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At least 91 records · Page 5Linked to original sources
PubMed1998

Construction injury rates may exceed national estimates: evidence from the construction of Denver International Airport.

BACKGROUND: Construction of Denver International Airport (DIA) provided a unique opportunity to describe the magnitude of injury on a major construction project for which complete data on injury and hours at risk were available for over 32,000 employees working 31 million hours. METHODS: Comprehensive payroll data for all workers, who were paid standard Davis-Bacon wages, allowed calculation of person-hours at risk by job classification. Complete reporting, facilitated by a single workers' compensation plan covering all contracts and by an on-site medical clinic and designated provider system, allowed us to determine both total and lost-work-time (LWT) injury rate per 200,000 hours at risk by industrial sector, company size, and year of construction. Workers' compensation payment rates were calculated and compared with expected loss rates, derived by the National Council on Compensation Insurance, by sector, company size, and year. RESULTS: DIA's overall total injury rates were over twice those published by the Bureau of Labor Statistics (BLS) for the construction industry for each year of DIA construction. Differences in LWT injury rates were more modest. Total injury rates were also at least twice BLS's rates for all contractor sizes. The injury rate pattern by company size at DIA differed from BLS's in that small firms had injury rates that were lower than or comparable to most other size categories; BLS's rates for small firms were lower than those for all but the very largest (250 or more employees) contractors. DIA's total workers' compensation (WC) payment rate of $7.06 per $100 payroll was only 11% higher than Colorado-specific expected loss rates reported by the National Council on Compensation Insurance. DISCUSSION: Complete reporting, facilitated by the existence of a single WC plan, an on-sites medical clinic, and designated medical providers, yielded injury rates significantly higher than previously reported. The relatively small difference between DIA payment rates significantly higher than previously that the discrepancy between DIA's injury rates and national estimates is due to underreporting of non-LWT injuries of the BLS. The burden of on-site work-related construction injury may be higher and more costly than has been evident from national data.

Accidents, Occupational↗
PubMed1997

A descriptive study of recurrent low back pain claims.

This is the first large-scale study of US workers that describes the demographic and cost differences between recurrent and nonrecurrent low back pain (LBP) disability claimants, using data from a large workers' compensation insurer. Persons with at least one LBP claim in 1990 and one or more additional claims in 1990 to 1996 were defined as recurrent. Persons with at least one LBP claim in 1990 but no subsequent claims were defined as nonrecurrent. Fourteen percent of claimants were recurrent. The percentage of recurrent claimants who were male (77.2%) was higher than the percentage that were female (22.8%). This difference was more pronounced in the younger age groups. The median total cost for recurrent LBP claims in 1990 was 4% greater than for nonrecurrent 1990 LBP claims, whereas the mean cost was 48% less. Most studies of LBP recurrence among US workers have followed single-corporation employees. Our rate of recurrence was lower than these previously reported rates. However, analysis of independent workers' compensation insurance company data may provide a more accurate assessment of LBP claim recurrence among US workers.

Adult↗
PubMed1987

The cost of disability.

Approximately 16.5% of the adult population in the United States is disabled. About half of the disabled are severely limited and unable to work regularly. Musculoskeletal disorders are the most frequent type of disability. In the United States, there are three major types of disability insurance: Social Security Disability Insurance (a federal program), Workers' Compensation Insurance (usually a state-regulated program), and private health insurance. Recent years have seen a greater demand for private long-term disability insurance, as the trend increases toward less than total reliance on public programs to support disabled workers. The most recent statistics available indicate that Social Security Disability Insurance benefits are currently about $16.8 billion per year; workers' compensation benefits, $16.1 billion; and private disability income protection benefits, $5.2 billion. These figures add up to almost $40 billion in insurance costs. However, insurance costs are only part of the total cost because not everyone is covered by insurance, and insurance does not cover all disabilities. Disability can never be totally prevented or eliminated, but disability and its costs can be substantially reduced through more effective treatment and rehabilitation, including patient education and vocational rehabilitation.

Adolescent↗
PubMed1986

Medical screening and monitoring as noted by the insurance industry.

Medical screening and monitoring have a long and varied history as part of the insurance industry's safety and health relations with its policyholders. Many workers' compensation insurance carriers have assisted policyholder management in understanding the requirements of cost-effective health programs, in planning and undertaking steps necessary to comply with state-of-the-art medical practices, and in locating knowledgeable physicians to supervise employee health systems. Managing employees' health and associated records has become, for many employers, a complex operational and regulatory problem because of the amount and type of health information being collected. Administration of group health and accident insurance plans, workers' compensation, treatment for the ill and injured employees, voluntary health screening and counseling programs, preplacement and periodic physical examinations, and control mechanisms for health hazard exposures all contribute to this huge pool of acquired and stored health information.

Humans↗
PubMedDate not supplied

Ergonomics in the clinical laboratory.

Ergonomics can improve work quality, increase productivity, raise morale, reduce absenteeism, and reduce workers compensation. Laboratory managers are responsible for recognizing employees at risk of developing CTSs which represent 65 percent of all injuries reported. It is a wise investment to prevent injuries. It needs to be stressed to laboratorians that just because one is not suffering now, does not mean suffering will not occur in the future. All of these micro- (mini-) traumas add up over the years. Once there is pain, there are things that can be done to alleviate the discomfort or disability, but that part of the body is never the same again. CTDs are not inexpensive; the National Council on Compensation Insurance reports the average CTD victim compensation is $29,000. Policies and procedures are needed in every facility to address ergonomic safety issues. All employees should be educated about tasks or situations putting an individual at risk for CTDs. Employees should communicate with management and management should be open to information about potential or real risk situations. Safety is everyone's job.

Cumulative Trauma Disorders↗
PubMed1954

Industrial dermatologic problems; interrelationships between physician, patient, employer and insurance carrier.

Dermatologists, employers, insurance carriers and patients often flounder in misunderstanding when dealing with industrial dermatosis. A large part of such misunderstanding stems from too limited a knowledge of compensation insurance law by physicians, employee-patients and many employers. Physicians dealing with industrial cases should not only familiarize themselves with compensation law and insurance practices, but take it upon themselves to interpret such considerations to their employee-patients and, where necessary, to their patients' employers. Present-day employer-employee relationships are frequently on a most impersonal basis, and great mutual benefit will accrue to all parties when the position and objectives of each are understood by the others and the provisions and limitations of the law are known to all. The dermatologist handling industrial cases must take the responsibility of bringing this about.

Dermatitis↗
PubMedDate not supplied

Occupational and environmental medicine in the United States: A proposal to abolish workers' compensation and reestablish the public health model.

The workers' compensation model of occupational and environmental medicine should be converted to a public health model. Occupational and environmental medicine, as a part of the public health infrastructure,could play a much more substantive part in bringing about a national program to deal with occupational and environmental health. The workers' compensation insurance system could be discontinued at any time,but it will be vital to do so when national health insurance is adopted in the United States. Abolishing workers' compensation would remove the perverse incentives that currently undermine the practice of occupational medicine. Medical care for workers should be provided by health care professionals who are not subject to influence by employers or insurers. Eligibility for benefits should not be determined by health and safety professionals. Wage-replacement benefits for workers should be determined by guidelines established by government and industry that prevent manipulation of health and safety professionals by employers and insurers. A nationwide comprehensive system to track work-related injury and illness, superior to the current reliance on records provided by employers and collated by government agencies, should be adopted. When unusually high rates of injuries, illnesses,and fatalities occur, government inspectors ought to respond and regulate the industry accordingly. Occupational health and safety professional strained in public health can and should participate in these activities, but not when they are in the employ of industry or insurers.

Accidents, Occupational↗
PubMedDate not supplied

Services provided by family physicians for patients with occupational injuries and illnesses.

PURPOSE: Many family doctors provide care to patients with occupational injuries and illnesses, but little is known about the type of medical services provided, or how they compare with services provided by other types of physicians. This study used national data to develop a statistical profile of office-based medical care delivered by family physicians to patients with work-related disorders. METHODS: Using data from 4 years (1997-2000) of the National Ambulatory Medical Care Survey, we classified visits for patients with work-related conditions according to patient and physician characteristics, services provided, and other visit characteristics. For comparison, we also compiled profiles for visits to other types of physicians for treatment of work-related disorders, and for visits to family physicians for treatment of nonoccupational conditions. RESULTS: Analyses were based on 96,183 office visits made to 4,947 physicians. A majority of visits made to family physicians for occupational conditions involved patients seeing their regular primary care doctor. Possibly for this reason, patients at these visits were more likely to have their blood pressure taken, receive diagnostic and screening services, and have prescription drugs prescribed or administered, compared with patients seeing other types of physicians. Only 73.3% of visits to family physicians for work-related disorders were expected to be paid for by workers' compensation insurance. CONCLUSIONS: Our findings suggest that the distinctive types of care provided by family physicians to injured workers may be related to their role as the patients' regular physician. This finding is relevant to the proposals being considered by many states to expand employers' and insurers' ability to choose the treating physician in workers' compensation cases.

Accidents, Occupational↗
PubMed1989

Pain clinic #13. Comprehensive pain center treatment of low back workers' compensation injuries. An industrial medicine clinical outcome follow-up comparison.

A clinical outcome follow-up comparison of treatment and nontreatment groups was conducted to investigate both the clinical and cost effectiveness of a hospital-based industrial medicine division offering inpatient pain treatment clinical services. Eighteen month followup data were collected on 63 patients participating in a pain treatment program and 37 patients referred for treatment but denied participation by their workers' compensation insurance company. Outcome data indicate that the population of workers' compensation low back injured patients participating in pain treatment programs subsequently consumed fewer analgesics, required fewer hospitalizations for additional diagnostics and/or treatment, required fewer additional surgery, and were more likely to return to employment than a comparison group of patients denied comparable treatment.

Adult↗
PubMed1978

How cheap is a life?

The oweners of capital in the United States have successfully transferred most of the costs of industrial casualties onto the working class and the public at large. This has been accomplished by the creation of the privately owened workers' compensation insurance system and the corporate-dominated safety establishment. This "compensation-safety establishment" has been able to take over most of the federal apparatus created by the Occupational Safety and Health Act of 1970. Nevertheless, workers and unions and their allies have begun to challenge the establishment's hegemony over job health and safety policy for the first time in seventy years.

Accident Prevention↗
PubMed1987

Regional musculoskeletal diseases of the low back. Cumulative trauma versus single incident.

Discomfort in the low back is a common problem that has been investigated for centuries. The need to cope has not changed, but for the past 50 years, the way in which one copes has been dramatically changed by the interaction of a pathophysiologic insight within a legal construct. The development of the concept of "ruptured disc" as a cause of backache allowed, for the first time, the perception that a drastic dissolution of anatomy accompanied the discomfort. Regardless of the precipitant, the inference of "trauma" was compelling. This heuristic pathophysiologic inference found a ready ear in the Workers' Compensation Insurance system. If backache is a personal injury, it would be compensable if it arise out of and in the course of employment. Today one no longer suffers a backache; one "injures" one's back. The experience is further confounded if the sufferer perceives himself as an injured worker. He must prove his persisting illness in an adversarial climate that questions the validity of his symptoms and their pathogenesis on the job. In this contest, the worker, the clinician, and the ethical fabric of Workers' Compensation all fare poorly.

Back Injuries↗
PubMed1994

Use of registry employees can pose legal problems.

In view of the potential legal liability to which a recipient entity can be exposed when using registry employees, some care must be taken in drafting registry contract services and in modulating the recipient entity's behavior towards the registry personnel. The following steps should generally be taken by health care establishments purchasing registry services to minimize such exposure: (1) Ensure that the registry treats its personnel as employees and complies with all applicable employment law obligations, including state and federal employment tax requirements, workers' compensation laws, and any state law wage and hour requirements in the recipient's state. (2) If using an out-of-state registry, make sure that the registry also has workers' compensation insurance in the recipient's state and complies with that state workers' compensation laws. (3) Make sure that termination decisions regarding registry employees are not made for reasons that violate any federal anti-discrimination laws. (4) Provide in the registry agreement for full indemnification by the registry to the recipient. (5) Ensure that the registry is solvent and has adequate insurance to honor its indemnification obligation. (6) Obtain a warranty from the registry that it carefully screens all of its employees before hiring them. (7) Expressly state in the registry agreement that the registry has the right to discipline and supervise the personnel it refers. (8) Do not reject registry personnel for reasons that would be improper with respect to the facility's own employees, e.g., race, sex, age, religion, disability, etc.

Contract Services↗
PubMed1995

Silicosis and workers' compensation in New Jersey.

The employer is expected to maintain responsibility for health care expenses and lost income that result from occupational injury and illness through the workers' compensation insurance system. However, financial support for individuals with occupational illnesses, especially those with long latency, is often from sources other than workers' compensation. Silicosis, a well defined, chronic, occupational lung disease, can be viewed as a sentinel for the inadequacy of the public policy to compensate workers for chronic occupational lung disease. Three hundred twenty-nine patients with confirmed silicosis were identified by the silicosis surveillance program in the New Jersey Department of Health using source data from 1979 through 1992. One hundred seventy-seven of these individuals provided information on the status of any compensation claims against their employer. Only 31% of these patients stated that a claim had been filed; 84% of those whose claims were settled were awarded payments. Severity of radiologic findings was not associated with the likelihood of filing a claim or with being awarded a payment; whereas, smoking was associated with these outcomes. The implications of these findings for the health care system are discussed.

Aged↗
PubMed2001

Using decision science to gain insight into ethical issues: an example involving thresholds in workers' compensation.

Systematically analyzing and comparing the ethical dimensions of policy-decision alternatives is remarkably difficult. The ethical implications of a set of decision alternatives, as well as the ranking of that set, are subject to any number of quantitative and qualitative variables, not the least of which is differing individual interpretation. In spite of this, decision science offers a consistent, transparent framework from which to analyze the ethical components and implications of policy decisions. Workers' Compensation insurance programs are state-governed systems of insurance in which workers, in exchange for giving up the right to sue their employer and their coemployees, receive some compensation if they are injured on the job, without regard as to who was at fault. Importantly, Workers' Compensation does not compensate workers for all losses. Thus, injured workers often sue those who provide goods and services to their employer's production system. Different states set different thresholds relating to who can be brought into such a lawsuit and under what conditions a sued means-of-production entity can, in turn, bring the injured party's employer into the suit as a third-party defendant. Forensic engineers are often involved in such lawsuits to evaluate whether or not a given component of a production system is or is not defective. Using Workers' Compensation as an example, this paper explores the methodology and the difficulty of quantifying the ethical implications of policy decisions by examining the concept of thresholding a policy variable. Thresholding will be defined and the ethical effect on the various parties of varying a policy threshold will be discussed.

Decision Making↗
PubMed1994

EDI clears a path for simplifying workers' comp.

In an effort to cut costs in the paperchoked workers' compensation insurance system, states, insurers, employers and third-party administrators are testing new electronic data interchange applications. Proponents say EDI will not only reduce administrative costs, but also will speed the flow of information so that workers can receive proper care sooner and return to work faster. Two groups are developing standard electronic formats for workers' compensation transactions to simplify the conversion to EDI.

Computer Communication Networks↗