Things you should know

Opioid abuse rises with length of prescription

According to a study by the U.S. Centers for Disease Control and Prevention, the risk of opioid abuse rises with lengthy prescriptions. If received a one-day prescription, 6% were still on opioids a year later; when prescribed for 8 days or more, this rises to 13.5%; when prescribed for 31 days or more, it increases to 29.9%.

Blacklisting rule repealed

President Trump repealed the so-called “blacklisting rule” that required federal contractors to disclose labor violations. The executive order had required employers bidding for federal contracts worth at least $500,000 to disclose any of 14 violations of workplace protections during the previous three years.

FMCSA will not reinstate overnight rest regulations for commercial drivers

The Federal Motor Carrier Safety Administration’s (FMCSA) regulation that required CMV (Commercial Motor Vehicle) drivers to take breaks in the hopes of preventing driver fatigue has been suspended since 2014 so that further research could be done to understand the efficacy of the program. A study from the Department of Transportation found that stricter mandated breaks did not do much to reduce driver fatigue or improve safety. Thus, the rule will not come out of suspension.

Study reveals occupations with sleep deprived workers

If your industry is health care, food service, or transportation, your workers are probably not getting adequate sleep, according to a study published March 3 in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report. Workers who averaged fewer than seven hours of sleep per night were classified as having short sleep durations. Occupation groups that failed to average seven hours of sleep included:

  • Communications equipment operators: 58 percent
  • Rail transportation workers: 53 percent
  • Printing workers: 51 percent
  • Plant and system operators: 50 percent
  • Supervisors, food preparation and serving workers: 49 percent
  • Extraction workers: 45 percent
  • Nursing, psychiatric and home health aides: 43 %

The American Academy of Sleep Medicine and the Sleep Research Society recommend that adults 18 to 60 years old get at least seven hours of sleep every day. A lack of sleep can contribute to cardiovascular disease, obesity, diabetes, depression, and other health issues, as well as contribute to more injuries on the job.

NIOSH announces free health screenings for coal miners

A series of free, confidential health screenings will be available for coal miners as part of the NIOSH Coal Workers’ Health Surveillance Program. The first set of screenings will take place from March 26 to April 15 in coal mining regions throughout Alabama. The second set will occur from May 10 to May 31 throughout Indiana and Illinois. Finally, testing will take place from July 30 to Aug. 26 throughout Eastern Kentucky.

NIOSH updates mine hazard assessment software

Mine operators and workers now have access to updated hazard assessment software from NIOSH. According to the agency, EVADE 2.0 – short for Enhanced Video Analysis of Dust Exposures – offers a more comprehensive assessment of the hazards miners face by pulling together video footage and exposure data on dust, diesel and other gases, as well as sound levels.

Study: PT as effective as surgery for carpal tunnel

Physical therapy is as effective as surgery in treating carpal tunnel syndrome, according to a new study published in the Journal of Orthopaedic & Sports Physical Therapy. Researchers in Spain and the United States report that one year following treatment, patients with carpal tunnel syndrome who received physical therapy achieved results comparable to outcomes for patients who had surgery. Further, physical therapy patients saw faster improvements at the one-month mark than did patients treated surgically.

When hospital inspectors are watching, fewer patients die

A recent report in the New York Times cited a study in JAMA Internal Medicine which found death rates dropped when inspectors were onsite. In the non-inspection weeks, the average 30-day death rate was 7.21 percent. But during inspections, the rate fell to 7.03 percent. The difference was greater in teaching hospitals – 6.41 percent when the inspectors were absent, and 5.93 percent during survey weeks. While the difference may seem low, an absolute reduction of only 0.39 percent in the death rate would mean more than 3,500 fewer deaths per year.

Although the reasons for the effect are unclear, it was suggested when docs are being monitored, diligence ramps up.

Wearing eye protection can prevent 90 percent of work-related eye injuries, experts suggest

Ninety percent of on-the-job eye injuries could be avoided if workers wore eye protection, according to the American Academy of Ophthalmology (AAO). AAO offers the following tips for avoiding workplace eyestrain or injury:

  • Wear protective eyewear appropriate for the type of hazard you may encounter
  • Position your computer monitor 25 inches away
  • Follow the 20-20-20 rule: Every 20 minutes, take a break by looking at an object 20 feet away for 20 seconds
  • Reduce glare on your cell phone or digital device
  • Adjust environmental lighting near your workstation

 

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

HR Tip: ABA’s summary of 2016 FMLA cases

Every February, the American Bar Association’s (ABA) Federal Labor Standards Legislation Committee publishes a comprehensive report of FMLA decisions handed down by the federal courts in the previous year. This handy report summarizes every FMLA decision from 2016 in a user-friendly manner.

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

Seven in ten employers impacted by employee prescription drug use

Seventy-one percent of U.S. employers say drug use among employees has impacted their business, but only 19% of them have comprehensive workplace drug policies in place, according to a survey by the National Safety Council (NSC). While 57% test their employees for drugs, only 41% screen for synthetic opioids – the kind of prescriptions usually found in medicines cabinets and increasingly available on the black market.

The types of incidents experienced in the workplace as the result of prescription drug use are: 39% absenteeism; 39% workers have been caught taking drugs while on the clock; 32% a positive drug test indicated use; 29% a worker had been found to be impaired or showed decreased work output; 29% a family member complained; 22% another employee complained to human resources; 15% an injury or near-miss occurred; and 14% an employee was caught selling drugs in the workplace.

“Employers must understand that the most dangerously misused drug today may be sitting in employees’ medicine cabinets,” Deborah A.P. Hersman, president and CEO of the NSC, said in a statement. “Even when they are taken as prescribed, prescription drugs and opioids can impair workers and create hazards on the job.” Cognitive impairments and physical pain masked by prescription drugs can make employees engage in riskier behaviors and reduce response time.

 

What employers can do

Develop a drug-free workplace policy, including prescription drugs

Most employers have a drug-free workplace policy directed at illegal drugs and an alcohol abuse policy, but most don’t have a prescription drug policy. Since prescription drugs are legal, it’s been difficult to craft a policy, but many addictions begin with legal prescriptions. Even when taken as prescribed, they can impair workers and create hazards on the job.

The NSC provides a free Prescription Drug Employer Kit to help employers create prescription drug policies and manage opioid use at work. The kit recommends actions including:

  • Define the employee’s role in making the workplace safe. A drug-free workplace program (DFWP) should state what employees must do if they are prescribed medications that carry a warning label or may cause impairment. The employer can create a plan around not operating vehicles or machinery while the prescription is in use. The DFWP should also spell out the steps an employer will take if it suspects a worker is using certain medications without a prescription, in larger doses than prescribed, or more frequently than prescribed.
  • Add prescription drug testing to illicit drug testing. Working with legal counsel, the employer should decide if additional testing is warranted for pre-employment screening, or for pre-duty, periodic, at random, post-incident, reasonable suspicion, return-to-duty, or follow-up situations.
  • List the procedures or corrective actions the employer will follow when an employee is suspected of misusing prescription drugs or for an employee with confirmed prescription drug abuse.
  • Obtain legal advice. An attorney experienced in DFWP issues should review the policy before it’s finalized.
  • Train supervisory staff and educate employees. Educate managers and supervisors about prescription drug abuse and what to do if they suspect an employee has a problem. Training also is an underused tool that companies can use to make employees aware of the risks and signs of prescription drug misuse, along with company policies.
  • Review service coverage for behavioral health and/or employee assistance program (EAP) needs. Evaluate the behavioral health portions of health insurance policies and EAP contracts to ensure employees are covered for abuse of prescription drugs.

 

Work with insurers to cover alternative approaches

Hersman advised employers to work with their insurers to cover alternative therapies so that employees can avoid taking opioids or other addictive medications for chronic pain. Alternative therapies include acupuncture, guided imagery, chiropractic treatment, yoga, hypnosis, biofeedback, and others.

While 88 percent of survey respondents were interested in their health insurer covering alternative pain treatments, only 30 percent indicated they would not act on that interest by negotiating expanded coverage with insurers.

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

Things you should know

ACP latest medical guideline to discourage opioids for treatment of low back pain

A new low-back pain treatment guideline from the American College of Physicians (ACP) is the latest to discourage the use of opioids, instead encouraging the use of such treatments as exercise, acupuncture, massage, or biofeedback. When low-back pain becomes chronic, defined as lasting longer than 12 weeks, ACP recommends that patients start with non-drug therapy, which might include exercise, acupuncture, biofeedback, cognitive behavioral therapy or spinal manipulation. The guideline applies to cases of nonradicular low-back pain, where pain is not radiating into the patient’s legs.

If patients wish to take medication, they should use nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, or skeletal muscle relaxants prescribed by a doctor. Acetaminophen and steroids are not recommended for low back pain, according to the guideline.

Guide offers advice on choosing the right slip-resistant footwear

Intended for workers, purchasers, and safety and health committees, a Montreal scientific research organization offers a free pamphlet detailing the procedures for choosing footwear with proper grip and protection against hazards. It also lists necessary steps, including creating a selection committee, considering risk factors, selecting the proper sole and verifying the selection before purchase.

ISHN annual update on hand protection

The Industrial Safety and Hygiene News February edition features its annual update on hand protection.

FMCSA delays effective date for CMV driver minimum training standards

The Federal Motor Carrier Safety Administration (FMCSA) rule establishing national minimum training requirements for entry-level commercial motor vehicle drivers has been pushed back until at least March 21 based on the executive order to temporarily postpone certain regulations that have yet to take effect. The agency could delay the minimum training rule beyond March 21, if necessary.

NIOSH publishes workbook on Total Worker Health

NIOSH has released a workbook it calls “a practical starting point for employers, workers, labor representatives, and other professionals interested in implementing workplace safety and health programs aligned with the approach.” The Total Worker Health concept emphasizes a work environment that is free of hazards and uses “a modern prevention approach” that acknowledges that occupational factors can affect the well being of employees, their families and their communities.

New Jersey’s toughens opioid laws

The New Jersey law limits doctors’ ability to issue first-time opioid prescriptions for more than five days, mandates doctors to create a pain-management treatment plan regarding the use of opioids and review prescriptions every three months, and requires doctors to obtain a written record that the risks of taking opioids were discussed with the patient. The law also mandates state-regulated health insurers to cover the first 4 weeks of inpatient or outpatient substance abuse treatment without the need for authorization. Insurers must provide additional coverage for up to 6 months of treatment, including medication-assisted treatments, if deemed medically necessary.

The prescription drug limit would not apply to patients with cancer and for end-of-life hospice care.

IRS will accept tax returns from individual filers without health care status but employer requirements remain the same

The IRS announcement that it will not reject taxpayers’ 2016 income tax returns that are missing health coverage information applies to personal income tax returns. Employers still must distribute 1095 forms to employees and report employee health coverage to IRS. Also, it is not a repeal of the individual mandate; penalty provisions are still in place and are currently being enforced.

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

Top 10 Workplace Trends in 2017

Performance Management tops the list

The Society for Industrial and Organizational Psychology (SIOP) asked its members – who study workplace issues of critical relevance to business, like talent management, coaching, training, organizational development, and work-life balance – about their predictions for 2017. Topping the list of top ten is the changing nature of performance management.

While much has been written about companies ending annual performance reviews and ratings, it’s unclear what will take its place. The group predicts, “Organizations can expect to rely less on once-a-year performance appraisals and more on frequent feedback and coaching to put the focus on improving performance. Strategies, such as continuous performance management, will lead to a greater emphasis on real-time feedback, daily manager-employee relationships and an increased need for managers to acquire the skills to coach and deliver timely feedback to employees.”

For the Top 10 Workplace Trends for 2017

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

Truckers’ medical conditions can increase crash risk

Commercial truck drivers who have at least three health issues can quadruple their crash risk compared to healthier drivers, according to a study from the University of Utah School of Medicine. Researchers examined medical records for nearly 50,000 commercial truck drivers, 34 percent of whom had signs of one or more health issues associated with poor driving performance, such as heart disease, low back pain and diabetes.

The crash rate involving injury among all drivers was 29 per 100 million miles traveled. The rate rose to 93 per 100 million miles traveled for drivers with at least three ailments. Researchers took into account other factors that can impact driving abilities, such as age and amount of commercial driving experience.

The study was published online Jan. 10 in the Journal of Occupational and Environmental Medicine.

Employee takeaway: It is well documented that truck drivers often have difficulty staying healthy because they tend to sit for long periods of time and sleep and eat poorly. With the industry facing a critical shortage of drivers, employers need to do all they can to keep their drivers healthy. There are a host of tools available to help drivers, including smart phone apps with guidance about nutrition and exercise on the road, customized in-house wellness programs, bio-screenings, coaching, sleep apnea testing and treatment, encouraging brown bagging and walking or bicycling during breaks, and so on. Some companies are ramping up their new-hire pain diagnostics, so they have a baseline for whether a new driver has pre-existing muscle pain. In an industry of high turnover and high claims, this puts the driver on notice and effectively deters claims.

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

Pressure to meet earnings expectations negatively impacts worker safety

New research in the Journal of Accounting and Economics, “Earnings expectations and employee safety” examined the relation between workplace safety and managers’ attempts to meet earnings expectations. The finding: significantly higher injury/illness rates in firms that meet or just beat analyst forecasts compared to firms that miss or comfortably beat analyst forecasts.

Changes in operations or production, specifically increased workloads and abnormal reductions of discretionary expenses, that are meant to increase earnings impacted the number of workplace injuries. The relation between benchmark beating and workplace injuries is stronger when there is less union presence, when workers’ compensation premiums are less sensitive to injury claims, and among firms with less government business.

Employer takeaway: When pressure is applied on managers to meet earning expectations, they can detract from safety by increasing workloads, hours, speed of workflow or cutting corners. Contrast these findings to a study published in the January 2016 issue of the Journal of Occupational and Environmental Medicine (JOEM), that found 17 publicly held companies with strong health and/or safety programs significantly outperformed other companies in the stock market. Two additional studies also found that financially sound, high-performing companies invest in employee health and safety. Rather than deviate from normal business practices to meet earnings expectations in the short-term, these companies have an ongoing, long-term commitment to a healthy and safe workforce that tangibly contributes to the bottom line.

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

Top 10 Non-Fatal Work Related Injuries

Overexertion tops list of serious, nonfatal work injuries for third straight year – Liberty Mutual

The 2017 Liberty Mutual Workplace Safety Index uses Liberty Mutual workers’ comp claims data, as well as information from the U.S. Bureau of Labor Statistics and the Washington-based National Academy of Social Insurance, to determine the costliest workplace injuries and those that result in employees missing six or more days of work.

For 2014, the injuries cost employers more than one billion dollars a week, or close to $60 billion a year.

The top ten include:

  1. Overexertion ($13.79B) 23%
  2. Falls on same level ($10.62B) 17.7%
  3. Falls to lower level ($5.50B) 9.2%
  4. Struck by object or equipment ($4.43B) 7.4%
  5. Other exertions or bodily reactions ($3.89B) 6.5%
  6. Roadway incidents involving motorized land vehicle ($3.70B) 6.2%
  7. Slip or trip without falling ($2.30B) 3.8%
  8. Caught in or compressed by equipment or objects ($1.95B) 3.3%
  9. Struck against equipment or object ($1.94B) 3.2%
  10. Repetitive motions involving micro-tasks ($1.81B) 3.0%

While overexertion, which includes lifting, pushing, pulling and other actions involving objects did decrease somewhat from 2013, falls on the same level and roadway incidents continue to trend upward.

Employer takeaway: Many employers have done a good job of implementing safety measures, adopting automation and new processes that reduce injuries, and fostering a strong safety culture, but injuries still happen. Understanding injury causation is a complex process. Factors ranging from human error, unsafe behavior, stress, and inadequate skills to unsafe conditions, insufficient training, faulty equipment, lack of supervision and so on come into play. Analyzing data to discover trends and problem spots that are driving the serious workplace injuries can help develop safety programs that target those causes. Moreover, employers have found success by increasingly involving employees in safety leadership, encouraging workers to be the “eyes and ears” of safe working practices, including the authority to stop work without fear of repercussion.

Related article: Overexertion accounts for more than 25% of the top ten injury costs: Liberty Mutual WorkComp Adv!sory – December 2015

 

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

From adversary to advocacy: the claims process

Advocacy-based claims models emerged as “buzz” in the industry in 2016. At its core is a focus on people. Employees respond better and take ownership when they become part of the claims process. It’s about caring for themselves and their co-workers.

While many employers recognize the value of employee involvement in claims processes, they often don’t connect the dots that it will have a long lasting impact on reducing costs. Lower litigation costs, speedier recovery at work, improved medical outcomes, shorter claim duration, and more productive employees lead to a healthier bottom line.

When an injury occurs, there’s a good chance that it is the employee’s first one. Even a minor injury can seem like a big deal because they have never dealt with the system before. Stress, confusion, anxiety, and frustration can lead to fear. And fear drives costs. The word “fear” or related words were in 84% of notes taken by workers’ comp claims adjusters for claims costing more than $100,000 according to a white paper by Lockton Cos. L.L.C.

With the traditional claims approach, it’s easy to understand how the employee feels they have fallen into an abyss, with no one there to help. The process can be intimidating and the language adversarial. Suddenly, they become “the claimant.” They don’t trust insurance companies based on what they’ve heard and this mistrust is quickly reinforced when they have to deal with the “claims examiner” and the “adjuster” who are “investigating” and “assessing” the claim. Missing is an expression of concern, a voice of empathy, and an open line of communications.

The advocacy-based claims model turns the process around. It focuses on the employee, helps them understand and navigate the process, provides information to help make decisions, makes access to benefits as simple and easy as possible, and builds trust. In effect, it treats the injured employee as a consumer.

While the structure of an advocacy-based claims model will vary with company size, type, and culture, there are common elements that are simple and easy to implement:

  1. Change the script. Don’t focus on how the claim will be investigated or all the insurance jargon. Begin with empathy, concern, and compassion. Let the employee know you will be there throughout the process and that the top priority is to get them back to work as soon as safely possible. Take the time to inform the employee of what to expect and when and who to contact with questions.
  2. Designate someone to contact the worker on a regular basis. Don’t rely on the insurance company to be the prime contact, designate a supervisor, risk manager, or HR representative to maintain contact throughout the claims process. Simple gestures such as get well cards, hand written notes, texts, and a visit to the hospital go a long way in reassuring the employee and building trust. Find out how you can advocate for them. There are many potential stumbling blocks along the continuum of care causing a claim to be snagged, slowed down, or stopped dead in its tracks. Some helpful questions: How are you feeling? How is the carrier doing? Are you getting your checks in a timely manner? Do you have transportation to your medical appointments? Have there been delays in getting your doctor appointments? How can we help you? And always remind them, “We’re looking forward to having you back.”
  3. Make medical care easy. Navigating the medical system is tough. And the system is still driven by a pay for service model, which encourages excessive procedures and inflates prices. Having the support of occupational doctors and therapists and a triage nurse, who share the same objective of improving the injured employee’s health for a recovery at work, eases the process.
  4. Recognize generational differences and make the process easy for everyone. Phone calls and snail mail just don’t cut it with Millenniums. A cumbersome process doesn’t work for anyone. Starbucks, which employs many young employees, now allows its workers to report an injury themselves immediately online or via a special phone line. The result has been less lag time in reporting injuries and no uptick in fraudulent claims.
  5. Don’t have a blanket approach. While one employee may respond well to several texts or phone calls in a week, another may find it disturbing and feel the employer does not trust them. Find a balance that works and set the right tone for maintaining communication.
  6. Engage in the recovery at work conversation early. Be sure the employee and the treating physician knows the options available and that the supervisor is on board. Be mindful of the employee’s situations and needs and show respect for the employee as a person. Throughout the process, discuss work capacities and restrictions and involve the employee in the process of establishing accommodations or alternative job functions, so that they engage in, rather than thwart, the recovery at work effort. Find out what they feel comfortable doing and what they are worried about.
  7. Handle denials differently. A denial is often the trigger for litigation. Let the employee know that the claim does not meet the definition of a compensable workplace injury and avoid the word denial. Do so with empathy and advise them of any other benefit options that could help.

While some of these are small gestures, they have a positive and long lasting impact. When employees receive emotional support and believe you care about them and doing all you can to help them recover, the claim is unlikely to spiral out of control.

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

New report weighs in on marijuana’s health benefits – nearly 100 conclusions

A new report from the National Academies of Sciences, Engineering, and Medicine offers a rigorous review of scientific research published since 1999 about the health impacts of cannabis and cannabis-derived products – such as marijuana. It lays out substantial evidence that associates the use of cannabis with the development of psychoses and schizophrenia, but also provides studies that show its potential benefits, such as relief of chronic pain and chemotherapy-induced nausea. Other benefits include: improvement of multiple sclerosis spasticity, improvement of short-term sleep in patients with obstructive sleep apnea, fibromyalgia, chronic pain, and multiple sclerosis, potential improvement of anxiety symptoms, and increasing appetite and decreasing weight loss in patients with HIV and AIDS.

But it also points out potential risks: worsening of respiratory symptoms and more frequent bronchitis with long-term smoking, increase in motor vehicle accidents, low birth weight in offspring of maternal smoker, and higher risk of cannabis overdose in children in states where cannabis is legal.

The report also acknowledges that it has been difficult for researchers to do rigorous research on marijuana, partly because of the federal classification of it as a Schedule 1 substance.

Employer takeaway: This report demonstrates how much more needs to be done – many health questions remain to be answered by better research. The increased legal availability of cannabis products in many states and the uncertain legal landscape has complicated workplace policies. It’s prudent for employers to establish a clear policy and communicate it effectively to employees as well as stay abreast of all legal decisions and regulations in the states where they do business.

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