HR Tip: SHRM benefit survey on popular perks30

aAccording to the Society for Human Resource Management’s (SHRM’s) 2018 Employee Benefits Survey the current low level of unemployment is driving employers to beef up their benefits to retain and recruit employees. More than two-thirds of the employers in the survey raised their benefit levels in the past 12 months. There were expanded offerings in:

  • Health-related benefits (up among 51 percent of respondents)
  • Wellness (44 percent)
  • Employee programs and services (39 percent) such as retirement savings and advice
  • Professional and career development benefits (32 percent)
  • Leave, family-friendly and flexible working benefits (each 28 percent)

The report details the types of increased benefit offerings in each category as well as trends that have stabilized or reversed. For example, under Wellness, it notes that substantial increases were seen in:

  • Company-organized fitness competitions/challenges (38 percent, up from 28 percent last year).
  • CPR/first aid training (54 percent, up from 47 percent).
  • Standing desks (53 percent, up from 44 percent).

“One sign that employers are targeting their benefit spending for maximum effectiveness: Since 2014, the share of organizations offering offsite fitness center memberships fell to 29 percent from 34 percent, while those that provide a subsidy/reimbursement for offsite fitness classes rose to 16 percent from 12 percent. Too often, people will join a gym but rarely go, employers found, while those who sign up for classes are likely to use them.”

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

Fatigue: a hidden workplace risk

Americans are known as a 24/7 society and often take pride in their sleep deprivation. Although some workers experience fatigue at work because of their lifestyle, the workplace is the root of fatigue for many workers. And, according to a study by the National Safety Council (NSC), 74% of employers underestimate the prevalence of fatigue in the workplace and 73% do not communicate with employees about fatigue.

Overtime, high risk hours (night or early morning), demanding jobs that require sustained attention physically and/or mentally, long shifts, quick shift returns, and no rest breaks are among the top fatigue risk factors identified by the NSC. The common argument made by employers is that productivity will be reduced if steps are taken to address fatigue. And the current employee shortage in many areas has exacerbated the problem.

Yet, as the work schedule progresses, workers tire naturally as they use up energy. Too few breaks and long shifts add to the strain on body and mind, leading to reduced alertness and lack of concentration. But employees are reluctant to say they are too tired to do their job safely for fear of being perceived as lazy, uncooperative, or losing needed overtime pay.

The result is not only a decline in productivity, but also increased accidents and near-misses. According to the NSC, 32% of reported injuries and near-misses are due to fatigued employees. Workplace fatigue problems can be cured, but the hurdle is recognizing the correlation between incidents and fatigue and developing solutions that are compatible with productivity objectives.

While each employer’s situation is unique, here are some considerations:

  • Analyze the workload and staffing imbalances that necessitate excessive overtime. Look at options such as reengineering processes to reduce staff hours and cross training employees
  • Rotate shift schedules to ensure no one is always on the night shift. Rotating shifts is a best practice that entails scheduling a worker for the night shift for two weeks and then giving them time off and then scheduling for day shifts for two weeks
  • Implement the 12-hour rule: make sure employees have 12 hours off between shifts
  • Control the boredom factor by varying tasks. Employees doing monotonous work and tasks are more susceptible to fatigue
  • Provide a designated area for employees to rest. A 15-30-minute power nap when working long shifts can be a great refresher
  • Educate workers on the symptoms of fatigue, the impact of shift work on sleep-wake cycles and the best ways to manage it. Provide resources to deal with sleep disorders
  • Let employees know they share responsibility with the company for preventing fatigue and, given adequate time away from work, they are responsible for getting enough sleep
  • Use ergonomic equipment designed to reduce physical strains
  • Provide plenty of water, healthy snacks
  • Evaluate the lighting and temperature in the workplace as well as other environmental issues that can produce fatigue. Minimize humidity, noise, vibration
  • Monitor fatigue. Research technology that fits your industry
  • Have a risk management system, including reporting of fatigue-related incidents, investigation, training and auditing

Rather than adopting the attitude “that’s just the way things have to be to get the work done” understanding how the workplace is set up, how the work is handled, and how fatigue is a serious, costly risk can guide employers to develop a plan that mitigates risks and maintains productivity levels.

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

HR Tip: Study: Engaged employees have fewer accidents and lower absenteeism

The 2017 Gallup Report, State of the American Workplace, corroborates past studies that engaged employees are measurably more productive and profitable, safer, healthier, more loyal, and less likely to leave their employer. Organizations in the top quartile of engagement had:

  • 70% fewer safety incidents
  • 24% lower turnover in high-turnover organizations
  • 59% lower turnover in low-turnover organizations
  • 41% lower absenteeism
  • 40% fewer quality incidents
  • 21% higher profitability

While this seems intuitive, many employers fail at engagement – only 33% of US employees are engaged at work, according to the report. The survey is based on 12 questions that measure the most important aspects of employee engagement. Common threads are relationships and trust. When employees feel good about what they are doing, that their job is important, their opinions matter, and they are treated with respect, they will bond in motivational ways.

Here are the 12 questions:

  1. Do you know what is expected of you at work?
  2. Do you have the materials and equipment to do your work right?
  3. At work, do you have the opportunity to do what you do best every day?
  4. In the last seven days, have you received recognition or praise for doing good work?
  5. Does your supervisor, or someone at work, seem to care about you as a person?
  6. Is there someone at work who encourages your development?
  7. At work, do your opinions seem to count?
  8. Does the mission/purpose of your company make you feel your job is important?
  9. Are your associates (fellow employees) committed to doing quality work?
  10. Do you have a best friend at work?
  11. In the last six months, has someone at work talked to you about your progress?
  12. In the last year, have you had opportunities to learn and grow?

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

 

Overcoming the opioid crisis in the workplace

The national crisis of the misuse of and addiction to opioids echoes in the workplace every day. A National Safety Council (NSC) poll, estimates that over one-quarter of the U.S. workforce is using opioids. The costs to employers are well documented – increased absenteeism, lower productivity, higher health care costs, more occupational injuries, fewer skilled workers who can pass drug tests, and increased workers’ compensation costs. A recent study by the Kaiser Family Foundation found that large employers experienced a sharp increase in costs for treating opioid addiction and overdoses among their workers, rising from $646 million in 2004 to $2.6 billion in 2016.

While the workers’ comp industry has made significant progress in limiting opioid prescriptions for acute pain, much work remains to be done. According to a new workers’ compensation drug trend report from Optum, forty-nine percent of injured workers receiving a prescription drug were taking an opioid in 2017, a figure that was about four percentage points lower than in 2016.

Although each workplace has its own challenges, an assessment of a company’s efforts to combat the opioid problem should focus on three areas:

  • Reducing or eliminating initial opioid usage for recently injured workers
  • Helping injured workers who have become long-term users wean off of opioids
  • Prevention – preinjury support

Reducing or eliminating initial opioid usage for recently injured workers

While efforts to curb opioids in workers’ comp vary significantly by state, customized formularies, utilization management and clinical programs, legislative action including limits on initial opioid prescriptions for acute pain, and claims professional education, have collectively worked to reduce opioid prescriptions for pain. Some states are requiring alternative approaches. In Ohio, for example, residents with work-related back injuries are now required by law to try remedies such as rest, physical therapy or chiropractic care before surgery or opioids.

Employers, too, play a powerful role in preventing the development of opioid addiction. Educating workers about the dangers of opioids may prompt injured workers to forego opioids altogether rather than accepting an initial short-term prescription. Monitoring opioids prescriptions by receiving alerts when they are prescribed and setting limits can ensure that guidelines are followed. Intervening early and ensuring that injured workers have a clear path for getting back to work helps control the fear of pain, which leads to avoidance behavior.

Physicians, who can clearly explain the advantages of alternative treatments and the dangers of addiction, as well as gain the workers’ trust, will be effective in facilitating a return to work without reliance on pain meds. Utilizing nurse case managers can provide valuable interaction with physicians and can help injured workers manage their pain, recover, and avoid opioid dependency.

Training supervisors and managers to identify workers who struggle with pain or are at greater risk for dependence will trigger a need for early intervention and behavioral programs that focus on pain management through employee engagement and resilience. Unsupportive supervisors who intimidate workers by insisting they work through the pain or ignore the problem may disrupt the recovery.

The process takes planning and must be geared to the individual. Effective change comes when workers understand the benefits of non-drug pain therapies and buy into the solution. There are some workers who will want immediate relief, the hallmark of pain meds. Others may not want to exert the effort or time involved in physical therapy, acupuncture, exercise, or yoga, and others may be skeptical of mindful therapies. It’s the employer’s role to foster trust, provide support, and help motivate the employee.

Helping injured workers who have become long-term users wean off of opioids

While averting opioid dependency in a new workers’ comp claim is no easy task it’s tenfold more difficult in legacy claims tied to long-term opioid prescriptions. There are many barriers to successfully resolving long-term claims that involve chronic opioid usage:

  • The treating physician doesn’t buy into alternatives and won’t suggest them to a patient
  • There aren’t enough physicians who have adequate training on pain management and opioid prescribing
  • There’s attorney involvement
  • The worker is in a vicious cycle of drugs trying to manage the pain – the worker hasn’t slept, has anxiety, depression or nausea, and takes other pills alongside their Vicodin or OxyContin to repress those side effects
  • The prospects of returning to work seem slim and the worker has psychosocial factors such as depression, hopelessness, and hostility
  • The worker is focused on pain and unwilling to quit or reduce their pain medications
  • Medicare set-asides allows comp claims to close with cash set aside to pay for future drugs – often strong doses – with little oversight

Although these barriers are daunting, there is promise in a recent report released by California’s Workers’ Compensation Insurance Rating Bureau. The report, Study of Chronic Opioid Use and Weaning in California Workers’ Compensation, showed nearly half of the study claims with employees demonstrating chronic opioid usage (11 months from the date of injury) weaned off of opioids completely within 24 months from the date of injury. The weaning process typically involved a gradual decrease in opioid prescriptions combined with a mix of alternative non-drug treatments and non-narcotic drugs.

Vital to success is the adjuster who must remain involved throughout the process. It begins with knowing how to look at the data, not only to identify claims where opioid usage costs are high, but to identify trends. What types of injuries are involved? Do they occur in the same department or under the same manager? Can they be linked to certain physicians? Chronic use of opioids extends disability, and data analysis is critical to building a plan.

The adjuster must be familiar with and open to evidence-based innovative treatment options and understand how best to work with the injured worker. The program’s success also relied upon peer-to-peer conversations with the prescribing physicians and developing a program specifically aimed at helping workers cope with significant chronic pain. It demonstrates that a well-designed, carefully managed program with the focus on the individual can work.

The increased awareness around the epidemic has improved the possibilities of success with legal action, as indicated by a recent decision of the West Virginia Supreme Court. In Grinnan v. West Virginia Office of Insurance Commissioner, the court ruled unanimously that a carpenter was not entitled to continued treatment with OxyContin for a 26-year old back injury. However, legal action should be viewed as a last resort because of the time, money, and hostility involved.

Prevention – preinjury support

In the past, opioids were often prescribed for musculoskeletal injuries, effectively masking the pain but doing nothing to treat the injury. Ensuring good ergonomics in work place design and processes and ensuring that workers can handle the physical demands of their job is a good first step. Listening to workers who have minor pain and providing the support to minimize it, will help prevent costly claims.

Drug policies should be reevaluated to identify the situations where testing makes the most sense as well as what tests should be used. Screening for prescription drug use, illicit drug use, and adherence to legitimate opioid medications is a sound approach to mitigate risk. Working with legal counsel, the employer should decide what testing is warranted for pre-employment screening, pre-duty, periodic, at random, post-incident, reasonable suspicion, return-to-duty, or follow-up situations.

Legitimate claims from workers who already are using opioids are among the most difficult to resolve. A recent article on lexisnexis.com by Thomas Robinson notes that a study to be published by the Journal of Occupational and Environmental Medicine supports the widely-held notion that pre-injury opioid and benzodiazepine use may increase the risk and cost of disability after a work-related injury.

Prevalence of compensable claims was higher among cases with pre-injury opioid use compared to cases without such pre-injury use (28.6 percent vs. 19.5 percent) and prevalence of post-injury opioid use was higher among claims with pre-injury opioid use compared to cases without such pre-injury use (67.2 percent vs. 22.8 percent). Train supervisors and managers how to identify the signs of drug abuse, the steps to take if abuse is suspected, and the legal issues involved. It is in the best interest of the employer to provide support and confidential access to treatment.

Proactive employers are also altering health plans to restrict the use of prescription opioids. The Surgeon General urges employers to ensure that health providers are following the Centers for Disease Control and Prevention (CDC) guidelines, “Use your levers on the health care delivery side.” He notes that dental prescriptions for opioids is the first step for many toward addiction. “If you tell your employees and their families that you’re not going to pay for more than 10 pills if they go to the dentist, that will have a quicker impact than anything I can do as surgeon general to educate the prescribers in the community.”

While the path to finding effective treatment of choice can be long, difficult, and expensive, doing nothing can be costlier to the employer and devastating for the worker.

Note: NCCI is doing a series exploring three viewpoints on issues surrounding opioid use and workers’ compensation: those of doctors, insurers, and workers compensation regulators.

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

OSHA watch

Enforcement of the Beryllium Standard begins May 11

Enforcement of the final rule on occupational exposure to beryllium in general, construction, and shipyard industries begins on May 11, 2018.

Local governments and emergency services will be notified when a company receives a serious citation

Spurred by a fatal chemical explosion and fire at a New York cosmetic factory, OSHA, the Environmental Protection Agency, and the Department of Homeland Security are working on the new protocols for communicating and training with local governments and first responders.

Regional campaign on ‘focus four’ construction hazards in Region Three

Running from March to June, a campaign to raise awareness of the four leading safety hazards in the construction industry (electrocution, falls, struck-by, and caught-in or caught-between) will take place in Delaware, Maryland, Pennsylvania, Virginia, West Virginia and Washington. Representatives will conduct toolbox talks on each hazard.

A $1 million settlement for safety violations

Hebron, Ohio-based Sunfield Inc. has agreed to pay $1 million in fines and hire a safety and health coordinator to resolve violations found at the company’s Hebron plant. The inspection, which took place after two employees suffered severe injuries when they came in contact with moving machine parts, revealed the company lacked adequate power press guarding and hazardous energy control procedures that could have prevented the incidents.

Standard interpretation related to recording and reporting injuries of temporary workers versus HIPAA requirements

A recent standard interpretation addresses injury and illness recordkeeping requirements pertaining to an employer that supervises temporary workers on a day-to-day basis but has limited access to their medical records when an injury or illness occurs.

New fact sheet for owners and managers on conducting a walk around

The fact sheet urges business owners and managers to personally conduct periodic walk around inspections. It reviews the best way to prepare for an inspection, what to do while onsite, and how to develop an abatement plan.

New bulletins provide information on horizontal drilling hazards and chemically induced hearing loss

“Preventing Hearing Loss Caused by Chemical (Ototoxicity) and Noise Exposure” was published in conjunction with the National Institute for Occupational Safety and Health and provides recommendations to employers and safety professionals about identifying ototoxicants in the workplace and establishing hearing conservation programs where these chemicals are used.

“Avoiding Underground Utilities during Horizontal Directional Drilling Operations” highlights the hazards associated with striking different underground utilities. Horizontal directional drilling has reduced visibility compared to vertical drilling. The bulletin was based on an incident that led to an explosion at a nearby restaurant, resulting in a worker fatality.

Enforcement notes

California

  • Alhambra Foundry Co. Ltd. faces $283,390 in proposed fines for workplace safety and health violations following a confined space accident that resulted in the amputation of an employee’s legs.
  • Petro Chemical Materials Innovation in South Gate faces $72,345 in penalties for failing to de-energize and guard a moving conveyer belt while a worker was cleaning it, resulting in the amputation of the worker’s right arm.

Florida

  • Jacksonville-based Jax Utilities Management Inc., a utilities contractor, was cited for $271,606 in proposed penalties and deemed a severe violator for exposing employees to trenching hazards. The investigation was launched after an employee was injured and hospitalized when an unprotected trench collapsed.
  • Naples-based L.I. Aluminum Design Inc., a pool and patio installer, received four serious citations, and faces proposed penalties of $40,096 after a worker fatally fell.
  • Middleburg-based Southeastern Subcontractors Inc. is facing $22,173 in proposed penalties following a heat-related fatality.
  • A Texas communications contractor, Tower King II Inc., faces penalties of $12,934 after three workers were killed while trying to install a new antenna on a communications tower in Miami Gardens. The capacity of the rigging attachments was not adequate to support the loads and the workers fell over 1,000 feet.

Georgia

  • Jose A. Serrato, a Marietta-based independent roofing contractor, was cited for exposing employees to fall hazards at a worksite in Birmingham and cited with $133,604 in proposed penalties. Mr. Serrato has been cited seven times in the past five years.

Massachusetts

  • Luis Guallpa, doing business as Milford-based Guallpa Contracting Corp., faces penalties of $299,324 for exposing workers to fall and other hazards at a Nashua, New Hampshire work site. The company had previously been cited in 2014 and 2015.
  • Jet Logistics Inc. (JLI) and New England Life Flight Inc., doing business as Boston MedFlight (BMF), were ordered to reinstate a pilot who lost his job after complaining about safety concerns and possible violations of the Federal Aviation Administration (FAA) regulations. JLI and BMF must pay the pilot $133,616.09 in back wages and interest; $100,000 in compensatory damages; reasonable attorney fees; and refrain from retaliating against the employee. The employers must also post a notice informing all employees of their whistleblower protections under AIR21.

Nebraska

  • An egg processing facility, Michael Foods Inc.’s of Wakefield, faces proposed penalties of $188,464 after an employee was fatally struck by a dock leveler. The proposed penalties relate to lockout/tagout, electrical and arc flash hazards violations.

New York

  • Summit Milk Products LLC faces $143,000 in proposed penalties for uncorrected and new hazards. A follow-up inspection was done after the company failed to report how it corrected violations found in an earlier inspection. Again, it was found that employees were not protected from heated milk in excess of 150 degrees and the injuries were not recorded in the 300 log.

Pennsylvania

  • Allentown-based Lamm’s Machine Inc. faces $14,782 in proposed penalties for exposing employees to hazardous chemical vapors from a degreasing operation in an enclosed space.

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

HR Tip: Report: why employers are getting wellbeing wrong

A new report from the Campbell Institute, A Systems Approach to Worker Health and Wellbeing indicates not all employers are getting worker wellbeing right, and it could be affecting the sustainability of their business. While many organizations today are focused on wellbeing programs that tackle smoking cessation, weight loss or nutrition, the Campbell Institute report indicates a more multifaceted approach to worker wellbeing focused on improving the areas of highest risk to their employees can have the most benefit.

Recognizing there is not a one-size-fits-all solution to worker wellbeing, the Institute proposes a systematic approach to assessing and addressing total worker wellbeing, such as the “Plan Do Check Act” model. It’s designed to identify top problem areas, develop intervention strategies at an organizational level to address those risks, and ensure that the improvements are maintained.

The report includes a 35-item questionnaire that addresses six primary stress areas on the job.

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

Work-related injuries can increase a company’s healthcare costs through underreporting and on-going care

Two new studies came to a troubling finding: the usual method of studying reported injuries using workers’ comp records may underestimate the true number of injuries due to underreporting and use of group health insurance. To understand the actual cost of workplace injuries and illnesses, NIOSH-supported researchers at the Harvard T.H. Chan School of Public Health studied the cost of health insurance and patterns of underreporting.

One study focused on female healthcare workers. The injured workers’ combined insurance claims were $275 greater at three months post-injury, and at six months had climbed by $587.

Another study looked at whether injury reporting patterns differed among racial groups. Researchers compared the number of workers’ self-reported injuries to the number recorded by their employer’s official injury reporting system among a group of patient-care workers in a U.S. hospital. They found there were almost two times the number of self-reported injuries than those actually reported. While researchers noted that more research is needed, they found that self-reported injuries were more likely to go unreported to the hospital by black workers than were injuries to white workers.

Employer takeaway: These findings indicate that workers’ compensation costs do not reflect the true cost of work-related illness and injury. There are many explanations for why injuries are underreported, but the safety climate and supervisory enforcement behaviors, which are critically important to determining whether employees experience accidents at work, play a major role in whether employees are comfortable reporting injuries. Workers may fail to report injuries to their employer because they fear retaliation by their employer, stigma from their coworkers, or because they perceive the injury to be too minor or an accepted part of the job.

When an injury isn’t reported or properly cared for immediately, it can worsen and lead to higher health care costs, more lost time, and reduced productivity. One of the best ways to control costs is through early reporting and intervention through the work comp process. The often-quoted study by the Hartford Financial Services Group found that injuries reported four or five weeks after the incident are 45 percent more expensive than injuries reported within the first week due to increased health costs and possible legal fees (or even a lawsuit) associated with late reporting. Equally important, treating injuries through the work comp process will help to ensure an early return to work and improve safety programs.

In addition, employers may not recognize the hurdles employees face in filing a claim. Poor communication about the process, language barriers, cumbersome and paper-laden processes, no provisions for weekend or late-shift employees to report injuries immediately, and slow adoption of technology to report injuries are some of the common roadblocks to early reporting.

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

What to expect in 2018

In today’s fast-moving business environment and volatile political atmosphere, nothing stays the same for very long, including Workers’ Compensation. Here are 18 ongoing trends and emerging issues to watch in 2018.

  1. Comp rates continue downward trend It’s good news for employers that comp rates are decreasing in most states as claims frequency declines and workplace safety continues to improve. This, coupled with relatively modest increases in medical costs and stable indemnity cost, means a reduction in loss costs and rates. Safety programs at the workplace, automation that has made hazardous jobs safer, a shift from more hazardous jobs to service jobs, and access to better medical care have all contributed to this favorable trend.There are a few areas that are more challenging, including the trucking and hospitality industries. Geographically, rates in California remain among the highest in the country and in Florida there still is concern about rising claims and legal costs, but rates are falling in both states in 2018. Rates in Pennsylvania are expected to increase 6-7% this year due to a Pennsylvania’s State Supreme Court 2017 ruling on injured employees on workers’ compensation over 2 years that will have a significant impact on rates in 2018 and moving forward unless legislation is addressed.  Moreover, workplace fatalities rose to the highest level since 2008.

    Takeaway: This is no time to become complacent. Hourly wages have been slowly trending up, along with employment. Claims have become more complex with comorbidities, aging, chronic pain, improved medical processes, and so on. The long tail nature of claims means that premiums collected today must cover losses for years to come. Insurance companies are using big data and more sophisticated predictive pricing models. Employers that collect and analyze data to improve cost controls, embrace innovative and progressive management of their Workers’ Comp program, and highlight them in underwriting submissions will reap the benefits.

  2. OSHA becomes more employer-friendly Under the Trump administration, there is a significant shift from the enforcement philosophy of the Obama administration to one of enforcement and compliance assistance.Combustible dust, vehicle backing hazards, hearing protection in construction, and updates to chemical PELs were removed from the regulatory agenda and workplace violence, process safety management, infectious diseases in healthcare, and emergency response and preparedness were moved to “long-term actions.” Enforcement of the silica standard on general industry and the maritime industry is scheduled to begin on June 23, 2018, but the Trump administration may seek a delay, depending on its experience with enforcement of the standard on the construction industry.

    Expect more emphasis on Voluntary Protection Programs (VPP), possible changes to “repeat” violation policies and National Emphasis Programs, much less public shaming, more limited use of the general duty clause, and changes to the e-recordkeeping and anti-retaliation rule.

    Takeaway: In spite of these shifts, employers should not assume they are guaranteed employer-friendly outcomes when dealing with OSHA, nor plan on specific regulatory changes, which will take time. While there may be closer adherence to the standards, the increased enforcement fines remain in effect, with some significant fines levied in 2017.

  3. New technologies will continue to emerge The ability to strengthen safety, provide health information, improve working conditions, and boost productivity with the adoption of new technologies (drones, wearables, the IoT, laser scanning, apps, emerging robotic technologies, and autonomous safety systems) will continue to grow. A virtual approach to ergonomics is emerging as a more efficient way to prevent or mitigate injuries.With this comes the need to understand regulatory requirements, privacy laws, insurance, and protection from liabilities. While the opportunities are compelling, some industries, such as construction, have been slow to adapt.

    The advances in technology also impact the medical treatment available for injured workers. Some new treatments will restore full functionality, others will significantly increase costs, and some expand the exposures for lifetime indemnity and medical benefits.

    Takeaway: As the benefits of using these technologies are proven and their prices decrease, more employers will adopt to improve safety and increase competitiveness. Evaluating functionality, security, and employee buy-in will be key in making product choices. New technologies mean new risks and promoting best practices for controlling exposures to hazards involving human interaction with technology, as well as training to mitigate the risks of workers becoming distracted or disengaged are crucial to obtain improved efficiency and reduced costs.

    From a medical vantage point, the use of evidence-based medicine and relationships with occupational physicians will continue to grow in importance.

  4. More employers will practice advocacy-based claims management Employers who have an “us vs them” attitude towards workers who have experienced a work-related injury are living in the past. Transparency, collaboration, and communication are the techniques that dominate effective claims management today.By easing the minds of injured workers and helping guide the recovery process, employers can avoid adversarial relationships and obtain better outcomes.

    Takeaway: It’s not a costly practice, but it takes commitment and consistency to work and an understanding of the injured worker. It can’t be a cookie cutter process; it’s a culture.

  5. New training techniques Training that requires focus, reinforces good practices, highly engages workers, is deliverable 24/7, and has no language barriers is not traditional training. Gamification, virtual reality (VR), and simulations have moved training from passive seminars, video watching, and form-filling to interactive culture and behavioral changing programs. Moreover, site specific safety orientation, daily tool talks, and near miss analysis and discussion build trust with workers and focus on the unique challenges of the job.Takeaway: While the top ten OSHA violations are evidence that many employers fail to meet their training obligations, it’s also true that training is often boring and ineffective. New approaches focus on problem solving and collaboration. The importance of training is how well employees remember and use what they know when the time comes to protect themselves, not that the obligation has been fulfilled.
  6. Alternative treatments for chronic pain While opioid prescribing is on the downturn in workers’ compensation and opioid early intervention programs have become an industry mainstay, legacy claims are a serious problem for the industry. Also, chronic pain particularly from musculoskeletal conditions, remains a serious problem among the workforce and must be addressed. Less invasive approaches such as education and self-care options; conservative therapies like exercise, acupuncture, physical therapy, and yoga; cognitive behavioral training to address psychological factors; and comprehensive pain management are leading the way. The debate rages on about the possibilities of medical marijuana.Takeaway: Employers offering access to affordable and evidence-based options that can help employees in pain can reduce their costs by mitigating unnecessary treatments, reducing lost time, and improving productivity. A comprehensive program provides education and is tailored to the individual needs of the employee.

    Medical marijuana continues to challenge employers in their substance abuse programs and drug testing, and state judicial and legislative bodies as they decide whether to permit reimbursement of medical marijuana as a compensable workers’ compensation benefit. Staying abreast of relevant legal decisions and clearly defined policies in employee handbooks is key.

  7. Medical practices will continue to change Telemedicine is here and expanding. Delivering medical care and information via telecommunication networks is impacting case management, physician’s visits, and rehab. It’s being used effectively for employees working in remote areas, integrated with the nurse triage process, particularly for minor injuries, and follow-up care, including post-op visits, home treatment plans, questions and answers, and consultations with specialists. There’s also been an uptick in telerehab, which supplements in-clinic physical therapy, with virtual access to physical therapy. The possibilities will continue to expand.Takeaway: The benefits of telemedicine can be significant, including cost savings, better access to care, immediate triaging of injuries, and faster claims closings. Issues facing employers include state laws, which vary in the types of services covered, provider requirements, reimbursements, and medical licensure; changing roles of stakeholders who are providing service to injured workers; patient and data privacy; monitoring quality of outcomes; and systems connectivity.
  8. Mental health issues will be talked about more The significant impact of mental health in workers’ comp continues to emerge. Legislative efforts to make it easier for first responders to receive workers’ compensation benefits for mental stress injuries (such as post-traumatic stress disorder) have met with varying degrees of success. The effect of depression, anxiety, and other mental health issues on delayed return to work, increased claims costs, and workplace violence are more fully understood and recognized.Takeaway: Companies are becoming more cognizant of these issues and are more focused on building healthy workplace cultures. The stigma attached to mental health is a societal problem and greater education is needed to identify mental health issues and appropriate treatment.

    Regulatory and external factors can become disruptors including:

  9. Natural disasters have a significant impact on the industry
  10. The national opioid crisis finds its way into the workplace, with double digit increases in overdose fatalities
  11. Globalization means borderless business and new challenges to keep traveling employees safe
  12. Debate over drug formularies will continue to rage in many states
  13. The Gig economy raises questions of adequately protecting workers
  14. The question of independent contractor vs. employee remains one of the hottest, most litigious areas
  15. Rising on-demand services change the risks faced by workers
  16. Changes to immigration laws have significant implications for the hospitality, restaurant, agricultural, construction, and technology industries as well as others
  17. 24/7 connectivity has implications for employee fatigue, driver safety, productivity
  18. The new tax law will mean changes in investment priorities and could lead to accelerated automation

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

Things you should know

NCCI published a large set of changes to the Basic Manual

While many of the changes are minor, such as replacing “insured” with “employer,” here are some you should know:

  1. Stores and day care services operated by the employer for employee use are now a general inclusion. Previously, they were a general exclusion. They must be separately rated if they also operate for the general public.
  2. The “automatic” exclusion for expense reimbursements when traveling overnight increased from $30 to $75 per day. Texas has their own exception to this and you can exclude up to the maximum IRS allowable per-diem, which is currently $189.
  3. 7228 and 7229 (Short and Long-Haul Trucking) are being retired in favor of 7219. This change has already happened in many states, with many more following along over the next year. Check with your agent for more information.

EEOC provides timeline for revising wellness regulations

In a court ruling in August, the American Association of Retired Persons, Inc. (AARP) challenged the EEOC regulations on the basis of the “voluntariness” of the 30 percent incentive limitation and the court held that the EEOC did not provide a reasonable explanation as to why the incentive limit of 30 percent of the cost of coverage rendered an employee health program voluntary rather than involuntary.

According to a status report issued in September, the EEOC intends to issue a notice of proposed rulemaking by August 2018 and issue a final rule by October 2019. Notably, the EEOC indicates in a footnote that, in order to give employers time to come into compliance with a new rule, any substantively amended rule on wellness programs would likely not be applicable until the beginning of 2021.

Adult obesity rate climbs to 40 percent

Obesity continues to present a problem to both the adult and younger population of the United States, according to new data from the Centers for Disease Control and Prevention (CDC).About 40 percent of U.S. adults are considered obese, and the rate grew 20 percent for 12 to 19 year olds, the CDC’s National Health and Nutrition Examination Survey (NHANES) indicated.

NIOSH center to focus on ‘safe integration of robots’ in the workplace

Citing a “knowledge gap related to robotics and worker safety and health,” NIOSH has launched the Center for Occupational Robotics Research in an effort to evaluate the possible advantages and hazards of robot workers, as well as foster safe robot-human interactions.
State News

California

  • The Department of Insurance announced that the pure premium rate will reduce 17.1% to $1.94 per $100 of payroll for workers’ compensation insurance, effective Jan. 1, 2018
  • California Gov. Jerry Brown vetoed a bill that would require employers to provide employees their injury and illness prevention plan upon request
  • Hepatitis A outbreaks have been reported in San Diego, Santa Cruz and Los Angeles counties and Cal/OSHA has issued a reminder to employers about preventive measures

Indiana

  • Indiana Department of Insurance approved a 12.8% rate decrease
  • A WCRI report notes that medical payments per claim decreased 10% from 2014 to 2015 – the first such decrease in more than a decade

Michigan

  • The pure premium advisory rate for work comp insurance will decrease by 9.3% for 2018

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

Important takeaways from recent studies and reports

Strategies to reduce costs and risks of musculoskeletal disorders

A report by the Northeast Business Group on Health (NEBGH) urges employers to look at their own experiences with claims, disability, workers’ compensation and health risk assessment data to best prioritize program selection and implementation to better manage MSDs. It addresses several strategies to mitigate cost and health issues and suggests using onsite ergonomics training, online courses on the subject and workplace redesigns. It also suggests new approaches to treatment, such as online pain education, direct access to physical therapy by bypassing physician referrals, and directing employees away from “unnecessary diagnostic imaging and expensive visits to specialists.” Finally, the report examined ways to ensure that if surgery is needed, that the care is performed in an efficient and cost-effective way.

Obesity and worker productivity by occupational class

The Journal of Occupational and Environmental Medicine has published a new study, “Impact of Obesity on Work Productivity in Different US Occupations: Analysis of the National Health and Wellness Survey 2014-2015”, which examines the impacts of obesity by different occupational classes on work productivity and indirect costs of missed work time.

BMI results were as follows:

  • Protective Services: 38% overweight, 39% obese
  • Transportation: 38% overweight, 36% obese
  • Manufacturing: 35% overweight, 30% obese
  • Education: 31% overweight, 30% obese
  • Healthcare: 31% overweight, 30% obese
  • Construction: 38% overweight, 29% obese
  • Hospitality: 32% overweight, 27% obese
  • Arts: 34% overweight, 26% obese
  • Finance: 36% overweight, 25% obese
  • Computer: 36% overweight, 25% obese
  • Legal: 38% overweight, 24% obese
  • Science: 37% overweight, 21% obese

The researchers concluded that there was a positive association between work productivity impairment and increases in BMI class that varied across occupations. Obesity had the greatest impact on work productivity in construction, followed by arts and hospitality, and health care occupations. Work impairment was least impacted by increases in BMI in Finance, Protective Services, Computers, Science, and Legal. It was estimated that the indirect costs associated with the highest BMI group in construction was $12,000 compared to $7,000 for those with normal BMI.

Would your floors pass the slip and fall test? 50% fail

Half of the floors tested for a slip-and-fall study failed to meet safety criteria, suggesting that many fall-prevention programs may overlook the effects of flooring selection and ongoing maintenance on slip resistance, according to a study by CNA Financial Corp.

Given the high frequency of slips and falls, these findings underscore the need for attention to floor safety and regular surface resistance testing to avoid fall accidents and related injuries.

Fatigue costs employers big bucks

Key findings from a recent study on fatigue by the National Safety Council (NSC) include:

  • More than 43 percent of all workers are sleep-deprived, and those most at risk work the night shift, long shifts or irregular shifts. As employees become tired, their safety performance decreases and their risk of accidental injury increases.
  • Missing out on sleep makes it three times as likely to be involved in an accident while driving. Also, missing as little as two hours of sleep is the equivalent of having three beers.
  • Employers can see lost productivity costs of between $1,200 to $3,100 per employee per year.
  • The construction industry has the highest number of on-the-job deaths annually. In a 1,000-employee national construction company, more than 250 are likely to have a sleep disorder, which increases the risk of being killed or hurt on the job.
  • A single employee with obstructive sleep apnea can cost an employer more than $3,000 in excess healthcare costs each year.
  • An employee with untreated insomnia is present but not productive for more than 10 full days of work annually, and accounts for at least $2,000 in excess healthcare costs each year.

Experts say employers can help combat fatigue by offering breaks, scheduling work when employees are most alert, and promoting the importance of sleep.

Workers welcome employers’ help in dealing with stress

Workers want their employers to offer assistance in coping with work-related stress, according to a new report from the American Heart Association’s CEO Roundtable.

The report also concludes that employees think more highly of employers offering resiliency programs. Valued programs include methods for dealing with difficult people, improving physical health, remaining calm under pressure, coping with work-related stress and accurately identifying the causes of work-related problems. It also includes actionable strategies for effective workplace resilience programs.

Supportive communication and work accommodation help older workers return to work

While early supportive contact with injured workers and offers of work accommodation are important to all injured workers, a recent webinar hosted by the Disability Management Employer Coalition (DMEC) and presented by Dr. Glenn Pransky, founder of the highly acclaimed, but now-defunct Center for Disability Research within the Liberty Mutual Research Institute for Safety, noted that these two strategies are particularly effective with older workers.

His research involved workers’ comp cases in New Hampshire related to low back and upper extremity problems. Negative responses, including lack of support, anger, disbelief, blaming the worker, or discouraging the worker from filing a claim resulted in significantly longer disability, and the effect was especially strong among older workers.

Click to hear the DMEC webinar

Loss control rep visits cut lost-time injuries in construction

Visits by insurance loss prevention representatives to construction job sites can lead to fewer workplace injuries, according to a study by a Center for Construction Research and Training supported research team at the University of Minnesota. One contact was associated with a 27% reduction of risk of lost-time injury, two contacts with a 41% reduction of risk, and three or more contacts with a 28% reduction of risk, according to the study. The study also found that these visits are often low cost and that the reduction in lost-time injuries reduced workers’ comp costs.

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