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Risk A Verse

Claims professionals can help risk control counterparts just by telling a few stories.

July 28, 2009 Photo
A number of sources, from the National Safety Council (NSC) to AARP, have revealed that Americans 65 and older no longer spend their days golfing or sunning on beaches. Instead, older Americans are working. In fact, since 1977, the number of American workers over age 65 has increased more than 100%, according to the U.S. Bureau of Labor Statistics (BLS).

While the increase in older workers might suggest a corresponding decrease in workplace productivity and increase in accident claims, the BLS reports the opposite has proven to be true. Older workers actually improve upon workplace safety and benefit the companies that employ them. They have less absenteeism, greater job satisfaction and fewer on-the-job accidents because they tend to be more careful and more focused on the tasks at hand. They offer something their younger counterparts can’t—experience—bringing a strong work ethic and character to the job. However, the aging of our workforce has brought about one dilemma: When older workers do get injured, they tend to have a higher severity of injuries and more prolonged recovery periods.

Claims professionals are uniquely situated to offer perspective across industries on age-related worker injuries. Opening up the communication lines by starting a little chatter between the claims and risk divisions can help risk managers target high-cost, high-incident risk areas. Claims officers can start the conversation with the most relevant occurrences and highlight the specifics of the claims, giving details to an otherwise generic problem.

Slip and Fall Accidents
One of the most common accident types for workers over age 55 is falling. The BLS reports that more than 7 million fall-related injuries are treated in U.S. hospitals each year, with the average workers’ compensation claim costing approximately $14,000. Moreover, it can take an older worker two to three times longer to recover from this kind of injury than a younger counterpart, compounding the cost. Match this with the fact that slip and fall accidents are quite common in the front of a retail store—a major point of re-entry into the workforce for seniors—and you have a condition ripe for repeated, serious claim events.

When claims professionals address the risk end of the insurance equation, the focus should be on the details. The nitty-gritty, down-and-dirty specifics can help risk control officers build a range of practices and recommend workspace modifications.
  1. Review of Incidents—Investigate and document the details of each incident. Over time, look for accident trends and recurring causes related to floor surfaces, time of day, locations and weather conditions. Your risk control counterpart can assist clients in creating an action plan to address these risks.
  2. Walking Surfaces—Inspect walking surfaces for condition and maintenance issues. Report unstable or unsecured surfaces, such as loose tiles, torn mats or rugs that do not lay flat. Check for details on inadequate clearances for doors, walkways and aisles. Each claim has its own risk information that is valuable to the risk manager.
  3. Stairs—Check for handrails and the height of risers, which should be between seven and 11 inches high. Note if tread nosing is highlighted with a contrasting color (yellow) to accent steps.
  4. Lighting—Look for lighting or glare problems in and between work areas.
  5. Spill Cleanup—Ask about the application of floor treatments and the posting of cautionary signage after a spill or cleaning, while floor surfaces dry.
  6. Shoe Selection—Are requirements for employee footwear, such as shoes with particular tread patterns, communicated and enforced? Your claims investigation could reveal a chronic problem that your risk counterpart should tackle.
  7. Test Floor Surfaces—A tribometer measures the slipperiness of floor surfaces by measuring the coefficient of the floor surface under dry and wet conditions.
  8. Audits—A claims investigation might allow the opportunity to conduct periodic audits to monitor areas where slips and falls are judged more likely. Follow up and conduct routine assessments of walking surface conditions.
  9. Medical and Wellness—Workers’ vision, stability, medications and other medical conditions can impact fall potential. Review files of claimants’ physical conditions.
Ergonomics Evaluation
With the widespread implementation of ergonomically designed work equipment, you’d think we’d never see another repetitive motion or backache claim again. Wrong. Injuries to the musculoskeletal system continue. Work performed using the shoulders, wrists and back generally shows the highest musculoskeletal claim severity for older workers.

By far, the most expensive claims from workers over 65 are rotator cuff sprains, which can cost up to $28,360 according to a study by the National Council on Compensation Insurance. At this cost, claims professionals have a vested interest in working side by side with risk control personnel on ergonomics to prevent shoulder injuries common to older workers. If claimants present with minor shoulder injuries, for example, this might offer the perfect opportunity for the claims professional to ask for an ergonomic evaluation. Whether it is in regards to weight limitations or range of motion, good ergonomic risk management efforts are key to preventing a larger claim from occurring. Otherwise, if the claimant goes through rehabilitation and back onto the jobsite, there is not only the risk of re-injury; it could eventually lead to more serious, more expensive damage.

Another common claim, back injury, can be mitigated by identifying tasks with heavy lifting, trunk rotation or forward bending beyond 30 degrees in an unsupported manner. Once they’ve identified the risk, material-handling aides can often minimize lower-back strain potential, or the task can be redesigned with ergonomics in mind.

When it comes to ergonomics, task rotation has long been recognized as a best practice. Particularly effective in industries with repetitive tasks, such as packaging or manufacturing, task rotation can ease the strain of repeated motions and static standing time. Some steps to consider are:
  1. Limit the amount of time employees are exposed to the physical stressors particular to each task.
  2. Bring muscle/movement variation to the tasks within the rotation program to provide position and movement variation.
  3. Vary tasks by degree of intensity. Some tasks require greater strength or force to complete than others, and variation between higher and lower intensity can help alleviate worker strain.
  4. Involve older workers early in the implementation process to earn their buy-in, respond to their feedback, and raise their awareness of the safety benefits of the program.
Safer Driving
The National Institute for Occupational Safety and Health (NIOSH) reports that roadway crashes are the leading cause of occupational fatalities for older workers in the U.S. Between 1992 and 2002, nearly 3,200 workers age 55 years and older died in motor vehicle crashes on public highways, accounting for 22% of all occupational fatalities among this group. In the general population, fatal crash involvement rates decrease with age, but NIOSH reports that death rates for work-related roadway crashes increase steadily beginning at around age 55.

The typical driving-related claim for workers older than 55 is the result of changes due to normal aging, such as diminished vision (e.g., reduced night vision and intolerance of glare), slower reaction times, decline in cognitive functioning, and decreasing muscle strength and range of motion. Claims professionals should be on the lookout for trends that swerve from the typical path. While many risk managers are aware of historical patterns, the claims advisor is best positioned to identify emerging trends and to aid risk counterparts on nipping new risk exposures in the bud. Additionally, the claims department has the opportunity to measure trends within specific companies, whether the trend is up or down, and notify risk control counterparts of potential problems—or, happily, of risk mitigation program successes—as the pattern is just appearing.

Return to Work
Not only do older workers sustain more serious injuries, claims statistics show that they require a significantly longer healing time than their younger counterparts. One of the biggest risks to claims severity after a claim occurs is the inability to get an employee back to work. The claims advisor plays a critical role in return-to-work recommendations and risk mitigation. Meeting the treating physicians’ return-to-work requirements and addressing workers’ comfort and confidence are keys to this issue. Consider the following:
  • Light- or modified-duty jobs across the company for injured workers—Claims professionals can help companies set up light-duty positions that minimize ergonomic risks, fall-related concerns, etc., to injured workers, allowing them to return confidently to their employment. Ergonomic intervention can play a key role here.
  • Safe transition back to work once medically appropriate—It’s advisable to work closely with health, medical and wellness providers to ensure a collective return-to-work focus. Educating injured workers and being solicitous in choosing the transitional duty position can go a long way toward addressing workers’ early concerns as they return to the work environment.
  • Assistance from managed care or risk control professionals—Claims professionals can communicate their concerns or observations to the underwriter or risk control representative assigned to the account so early intervention can reduce the potential for future claims from other employees.
  • Preventing future claims—Even though a claim has already occurred, claims professionals can still be proactive in mitigating the claim and helping the company prevent future claims. They can do this by maintaining a strong awareness of the types of claims workers over 55 are most susceptible to and ensuring the return-to-work positions do not create further risk to the returning employees.
Addressing the Needs of Valued Workers
The National Safety Council reports show that older workers are a true benefit to the companies that employ them. They tend to be leaders by example—committed to the job, punctual, experienced, hard-working and satisfied. At the same time, an older worker is one whose hearing, vision, cardiovascular fitness, strength, balance and flexibility are waning. They need the tools of the job to be lighter, the workspace to be brighter, and the floors, chairs and desks to be more stable.

Fortunately, these particular needs can be addressed through a multi-disciplined approach to risk control that implements specific risk control measures. Innovative ideas for addressing safety for older workers are emerging nearly every day, such as the night-vision systems available in some cars. Preventative slip and fall measures, ergonomic evaluations, ongoing driver and safety training, and a focus on returning to work are all tools that can improve a work environment so that it is safer for older workers. Claims professionals can use the information gleaned from specific cases to let their risk counterparts know if risk mitigation programs are working or are even being implemented. Risk managers know what they’ve recommended. It’s up to the claims advisor to tell the rest of the story.
Ken Nogan, MS, CSP is a risk control consultant for PMA Companies. He can be reached at Ken_Nogan@pmagroup.com.

About The Authors
Ken Nogan, MS, CSP

Ken Nogan, MS, CSP is a risk control consultant for PMA Companies. Ken_Nogan@pmagroup.com

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