The Workers Compensation Crisis: An Effective Business Response
California's Workers Compensation system is in crisis.
Most people in business agree that healthcare costs are
skyrocketing and it is difficult to keep these costs under
control. Insurance companies, lawyers, healthcare providers
and the injured worker have all been blamed for the rising
costs. It is startling to realize that costs associated
with an average workers compensation claim can be $60,000+
and repetitive stress injuries are costing industry $20
billion per year.
First it is necessary to understand this problem. Workplace
injuries, workers compensation claims and costs must be
defined. It is important to understand that injuries and
claims are not the same thing. Valid injuries happen at
California companies everyday. These can be an acute injury
like a slip and fall or a cumulative trauma injury like
carpal tunnel. Some of these injuries, however, do not occur
from an accident but develop over time from repetitive motion
and static postures. This is where it gets confusing because
it is harder to define when the injury actually occurred
and what were the causes of the injury.
An example would be office workers that sit and work on
computers all day. The employees develop carpal tunnel and
file workers compensation claims. They are frustrated because
they are in pain and want to rest their wrists. The employees
blame the company for making them type so much each day.
The company is frustrated because the injured workers want
to be off work to rest their wrists and productivity in
that department will go down. The company may also feel
the injury is because the employees are overweight, sit
awkwardly at their desks, or strain their arms further by
playing computer video games at home every night.
In this situation the employees see their problem as injuries
and file a claim. The employer sees their problem as claims
that will have costs attached to them. Neither is right
or wrong- this is just a perception of each side's reality.
When emotions get involved, the situation can get worse.
If the employees are having problems with their managers
or the managers are not responsive to the employees' initial
request for help, they are more likely to file a claim and
the costs of the claim will go up regardless of the severity
of the injury. If the managers and employees have good relationships
and the managers respond to the employees' initial request
for help, the employees will still get the treatment they
need, but will be much more likely to stay at work and be
productive. The biggest factor affecting the costs of a
claim is not the severity of the injury in most cases, but
the relationship between the employees and the management
of the company.
This is why injuries, claims and costs need to be addressed
in three different ways. Most injuries can be prevented.
Providing a safe work environment is a good start, but companies
must go beyond that by providing opportunities for their
employees to become educated and empowered to keep themselves
safe and healthy. This is important for the employee and
the company. By providing ergonomic assessments, seminars,
stretch programs, on-site healthcare, gym memberships and
safety teams, companies empower their employees to stay
healthy and work productively. When an injury does occur,
the right processes must be in place to handle the injury
appropriately. This includes offering a light duty program,
on-site treatment and letting the employee know the company
values them and cares about their well being.
Companies and insurance carriers care most about claims.
How much is this claim, not injury, going to cost? Injuries
can be very subjective, but claims are objective and can
be quantified by costs and lost work time. Companies are
in business to make a profit and expensive claims can affect
the bottom line. Fortunately, most companies do care about
their employees too and realize that a company is successful
because of their employees.
Many companies discourage reporting of injuries to keep
the workers compensation claim rate low. This works if there
are no injured workers, but if employees are working with
an injury and do not get treatment, it will get worse. The
resulting claim will be much more expensive than prevention
or early treatment would cost.
The best way to implement a prevention program is to get
buy in from the top levels of the corporation/business.
It is also recommended that external professionals in corporate
wellness look at the company from an objective point of
view. Senior management must believe in this process for
it to work. Managers must be trained and employees empowered
to be responsible for their own health. The costs and implementation
process will vary from company to company but the upfront
costs will be returned 10 to 1 in reductions of expensive
claims and lost work time. Another way to start this process
is to pick one department as a case study. Start with a
small implementation in that department and track results.
The California Workers Compensation system, companies and
injured workers are in a crisis. It is time to start working
on the solution. Prevention, education, empowerment and
attitude are the key ingredients. Commit to those ingredients
and your employees and your bottom line will be enhanced!
Sharon Hebert MSPT, CEES, ACE