixed effect on behaviors.


Encouragingly, 42 percent are getting more preventive care and 40 percent are looking for lower cost health services options since choosing this plan. More troubling, a sizeable number of workers (35 percent) are sacrificing or postponing care (28 percent) to avoid out-of-pocket costs.


"While an eye towards cost is certainly a valid and reasonable reason for consumers to select a certain health care plan, choosing a plan that fits a worker's lifestyle and needs also ensures that people are getting the most appropriate coverage for their needs," said Cathy Tripp, managing principal Health & Benefits at Aon Hewitt and project leader for this study. "However, employers need to make sure workers aren't sacrificing health and the future costs of poor health for lower costs today. Giving employees the tools and advice to decide what is the most appropriate plan for them is critical."


When it comes to tools to help them make health decisions, consumers want information that is tailored to their specific situation. Half of participants (50 percent) want a personalized plan that recommends specific actions they can take to improve their health based on their health status, up 9 percentage points from 2010. Workers are also looking for convenient, one-stop access to information with 40 percent expressing a preference for a wellness website and more than a third (35 percent) want personalized health tips and reminders. Cost is still not far from the minds of consumers though. Fully 44 percent would like cost savings tips and a third (33 percent) want cost estimating tools.


"If companies truly want to move the needle in terms of overall health and cost, they have to stop looking at employees as one group, and start looking at the individual," stressed Joann Hall Swenson, principal and health engagement best practice leader at Aon Hewitt. "Employers can customize health information and related programs to address the specific health conditions and risks of their workers as well as offer specific tips and actionable steps they can take to improve their condition. In addition, offering tools that allow individuals to see and understand the cost of their health care services goes a long way in helping workers make the most of their health care dollars."


In addition to shifting a greater share of the cost to employees, companies are also looking at ways to get employees and their dependents healthier. According to consumers, the best way to motivate them to participate in employer-sponsored health plans is by using rewards. More than half of consumers would prefer either non-cash or cash incentives to encourage them to take part in wellness (60 percent), condition management programs (50 percent) or respond to a health risk questionnaire (58 percent).


For employers, getting workers engaged in their health is critical to health improvement and cost containment. However, the survey finds that there is a disconnect between how healthy people think they are and how healthy they actually are.


The Centers for Disease Control and Prevention reports that approximately one-third (33.8 percent) of U.S. adults are obese, though only 24 percent of survey participants say they are obese. Similarly, the survey found that more than three-quarters (76 percent) of consumers rated their health as "very good" or "good,” while just 15 percent considered their health "fair" or "poor." While employees may think they are healthier than they likely are, they do acknowledge that their health is not perfect. Approximately 60 percent of consumers report having at least one health condition with obesity, high blood pressure and back pain most often mentioned.


"This lack of awareness between real and perceived health is a huge problem since we know that concerns about risk factors can help overcome our natural tendency to put-off making the tough life changes needed to significantly reduce health risks," stressed Darling.


Despite the potential disconnect between real and perceived health status, consumers do understand what it takes to get and stay healthy. When ranking what matters most to their health, many (85 percent) say that good health is a result of making smart health choices each day, over two-thirds (68 percent) say that getting regular preventive care ranks in the top three, while 40 percent rank living and working in a healthy environment in the top three. While people know what it takes to be healthy, there are still often barriers to reaching health goals. Most people cite lack of time (42 percent), cost (40 percent) and unwillingness to sacrifice (35 percent) as the leading obstacles to getting and staying healthy.


Consumers do acknowledge that there are people and things in their lives that may help move the needle when it comes to improving their health. Nearly three-quarters (72 percent) are influenced by advice from a doctor, almost half (47 percent) from friends or family, and 41 percent from general health websites. Just 13 percent consider health information from their employer a trusted source.


To improve health and productivity, employers are increasingly offering programs to both workers and their dependents such as biometric screenings, health risk assessments, onsite clinics/pharmacies and Employee Assistance Programs. However, many employees and their dependents do not seem to be aware of many of these programs. In 2011, more than one-third (36 percent) of consumers did not participate in any health program or service offered by their employer. Among the programs that workers did participate in, blood tests or biometric screenings were the most popular (61 percent participation), followed by health risk assessments (57 percent participation).


Despite low participation, when workers do take part in these programs, satisfaction is extremely high. Almost all (97 percent) of consumers who took part in blood work/biometric screening were satisfied, 97 percent were happy with their on-site clinic or pharmacy, and 92 percent were satisfied with the health risk assessment.


In addition to lack of awareness, and despite the availability of health improvement programs, many consumers do not feel their employers are fully supportive in helping them get and stay healthy. A majority of workers (60 percent) think their company is only moderately-to-not supportive when it comes to their efforts to be healthy.(WCxKit)



"Employers may be missing the mark when it comes to health improvement programs being offered to workers," said Tripp. "Workers need to see that their efforts to become healthy are supported by the company. Developing a culture where leaders care and support healthful living communicates to workers that this matters to the company."
 
 
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.
 
 
WORKERS COMP MANAGEMENT GUIDEBOOK:  www.WCManual.com
 
WORK COMP CALCULATOR:  www.LowerWC.com/calculator.php
 
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
 
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contactInfo@ReduceYourWorkersComp.com.

Reducing CoMorbid Conditions with Obese Workers

An Interview with Doctor Alice Martinson
 
We hear a lot about the rising cost of workers compensation when injured workers suffer from co-morbid conditions. What is “comorbidity?”
Co-morbidity refers to any unrelated medical condition, which nonetheless has some bearing on the primary condition under discussion, or upon an individual’s ability to return to a functional level. An example of this would be a chronic cardiac condition delaying or preventing surgery in someone who has work-related knee osteoarthritis. Another, though somewhat graphic example, is an individual with a leg amputation who sustains an injury to two of the remaining three extremities. Given the number of returning Middle East veterans who are amputees, this is not such a far-fetched possibility.
 
 
How do you define obesity?
Obesity is defined in terms of body mass index (BMI). A BMI between 25 and 30 is considered “overweight.” A BMI over 30 is considered obesity, and a BMI over 40 is considered extreme obesity. In some written material it is called “morbid obesity.” This latter term is falling out of favor because it can carry an emotionally-charged meaning getting in the way of useful discussion. BMI is calculated as the relationship between height and weight. (WCxKit)
 
Rather than fooling with the math, I use a very convenient table available on the NIH website: Calculate BMI
 
 
Workers compensation will usually not cover that portion of a workplace injury related to a comorbid condition. How can the workplace injury be separated from the pre-existing condition for compensation?
For workers compensation treatment, that is not usually a hard distinction to make. A good example here would be carpal tunnel syndrome in a diabetic. Diabetes does not cause carpal tunnel syndrome, but diabetics will many times experience progression of the condition, once it occurs, at a much faster rate than non-diabetics do. Thus, surgical decisions and timing may well be affected by the diabetic state.
 
 
Where it gets harder within the workers compensation system is the question of whether a co-morbid condition interfering with the treatment of a workers compensation problem should be treated through the workers compensation system.
 
 
The most frequent instance of this I have come across is the question of whether bariatric (weight loss) surgery should be covered by workers compensation when the primary injury is knee trauma. Continued obesity in the face of a knee injury is inviting progressive osteoarthritis, so the question comes up – “Is bariatric surgery necessary to cure or relieve the effects of the work injury?” A similar example would be when a serious cardiac condition is found that interferes with necessary surgical treatment of a work injury.
 
 
Should treatment of the cardiac condition be provided under workers compensation?
There are different policies and case law in each state, so I would encourage anyone who encounters this issue to check for the rulings in their particular locale.
 
 
What pro-active steps can an employer take to communicate to employees their pre-existing conditions are not covered in the event of a workplace injury before injuries occur in a way that does not cause “uproar,” i.e., hurt feelings, cries of discrimination, threats of lawsuits?
The key word in your question is “pro-active.” Certainly, employees need to be educated about health maintenance issues and policies as general principles BEFORE a specific instance workplace injury brings up a specific question in a specific individual. Many large employers have incentive programs for smoking cessation, weight loss, and similar issues further reinforcing the importance the employer places on avoidable problems. There are enough benefits to these programs, that I encourage even small employers to adopt wellness programs as part of their employee policies.
 
 
Do you recommend pre-employment/post-offer screening for pre-existing conditions?
Except in the unusual case of extraordinarily critical or demanding work, pre-employment/post-offer screening using such things as spine X-Rays does not seem to be cost-effective. It is always appropriate to obtain a history of pre-existing conditions after an offer is made, because no one can predict the future but it is a great way to document the past. Having a starting point is very beneficial if the question of work-related progression or aggravation comes up. The best pre-employment screening I know of is not screening of the employees, but of the physical demands of the job for which an employee is sought. (WCxKit)
 
 
Can you explain what you mean by having the employer screen the physical demands of the job?
The more physically demanding the job, the greater the opportunity for something bad to happen to an individual doing it. An employer must know the physical demands of the job tasks. This is not rocket-science. A 5’2” woman weighing 130 lbs should not be hired to lift and carry cartons about a warehouse that are almost as tall as she is. You laugh! Several months ago I was doing a workers compensation exam on just such a woman doing just such a task. Or a more subtle instance — someone with knee pathology (problems) is not suitable for a job requiring constant squatting or climbing stairs and ladders. If you know those are the physical qualifications of the position, you as the employer have every right, and perhaps the responsibility, to determine if a prospective employee meets those qualifications. What is important is to determine the physical qualifications in advance, just as you do with education, temperament, ability to work without supervision, and so many of the other non-physical aspects in any job description. When you decide on an individual’s suitability for hiring into a specific position, you then have the opportunity to choose the whole package.  A physical therapy or rehabilitation firm can often do a physical demands evaluation of the jobs in your facility.
 
 
As an example – a clerk is hired into a prison office. The only problem is it takes a half-mile of walking each way from the parking lot to her job. You would never know that from her job description. Some folks cannot do that. Same thing for some work settings where the employee works on one floor and the bathroom is on another. Do not think that does not happen – the IRS office in Fresno is exactly like that.
 

Does the ADA come into play when dealing with employees with comorbid conditions?
The ADA requires “reasonable accommodations” for an individual who declares a disability. An employer should decide in advance how to define “reasonable” in their setting. Obviously, a bricklayer with a pre-existing back disability cannot be reasonably accommodated in another brick laying job. On the other hand, there are a great number of office jobs in which individuals with back disability can be reasonably accommodated by altering the seating or the supervisor’s expectations in regard to the need to get up and change positions periodically.
 
 
What can employers do to reduce comorbid obesity in their workers and make them less likely to suffer workplace injuries aggravated by their condition?
Peer pressure is a wonderful thing. If all workers are educated about wellness issues and buy into proactive wellness efforts, getting an obese individual working towards his or her own wellness should not be too hard. It has to be a group effort for support and encouragement. That is one of the principles behind Weight Watchers, the 12-step programs, and – for that matter – TV’s “The Biggest Loser.”
 
 
What do you think about employer-sponsored wellness programs?
I am clearly in favor of them. They have to be properly designed and incentivized in order to be effective. That means the leadership needs to be involved in them too, and there has to be public recognition and tangible benefits – even small ones – to encourage ongoing participation
 
 
Are there any “pre-canned” programs out there an employer can use rather than reinventing the wheel? Do you recommend them?
Each program has to be tailored for the specific work situation. Something is better than nothing, but whenever feasible I would suggest seeking the advice and participation of a consultant who is experienced in these issues and has a track record of success they can point to. (WCxKit)
 
There is a really good article in the magazine Inc. that addresses these programs. See How to Build a Wellness Program There are an abundance of commercial firms interested in getting consultant business. Read the article first.ThTTh    

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. To read more about "Doc Alice,” go to our Directory at: http://reduceyourworkerscomp.com/workerscomp-medical-doctor-advisors.php.

Our WORKERS COMP BOOK:  www.WCManual.com
 
 

 

WORK COMP CALCULATOR:  www.LowerWC.com/calculator.php
 
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
 
©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.

Comorbidity Run Amuck – Medical Conditions Make Work Comp Injuries More Costly

Comorbidity is the presence of two or more medical conditions in a person at the same time. When an employee with a prior medical problem has an on-the job injury, the cost of the medical care and the length of time the employee will be off work is normally extended. This does not mean that workers compensation will pay for an employee's pre-existing medical problems, but it does mean that the pre-existing medical problems can complicate the medical care for the workers compensation injury.
 
 
When an employer takes an active interest in the medical status of its employees, it has a far reaching positive impact. Take for example the trucking company that did not have an overall wellness program for its employees. It was not only paying more for the cost of health insurance, it was paying more for the cost of workers compensation insurance. And then the inevitable happened: a truck driver with several — not one or two health issues — but several health issues got hurt on the job.(WCxKit)
 
 
The truck driver, who was driving a tanker truck, decided to check the level of the liquid in the tanker. The driver, 51, climbed up on the catwalk. To hold on, he took hold of a handle for that purpose, but lost his balance and started to fall. By holding on to the handle, he was able to prevent the fall, until all of his 297 pounds was on his arm and shoulder. Rip went the rotator cuff in his shoulder, pop went the handle as it was there for balancing, not to hold 297 pounds, and the trucker fell to the ground.
 
 
The doctor's immediate assessment was probable torn rotator cuff. The MRI confirmed a large rotator cuff tear in this very large guy. Normally, the doctor would schedule surgery, repair the rotator cuff, and send the employee to physical therapy for six to eight weeks, returning the employee to light duty in four weeks and returning the employee back to work full duty in eight to 10 weeks.
 
 
The obesity alone would not have been much of a factor for rotator cuff repair, but the issue that caused the obesity was. The trucker liked beer. A lot of beer, which is how he got to 297 pounds. But the alcohol also brought on other comorbidity factors including hepatitis C and cirrhosis of the liver. The orthopedic doctor did what any other doctor would do, he delayed the surgery until the claimant could get surgical clearance from the gastroenterologist. The gastroenterologist could not see the claimant immediately and four weeks of temporary indemnity benefits were paid while the claimant waited the appointment with the gastroenterologist.
 
 
The gastroenterologist agreed to take the claimant off antiviral medications. The claimant's body needed at least three months to adjust to not having the antiviral medications and for his platelet count to recover adequately for the rotator cuff surgery. Another three months of indemnity benefits.
 
 
The rotator cuff surgery was completed, but then diabetes came into play (I should have mentioned earlier that the trucker was also a diabetic). Three weeks post surgery, the area around the surgical wound began to turn red. Due to hyperglycemia, brought on by the diabetes, cellulitis (infection) of the wound and surgical area developed. The driver went back to the hospital for another surgery to surgically remove the infection. Of course when the wound was opened, the rotator cuff had not healed due to cellulitis and had to be repaired again. The second rotator cuff surgery caused by the comorbidity of diabetes adds both additional medical cost and another three weeks of indemnity benefits, as all the recovery time between the first surgery and the second surgery is loss.
 
 
When you are immobile due to obesity and recovering from two surgeries, have hepatitis C, cirrhosis and diabetes, it is nothing unusual to develop edema (where the body retains excessive levels of fluid). When you are severely bloated, it is difficult to actively participate in physical therapy. With drugs for the edema, physical therapy was only delayed two weeks, but this was two extra weeks of indemnity benefits in addition to the medical cost of the doctor's visit and the pharmacy.
 
 
For brevity of this article, we will not discuss the hypertension and basilic vein clot/thrombosis and how they delayed the medical recovery that further extended the time the employee was drawing indemnity benefits. Also, for brevity we will not discuss the employee's anxiety, depression, panic attacks, insomnia, abdominal pain, jaundice, and weight loss issues as these conditions individually did not prolong the worker compensation claim, but collectively added to the medical cost as the primary doctor had to address the issues or refer the medical issues to other doctors.(WCxKit)
 
 
While few workers compensation claims have this many medical complications, the non-work related medical issues of your employees will interfere with the recovery from the on-the-job injury. You can reduce the cost of both health insurance and workers compensation insurance by encouraging your employees to individually maintain good health and by providing a wellness program.

Author Rebecca Shafer
, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing, publishing, pharmaceuticals, retail, hospitality, and manufacturing. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.
 
 
 
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
 
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.

Wellness Programs Should Address Allergies that Affect Performance and Safety in the Workplace

We intend the outline to provide a rationale explaining what combinations of medicines may be used to control allergies.  Use only those steps that are needed to solve the problem for you.  In general, try to use remedies toward the top of the list.  Reducing the allergic load and using protective masks for special tasks are prudent for everyone with allergic problems.  Beyond that, most people prefer to use antihistamines as their sole treatment.  Antihistamines usually will work with one or two doses of medicine per day, which is more convenient than the four times a day required for Nasalcrom®.  Some people find that antihistamines make them nervous or jittery.  Usually, it is not an antihistamine that causes this but rather a decongestant mixed with antihistamines in over-the-counter sinus or cold remedies.  Watch for the word "decongestant;" it usually means there is an adrenaline-like drug in the preparation.  If antihistamines alone are not adequate, or if they cannot be taken for some reason, the next line of defense usually is a corticosteroid nasal spray to reduce the inflammation caused by the allergic reaction.  Again, the reason is mostly the convenience of once- or twice-daily dosing.  Nasalcrom® would also be an excellent choice for a second level treatment.  For patients using both an antihistamine and a corticoid spray, Nasalcrom® really is the next best addition, despite the need to use four times a day for best effect.  Using a decongestant such as pseudoephedrine (Sudafed®) would follow as a fourth level of defense.  Treatments lower in the outline than the decongestants are usually needed only if the problem developed without warning, so that the other remedies could not be applied in time.  If you should reach the point of requiring antibiotics, it is important to use methods to open the sinuses at the same time and afterwards.  If you do not, the bacteria causing sinusitis may be destroyed as planned, but may be replaced with a fungal or yeast infection, which is even more difficult to treat. Using a saline solution to rinse mucous out of the nose often helps symptoms greatly.  The recipe is 2 tsp salt, 1 tsp baking soda, and 1 quart (~900 mL) water.  You can buy a salt solution in a spray bottle and then refill the bottle.
 
Author:  Sanford S. Leffingwell, M.D., MPH is a board certified specialist in occupational medicine, with degrees from Harvard University, University of Colorado School of Medicine and The Johns Hopkins School of Hygiene and Public Health.  He can be reached at ssl@hlmconsultants.com. www.HLMConsultants.com

 Click on these links to try it for yourself. WC Calculator www.ReduceYourWorkersComp.com/calculator.php TD Calculator www.ReduceYourWorkersComp.com/transitional-duty-cost-calculator.php WC 101 www.ReduceYourWorkersComp.com/workers_comp.php Do not use this information without independent verification.  All state laws are different so do not implement any cost containment procedures until you have discussed them with your corporate counsel. Your individual doctor must treat medical issues. We are not giving medical advice; this is an overview of wellness topics, not medical advice.     ©2008 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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