National Return to Work Week Part 4 – The Injured Worker

Yesterday's series of webcasts dealt with return to work from the injured worker's perspective. When a worker becomes injured they may be pulled in multiple directions:

• The employer wants them back at work as soon as possible, and may have a different idea of asap than the injured worker's doctor.

• Family members wonder what will happen now that a bread winner is injured. They may be the one who pushes for a lawyer.

• Supervisors can make or break a safety/WC comp program. If the injured employee doesn't like working for a specific supervisor, they will be far more reluctant to return to that department.

• Coworkers can become irritated with an employee because they are now doing extra work.

• The employer can also bring in their 'experience' with similar injuries. Employers tend to be motivated to recover due to the fact they own the business and can't afford to take off. Employees do not have the same motivation.
  

If we as WC professionals have trouble understanding the laws, how much tougher would it be for the injured worker?

This general lack of understanding the process breeds suspicion. When an employer has no, or very limited light duty, and mandates the employee must be 100% recovered to return, the suspicion on the workers part becomes greater as they feel the employer is trying to get rid of them. If the worker doesn't recover as quickly as the employer expects it also breeds the suspicion the employee is malingering. The result is there is now suspicion on both sides that the other party isn't doing their part.

The workers compensation process is made yet tougher with the physician process. Depending on the state, workers may have an unfamiliar doctor chosen for them. Depending on the work load, the doctor may not give the worker much time in diagnosing the injury. The doctor says they can go back to work with certain restrictions. However, the doctor may not have been given a list of essential duties of the job, thus may not fully understand how the job tasks can effect the injury. This breeds suspicion that the doctor is on the employers side, and just pushing them back to work.

The employer may offer light duty, without fully understanding the restrictions. The light duty may require the injured worker to do something that is against the restrictions. When the employee refuses, it just reinforces the suspicion that the employee is malingering and playing the system.

The workers compensation provider also adds to the misunderstanding and suspicion. Tests, and procedures may take weeks to get approved. Both sides are now unhappy with the delays and may blame the “other side”.

All sides agree that the workers compensation system is not user friendly. Employers and Insurers may wrongly deny benefits causing yet more delays in treatment. The system encourages both parties to settle thus disposing of the 'problems' as quickly as possible. The system rewards those that play the system by essentially offering them money to settle and go away. For those that truly are injured to the point of not being able to work, the system can just get more confusing when they apply for Social Security Disability Insurance.

How do you cut through all of this misunderstanding, suspicion, and get the employee back to work as soon as reasonably possible? Check out the webcasts (available on demand) to find out more. Here: Nation Return to Work Week - Free Webcasts.

National Return to Work Week – Part 3 -- JAN

The Tuesday webcasts for National Return to Work Week were all very good. It would be a disservice to try to include everything in a quick overview. Instead I'm going to just focus on just one. All previous webcasts are available for immediate viewing here.

The focus of this blog is the webcast - “Creating Positive Return to Work Experiences” with Anne Hirsh and Dr. Beth Loy of the Job Accommodation Network (JAN). The Department of Labor, Office of Disability Employment Policy provides the Job Accommodation as a resource for both employers and employees. JAN is a collaborative effort with the U.S. DOL Office of Disability Employment Policy, the International Center for Disability Information at West Virginia University, and private industry throughout North America. JAN can be found at: http://www.jan.wvu.edu/.

JAN's mission is to facilitate the employment and retention of workers with disabilities by providing employers, employment providers, people with disabilities, their family members, and other interested parties with information on job accommodations, entrepreneurship, and related subjects. Anyone may call JAN for information about job accommodations and the employability of people with functional limitations.

JAN provides consultation to employers in order to:

• Increase the hiring, retention, and promotion of qualified employees with disabilities;

• Create accommodation solutions to benefit both employer and employee;

• Protect their business by educating employers about their responsibilities under the ADA,

• Rehabilitation Act and other disability related legislation;

• Reduce workers' compensation and other insurance costs; and

• Address issues pertaining to accessibility.

JAN provides consultation to people with disabilities in order to:

• Increase the hiring, retention, and promotion of qualified employees with disabilities;

• Create accommodation solutions to benefit both employee and employer;

• Educate people with disabilities about their rights under the ADA, the Rehabilitation Act and other disability related legislation;

• Inform people with disabilities of the local, regional, and national resources that can assist them in pursuing employment opportunities; and

• Address issues pertaining to accessibility.

JAN provides consultation to rehabilitation professionals in order to:

• Facilitate placement of clients through accommodation assistance,

• Brainstorm accommodation options, and

• Find local resources for workplace assessment and discover resources for device fabrication and modification.

JAN provides consultation to people affected by disability in order to:

• Discover local, regional, and national organizations, resources, and support groups; and

• Obtain helpful accommodation and legislative information.
  

JAN provides a multitude of information to help negotiate the issues involved with the new Americans with Disabilities Act from how to write a job description, to helping an employer determine if their employee is disabled, to how to recognize and deal with an accommodation request. JAN provides employers with accommodation ideas so that injured and disabled employees can return to work in an effective manner. According to JAN, for every dollar an employer invests in an accommodation, the employer will receive back $10 in increased productivity.

I personally have had occasion to discuss accommodation issues with JAN. In all cases the information has been invaluable. Of all of the resources provided in the National Return to Work Week webcasts, this is perhaps the most important.

More information on JAN:

http://www.jan.wvu.edu/

http://www.dol.gov/odep/

http://en.wikipedia.org/wiki/Job_Accommodation_Network

http://www.jan.wvu.edu/soar/index.htm

http://www.jan.wvu.edu/janondemand.htm

http://www.jan.wvu.edu/webcast/archive/index.htm

National Return to Work Week - Part 2

The first group of webinar sessions for National Return to Work Week were a great introduction into the why a company should make the effort, perhaps even amid lay-offs, to returning an employee to some sort of productive work.

Annually, 1.1 million employees lose and average of 7 days due to their work injury. When looking at the significant costs of those injuries, one finds that according to the National Safety Council's Accident Facts ® injuries cost US employers $160.4 billion each year in medical and other direct costs, lost productivity and wages. This expense does not count the additional expenses related to adding to the social security systems.

Now not all injuries are workplace injuries. A return to work program can also be effective to keep short-term and long-term disability claims down. Disabling injuries happen off the job as well as on the job. Every 1.3 seconds someone suffers a disabling injury. That's 63,000 people total people injured daily. Almost half of the 6.8 million people who collect Social Security benefits are under the age of 50.

In the current economic downturn both company employers and the insurance industry are showing huge losses. These staggering statistics make an excellent case for an effective return to work programs for employees injured both on and off the job. The new amendments to the ADA and updates to the FMLA that went into effect this year may also substantially affect companies who do not have a progressive return to work program.

Allowing or forcing an employee to stay at home rather than working a modified duty does nothing more than create an end settlement that does one of two things:

1. Either it rewards those workers who have a tendency to play the system, encouraging them to repeat the actions at their next job.

2. For those workers with a legitimate injury the settlement is rarely enough to survive on, thus creating an additional burden to society though welfare and social security systems.
   

An employer must effectively manage the workers compensation process from the date of injury through return to work or settlement. The insurance adjuster is not the employer. The employer has a far better handle on the issues related to the injury. However, a well managed return to work program doesn't have to be a daunting task, as Dennis Chandler – Director of Return to Work Programs with Company Nurse shows.

Attorney Michael Moebes, who has the unique position to have worked on both the employer and worker sides of the workers compensation issues, discussed the mistakes employers make. Attorney Moebes also talked about the current economy and the success of return to work programs.

To learn more a, please review yesterday's webinars and sign up for others happening this week. The webinars will be stored and the recording available for you to watch on-demand.

http://nationalreturntoworkweek.org/register-for-national-return-to-work-week-sessions/

National Return to Work Week – Part 1

May 10 – 16th is National Return to Work Week. This week is an opportunity for safety professionals and others involved in workers compensation and disability management to demonstrate their commitment to helping injured, disabled or ill employees stay-at-work or return-to-work. By doing so, one of the largest business expenses for a company can also be significantly lowered.

Annually 1.2 million employees loose work days due to workplace injury or illness. Unfortunately once an employee is injured, too many employers feel that person has become a liability. Often the company does not offer light duty, or only for a very short time. When that happens the employee is forced onto workers compensation. Often times the employee is also laid off.

Statistics have shown that 40% of the employees who are off work for over 12 weeks (FMLA time) have serious trouble finding other work. If an employee is out for more than sixteen weeks, there is a good chance that individual will never return to employment. Even if an employee finds a job, it is frequently at a much lower position than held previous to the injury or illness. Employees begin to lose contact with fellow workers and feel shut out.

Unless returned to work as soon as possible, some employees begin to feel that that a workers compensation benefit is better than looking for another job. Workers compensation essentially “rewards” employees for not working. An employee sitting at home is exposed to advertisements from lawyers offering to help them continue to collect workers compensation. This begins to look good as a way to get even with the employer that seemed to discard them as easily as yesterdays trash.

Unfortunately in this system, both employers and injured employees lose. Beyond the initial injury, employees may suffer depression Entire whole families may suffer emotionally and financially if the major bread-winner is injured and off work for any length of time.

The longer an employee is off work, the more expensive a workers compensation (or long-term disability) case becomes. Insurance rates or direct expenses skyrocket. Employers may set themselves up for additional discrimination claims and expensive settlements. Employers lose employee loyalty, and may have under-reporting issues especially if the employee feel their jobs are likely to be lost if they claim a workers compensation injury.

This week's blog will continue the theme of establishing an effective return to work program.

Links:

National Return To Work Week was founded by Margaret Spence, CWC, RMPE - President of Douglas Claims & Risk Consultants, Inc. author of “From Workers’ Comp Claimant to Valued Employee - Employer’s Guide to Implementing a Proactive Return to Work Program - Florida Edition”. - http://margaretspence.com/

National Return to Work Week - http://NationalReturnToWorkWeek.org/.

Free webcasts as part of NRTWW - http://nationalreturntoworkweek.org/register-for-national-return-to-work-week-sessions/.

More about Margaret Spence - http://workcompseminars.com/about/about-margaret-spence/

Job Hazard Analysis - Introduction

The job hazard analysis is an important safety tool. A job hazard analysis (JHA) or job safety analysis (JSA) breaks down a worker's job into specific tasks. From there each task is broken into specific steps. Each step is then analyzed for hazards that may be present.

Since a job hazard analysis takes time, priorities must be set to determine which jobs should take precedence. Review incident and accident logs to see if certain areas come up more frequently. Employee surveys are another way to track areas of greater concern. A job hazard analysis should be performed as part of setting up a new task, or when the area or task is changed. JHA's should be done after a near miss, or accident.

Video taping the employee at work is an excellent way to determine hazards as each specific task can be viewed multiple times. However, one must be sure that workers being video taped understand this is to make their jobs safer and not a critique of the employee. In fact, employees should be included in the entire process of the JHA. Who better knows the job and the tasks that cause pain or awkward positions? Employees have a better understanding of the task, and may offer clues to hazards. Employees should also be encouraged to offer suggested solutions as they may have found “work-arounds” to minimize the hazard. Include supervisors in the JHA as their input may also be valuable.

While each job task must be broken into steps, an overview of the area must also be analyzed. Is lighting adequate? Are there issues with employee or material handling traffic in the area? Once the overview is complete and any hazards noted, the specific task and each step must be analyzed. Writing down each step is important. Note any hazards for each step. Then work on the recommended solutions. Recommendations should:

1. Eliminate the hazard if at all possible (add guards, add a hydraulic table, use a non-hazardous alternative to a current chemical, etc.).

2. Provide administrative controls if the hazard cannot be eliminated (job rotations, changes in the way the tasks are performed, etc.).

3. Provide proper PPE if engineering and administrative controls aren't adequate to eliminate or control the hazard.
   

Once the solutions are found and the hazards eliminated or controlled, all employees and supervisors will need to be trained in the new procedures. The task should also be revisited to see if the solutions are working, and reviewed yearly.

Here is an excellent video on job hazard analysis: http://revver.com/video/1385172/introduction-to-the-job-hazard-analysis-process

Links:

http://www.safetyworksmaine.com/safe_workplace/safety_management/hazard_analysis.html

http://www.ccohs.ca/oshanswers/hsprograms/job-haz.html

http://www.forensicmag.com/articles.asp?pid=243

http://tinyurl.com/o9lnjw

http://www.osha.gov/Publications/osha3071.html

http://www.the-osha-advisor.com/JHA.html

More on Overexertion Injuries: Repetitive Motion Injuries

Repetitive motion injuries (RMI), are gradually developing injuries of soft-tissue structures such as tendons, nerves, and muscles. Repetitive motion injuries are most common in fingers, wrists, elbows, arms and shoulders. Characterized by pain and discomfort, repetitive motion injuries tend to become progressively worse over time if not treated, and may result in a disabling loss of function of the affected area.

While Tennis Elbow (tendinitis) is a well known as a sports related injury, most RMI's have occupational stressers as the major contributing cause. Unlike other injuries, RMI's do not have a single definitive date of injury. Repeated motion of a body part without time for recovery causes micro-tears in the tissues and nerve. These micro-tears accumulate to cause a permanent cumulative trauma to the area. Repetitive motion injuries are also known as Cumulative Trauma Disorder (CTD). Symptoms include chronic aches, stiffness, sore muscles, decreased coordination, tingling or numbness especially upon waking, and trouble sleeping because of the pain.

Carpal tunnel syndrome (impingement of the nerves in the wrist) may be the best know work related RMI. However, hand-arm vibration syndrome (wrist), radial tunnel syndrome, cubital tunnel syndrome, tenosynovitis of the forearm extensor and flexor muscles (elbow and forearm), tension neck syndrome, thoracic outlet syndrome (shoulders and neck), are also examples of repetitive motion injuries. Repetitive motion injuries are often tough to diagnose and treat. However, once diagnosed, OSHA considers this to be a recordable occupational illness. Due to the difficulty in diagnosis and treatment, RMI's are among the most costly occupational injuries. Preventing these injuries can result in significant cost savings for a company.

The first step in prevention is determining which tasks are at risk. A job hazard analysis with a focus of which tasks are frequently repetitive or tasks that very little throughout the workweek, awkward positions and posture, excessive pinching, frequently raising the arm or shoulder and excessive force needed in the job task. Employee surveys, reviewing incident records, and noting areas where employees leave or bid out to other areas are great ways to pinpoint which areas may need the most attention.

Educate employees to the risks of repetitive motions injuries. Encourage employees to promptly report all concerns with repetitive tasks and aches or pain. Repetitive motion injuries can often be healed quickly if promptly reported.

Train supervisors to be aware repetitive motion tasks and issues employees may have. Supervisors should help evaluate workstations. Encourage and allow supervisors to cross train employees, and vary their tasks through-out the day or week. Supervisors must continually monitor work areas for proper ergonomic work practices.

Once an employee reports a repetitive motion injury or pain and swelling, take them off the task to allow the injury to heal. Before allowing the employee back on the task, adjust the workstation or task to control the hazard. Merely allowing a healed employee back on the same task that caused the issue, doesn't fix the problem. Inevitably the repetitive motion injury will return.

An untreated repetitive motion injury can be disabling for the employee. Controlling repetitive motion injuries can result in a significant cost savings in workers compensation rates, reduced absence rates, and increased productivity. One study estimated that each controlled or eliminated repetitive motion injury saves a company $27700.

Additional Links:

http://www.cdc.gov/niosh/docs/97-141/ergotxt1.html

http://www.cdc.gov/niosh/docs/2006-119/pdfs/2006-119a.pdf

http://www.cdc.gov/nchs/data/series/sr_03/sr03_031.pdf

http://www.cdc.gov/nchs/data/series/sr_03/sr03_031.pdf

https://www.hrtools.com/insights/jennifer_blanchard/dont_let_repetitive_motion_injuries_damage_your_workplace.aspx

http://www.scif.com/safety/safetymeeting/Article.asp?ArticleID=99

http://ehstoday.com/news/ehs_imp_37502/

http://www.cdc.gov/niosh/docs/2007-122/glossary.html

Eye Injuries and Protection

Approximately 2000 eye injuries occur everyday in the workplace (in the US). The construction Industry has one of the highest rates of injury. Common sources of injuries are from dust, metal, wood, slag, drywall, cement and other fine particles. Rebounding nails are also one of the most common causes of vision loss for construction workers. Wet or powdered cement in the eyes may cause chemical burns. Improper or non-existent eye protection when handling chemicals can also lead to chemical burns if splashes reach the eyes. Improper eye protection can lead to weld flash burns to eyes for welders, helpers and bystanders. Laser burns from cutting machines or surveying equipment can be another source of eye burns.

All injuries must be taken seriously, as even minor injuries can cause life-long vision problems. Suffering a simple scratch from sawdust, cement, or drywall could cause painful corneal erosion. Everyone working in or passing by a construction site must be aware of the risk, as dusty or windy conditions may lead to particles in the eyes. Coworkers may generate hazardous conditions that could cause eye injuries to others.

Even passing through an area where work is being performed may lead to eye injuries if the hazard isn't controlled. Machine guarding may prevent particles from becoming airborne. Weld curtains can protect bystanders from weld flash burns to the eyes. All workers in an area that may contain eye hazards must wear proper eye protection. The most common injuries to the eyes are from those who didn't think they needed eye protection.

All eye protection must have a “Z87” or “Z87+” mark along the frame or lens. Safe eye protection includes safety glasses (prescription or no-prescription), clear or tinted goggles, faceshields, welding helmets, and some full-face type respirators that meet the ANSI Z87.1 Eye and Face Protection Standard.

Safety glasses are the most common type of eye protection. Safety glasses are used as protection against impact. Side protection is required when hazards from flying objects are present. Most safety glasses include wrap around side shielding. Some safety glasses are made in different sizes to fit different shape faces. Some styles fit better than others. Safety glasses should fit snug against the face to provide the best protection. Face shields provide protection from impact to the face, but not the eyes. Safety glasses must be worn underneath a face shield.

Goggles provide more protection than safety glasses. Goggles are used for higher impact protection, greater particle protection, chemical splashes, and welding light protection. Goggles with direct venting (small holes around the sides) tend to fog less, but should not be used with liquid or fine dust hazards. Goggles for splash or high dust protection should have indirect venting.

Tinted safety glasses used in torch soldering must have a shade number (1.5-3) on the lens, but do not provide adequate protection for gas or arc welding which need shades 4 or higher (the shade number is marked on the lens and shows how dark the lens is). Welding goggles with shade numbers 4-8, must be used for gas welding or cutting. Welding helmets are needed for all arc welding requiring shade numbers 10-14. Safety glasses must be worn underneath welding helmets.

More information can be found here:

http://www.cdc.gov/niosh/topics/eye/default.html

http://www.cdc.gov/niosh/topics/eye/eyechecklist.html

http://www.safetyequipment.org/eyeface.htm

http://www.elcosh.org/docs/d0100/d000018/d000018.html

http://www.elcosh.org/docs/d0500/d000553/d000553.html

http://www.osha.gov/SLTC/eyefaceprotection/index.html