Things you should know

NSC offers free toolkit to fight opioid abuse

The National Safety Council (NSC) is offering a free toolkit to help employers address the opioid crisis. The Opioids at Work Employer Toolkit addresses warning signs of opioid misuse, identifying employee impairment, strategies to help employers educate workers on opioid use risks, drug-related human resources policies, and how to support employees struggling with opioid misuse.

Workplaces most common site of mass shootings: Secret Service report

In its second Mass Attacks in Public Spaces report, the Secret Service examined 27 incidents in 18 states that involved harming three or more people. Most occurred in workplaces (20) and were “motivated by a personal grievance related to a workplace, domestic or other issue.”

Worker participation key to preventing safety accidents: CSB

The U.S. Chemical Safety Board (CSB) published a new safety digest discussing the importance of worker participation to avoid chemical mishaps. The report outlines how the shortage of worker engagement was a factor in various incidents examined by the CSB.

2018 guidelines more effective in preventing carpal tunnel: NIOSH

Previous studies showed that the 2001 American Conference of Governmental Industrial Hygienists (ACGIH) Threshold Limit Value (TLV) for Hand Activity was not sufficiently protective for workers at risk of carpal tunnel syndrome (CTS) and led to a revision of the TLV and Action Limit in 2018. A new study compares the effectiveness of the 2018 and 2001 guidelines, concluding that the 2018 revision of the TLV better protects workers from CTS.

NIOSH notes that many workers are exposed to forceful repetitive hand activity above the guidelines and urges compliance with the updated guidelines.

First aid provisions in workers’ compensation statutes and regulations: NCCI

The National Council on Compensation Insurance, Inc. (NCCI) has compiled state statutes and regulations related to First Aid in Workers’ Comp. The document does not include review or analysis of the statute or regulation, of relevant caselaw, or other guidance and is subject to change.

Mandatory treatment guidelines may lead to fewer back surgeries

States with mandatory use of medical treatment guidelines in utilization review, reimbursement and dispute resolution may lead to lower rates of lumbar decompression surgery among workers with low back pain, according to a new report by the Workers Compensation Research Institute.

The 27 states in the study include Arkansas, California, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin.

Engineered-stone fabrication workers at risk of severe lung disease

Exposure to silica dust from cutting and grinding engineered stone countertops has caused severe lung disease in workers in California and three other states. The CDC released information on cases in Washington, California, Colorado and Texas in an article published in the agency’s Morbidity and Mortality Weekly Report. According to the article, 18 cases of silicosis were identified in the four states from 2017 – 2019. Two of those workers died from the illness.

Campbell Institute offers a guide on how to get started with leading indicators

An Implementation Guide to Leading Indicators is intended to help employers initiate the process when implementing leading indicators for the first time.

Annual wind energy safety campaign focuses on hands

The American Wind Energy Association will offer several free resources in October as part of its annual month-long safety awareness campaign aimed at helping protect renewable energy workers from on-the-job injuries. The theme of the 2019 campaign is Take a Hand in Safety: Protect These Tools.

NIOSH releases international travel planner for small businesses

The 36-page travel planner is a new resource intended to help small-business owners ensure the health and safety of employees who travel internationally.

State News

California

  • Governor Newsom has signed two bills relating to workers’ comp. A.B. 1804 will require the immediate reporting of serious occupational injury, illness, or death to the Department of Industrial Relations’ Division of Occupational Safety and Health. A.B. 1805, modifies the definition of “serious injury or illness” by removing the 24-hour minimum time requirement for qualifying hospitalizations, excluding those for medical observation or diagnostic testing, and explicitly including the loss of an eye as a qualifying injury for the new reporting requirements. Both bills will take effect Jan. 1, 2020.
  • Legislators approved a landmark bill that requires companies like Uber and Lyft to treat contract workers as employees. The Governor is expected to sign it after it goes through the State Assembly. Uber, Lyft, and DoorDash have vowed to fight it.
  • Insurance Commissioner Ricardo Lara approved the Workers’ Compensation Insurance Rating Bureau’s annual regulatory filing that will, among other things, lower the threshold for experience rating.
  • The Division of Workers’ Compensation (DWC) announced that the temporary total disability rate will increase 3.8% next year, not more than 6% as the agency previously announced.
  • The DWC has issued an order modifying its evidence-based treatment guidelines for work-related hip and groin disorders. Effective October 7, 2019, the changes involved two addendums to the workers’ compensation medical treatment utilization schedule and incorporate the American College of Occupational and Environmental Medicine’s most recent hip and groin disorders guidelines.
  • The DWC launched an updated free online education course for physicians treating patients in the workers’ compensation system.

Illinois

  • Beginning July 1, 2020, hotels and casinos will be required to have anti-sexual harassment policies that include, for certain workers, access to a safety button or notification device that alerts security staff under the newly created Hotel and Casino Employee Safety Act.
  • Gov. J.B. Pritzker signed legislation requiring freight trains operating in the state to have at least two crew members, challenging the Federal Railroad Administration’s recent effort to prevent states from regulating train crew sizes. Scheduled to go into effect January 1, 2020, S.B.24 is to be known as Public Act 101-0294.

Minnesota

  • Department of Labor and Industry has posted new workers’ compensation medical fee schedules that took effect Oct. 1. The schedules update reimbursement for ambulatory surgery centers, hospital inpatient, and outpatient services, and provide new resource-based relative values for providers.
  • The workplace fatality rate in Minnesota grew to 3.5 per 100,000 full-time workers in 2017, the highest rate in at least a decade, according to new data from the Safety Council. Almost one in three fatal workplace injuries involved driving a vehicle.

North Carolina

  • The Industrial Commission announced that the maximum for temporary and permanent total disability will go from its current level of $1,028 to $1,066, starting Jan. 1.

Pennsylvania

Tennessee

  • New rules for medical payments went into effect September 10, 2019. Not only are reimbursement rates increasing for providers and hospitals, but the conversion factor may now “float” or follow Medicare’s changes, rather than being fixed.
  • The NCCI is recommending a 9.5% decrease in loss costs for the voluntary market in 2020, a figure that’s half of what the rating organization recommended for this year.

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com

Getting employees onboard to new approaches for back pain

Chronic back pain is one of the most persistent and difficult issues to deal with in Workers’ Compensation. With an aging and overweight workforce, it will continue to be a dominant cause of work comp claims. Moreover, about 85 percent of lower-back pain is idiopathic – without a specific or known cause – making it difficult to separate the impact of aging or outside activities from legitimate work-related causes.

Within the last several years, the industry has shifted away from bed rest, medical imaging, pain medications, and surgery to more conservative care, such as exercise, customized ergonomic training, yoga, physical therapy, cognitive behavioral therapy, acupuncture, and anti-inflammatory medications.

A 2014 study by Liberty Mutual’s Institute for Safety found that early use of MRIs on injured workers complaining of back pain may lead to unnecessary procedures and even longer disability periods. Other studies have put the cost of back-pain claims using MRIs at $12,000 more than claims that did not use early MRIs.

In some cases, an MRI can trigger a recommendation of surgery even though the changes can be attributed to a normal result of the aging process. If a physician wants to find an excuse to recommend surgery, it is there. Suddenly, for the employee, the perception of the problem escalates from annoying pain to a catastrophic condition.

In an age of MRI scans, getting employees on board with alternative approaches can be challenging. Understandably, employees are afraid of doing more damage to their spine and movement and exercise can seem counterintuitive. They anticipate worsening of symptoms with certain activities. And for couch potatoes, the prospects of activity can be overwhelming and surgery can be viewed as a cure-all. Changing the mindset is an important first step.

Provide reassurance with carefully chosen words

Speaking at the recent California Workers’ Compensation and Risk Conference, Dr. Jennifer Christian, president and chief medical officer at Wayland, Massachusetts-based Webility Corp., spoke about the power of words. Don’t call it “your injury,” instead, call it “your recovery process.” Don’t say “getting you back to work.” say, “getting your life back to normal.” Don’t ask about pain; ask about progress. She urged employers and claim handlers to be on the front line and help employees overcome their fears about how long they are going to be laid up and how they can manage their job, questions doctors often find difficult to answer.

Make ergonomic training effective

Employees will listen and buy into training if it makes them feel better. A recent article in Business Insurance highlighted a successful tailored ergonomic training program for employees of Greyhound Lines Inc. In 2010, the company saw 745 mostly musculoskeletal injuries. Most were related to material handling issues – pushing, pulling, twisting and lifting.

At the time, its training was a basic lifting program – one size fits all, regardless of what the person did. Today, safety experts study the job and come up with a tailored approach. With this customized program, the number of such claims dropped to 295 in 2016. Employees need motivation to make changes in behavior; feeling better, both on and off their job, is a great motivator.

In the article, ergonomics expert Dennis Downing, CEO of Future Industrial Technologies, Inc., noted some common, yet, ineffective practices. Likening the practice to teaching a child to swim, he said video-based training doesn’t work. You wouldn’t show a child a video, and then toss them in a pool. Offering a free lunch is also a no-no. “We had a hard time figuring out why companies were bribing employees with food,” he said of the common practice of providing ergonomics training – how to better lift, push, pull, and stretch – over a free lunch.

There is no silver bullet

It is going to take a careful assessment of the workplace, the demographics of the employees, and an analysis of the claims related to back pain to craft an effective plan. Whereas some employees may embrace new approaches with simple education, others need a multidisciplinary approach that includes more advanced psychological informed rehabilitation.

For Cutting-Edge Strategies on Managing Risks and slashing Insurance Costs visit www.StopBeingFrustrated.com