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PubMed1995

Policy development for compensating workers exposed to crystalline silica in Ontario, Canada.

The Ontario Workers' Compensation Board develops policy for diseases by considering scientific information within legal, political, and social contexts. The purpose of this paper is to describe the process used to develop a policy for lung cancer among gold miners and to examine the extent to which this process assists the development of similar guidelines for workers with silica dust exposure. The scientific and policy questions are similar, both requiring consultation with stakeholders. To improve the development process for the gold miner policy, consultation for silica and lung cancer needs to be more inclusive. The resulting procedures would also need to be precise enough to assist adjudicators to make decisions without limiting their ability to decide each claim on the merits of the case. The major challenge is to ensure that the final policy is scientifically and legally supportable and acceptable to both workers and employers.

Canada↗
PubMedDate not supplied

Compensating workers for permanent partial disabilities.

There is substantial variability in how state workers' compensation laws provide benefits to workers who have a permanent partial disability. The basic approaches used by the states can be classified into four groupings, although important differences exist within each group. Depending on the approach used, workers with similar injuries can receive substantially different amounts of benefits. Because compensating permanent partial disabilities frequently involves contention, the matters in dispute will depend on the approach used to determine benefits. The continuation of such differences in approach suggests that the states have not found a single "best practice" for determining what such benefits should be.

Disability Evaluation↗
PubMed2000

First lifetime back pain and psychiatry treatment: psychological factors and recovery in compensated workers.

The role of psychological factors in recovery from first lifetime low back pain (LBP) was explored in this study. Consecutive clients from one physiatry clinic in Montreal who had LBP of less than 3 months' duration, were on sick leave and receiving workers' compensation benefits, and reported the current event as first lifetime LBP were enrolled. Psychological factors that fluctuate with current events (Psychiatric Symptom Index) and remain stable over time (General Well Being Scale) were assessed. Outcomes were late return to work (> 31 days) and 1 year incidence of compensated recurrence. Results from two multivariate models indicated lower psychological distress predicted late return to work, and higher well being, higher aggressiveness, and lower anxiety predicted compensated recurrence. Researchers concluded psychological factors do not impact clients with all types of LBP in the same way. For individuals lacking prior LBP experience, better psychological functioning increased lengthy work absence. Thus, awareness of the clients' psychological profiles and previous LBP experiences may benefit recovery.

Adult↗
PubMed1976

The effort to rehabilitate workers' compensation.

State workers' compensation laws have been subjected to criticism since their inception; pressure to change them is now increasing. Most of the current challenge arise from dissatisfaction with the level of benefits available to disabled workers or their survivors, and, to a lesser degree, with the extent of program coverage. In response to this challenge, changes will occur that my range from reform-simply raising benefit levels and extending coverage-to program redesign, implying major structural revisions or abolishment of the system. For several reasons, including public apathy, the role of interest groups, and experience with other social insurance programs, it seems likely that basic structural shifts will not occur in the near future. While the criticism of these state laws is widespread, the problems can be dealt with in the existing framework. One area, however, could conceivably arouse sufficient public and legislative interest to upset this forecast. If it develops that the system is excluding large numbers of individuals disabled or killed by occupational diseases, workers' compensation laws could be placed in jeopardy. While evidence on this is scarce, it is clear that the current system compensates only a small number of serious cases of disability arising from occupational diseases.

Jurisprudence↗
PubMed2003

Employer satisfaction with workers' compensation health care: results of the Washington State Workers' Compensation Managed Care Pilot.

Developing more effective approaches to disability prevention has been a longstanding challenge for the workers' compensation system. A major obstacle to this goal has been the lack of communication and interaction between employers and physicians who care for injured workers. From 1995 through 1997, the Washington State Department of Labor and Industries sponsored a major demonstration program, known as the managed care pilot (MCP), to assess the effects of managed care on medical and disability costs, patient satisfaction and employer satisfaction. We developed a telephone survey and administered it to 243 employers as part of the MCP evaluation. Topics covered in this survey include satisfaction with treatment rendered, duration of lost work time, work modifications, and satisfaction with communication received during the employee's recovery period. Employers in the intervention (managed care) condition were more satisfied with the managed care/occupational medicine system than the employers in the comparison group were with the fee-for-service system. MCP employers were satisfied particularly with the frequency and quality of communication received from the health care provider regarding return to work and work modification issues. Improved employer-provider communication may foster early return to work and thereby have a beneficial effect on health and employment outcomes for injured workers.

Fee-for-Service Plans↗
PubMed1992

Responding to the workers' compensation crisis. A proposal on the structure and management of workers' compensation programs.

In 1990 job-related injuries are estimated to have cost American employers over $60 billion in direct workers' compensation expenses, a figure which has doubled in the past four years and which may do so again by 1995. The medical costs of treating work-related injuries and illnesses are estimated to have consumed 41 percent of workers' compensation payouts for 1990, the remainder by indemnity claims costs. Taken together with a 17.1 percent increase in group health care costs in 1990, there is concern for the maintenance of a reasonable business atmosphere under which businesses may remain competitive and prosperous, and employment will be available.

Humans↗
PubMed1984

Claims for medical benefits under the Federal Employees' Compensation Act. Office of Workers' Compensation Programs, Labor. Notice of proposed rulemaking.

The Department of Labor proposes revisions to the sections of 20 CFR Part 10 which concern the procedures for submitting bills for medical services provided to Federal employees covered under the Federal Employees' Compensation Act, and the limits of coverage for medical services thus provided. The chief effect of the revision will be to establish limits for fees for medical procedures and services according to a published schedule developed and maintained by the Director of the Office of Workers' Compensation Programs. The proposed rule provides for the development and implementation of a fee schedule; directs its maintenance and revision by the Director of the Office of Workers' Compensation Programs; sets forth procedures for providers and claimants to seek reconsideration of fee requests under the schedule; and establishes a required format for medical bills other than hospital bills.

Fee Schedules↗
PubMed1985

Importance of satisfactory reporting in the care of patients covered by workers' compensation.

The workers' compensation system has become an increasingly important part of our medical care system. That this system presents problems to attending physicians is apparent. Most of these problems result from ignorance on the part of physicians, born of the lack of effective training in this area and its dependence upon timely and complete reporting. This paper emphasizes the importance of communication and suggests simple procedures by which the attending physician can accomplish this. It is incumbent upon the medical profession to involve itself in controlling the cost of health care delivery.

Costs and Cost Analysis↗
PubMed1993

Understanding Workers' Compensation Law.

"Understanding Workers' Compensation Law" is a primer on workers' compensation, intended to give physicians a basic understanding of how workers' compensation systems function. With this background, it is hoped that those physicians who treat patients suffering from work-related injuries will more fully appreciate their role in the system. The article also outlines a few helpful hints to assist the physician when she or he is treating workers' compensation patients so that the physician can streamline his or her practice and involvement in this area and make interaction with all parties less burdensome.

Accidents, Occupational↗
PubMed2006

Prioritizing industries for occupational injury and illness prevention and research, Washington State Workers' compensation claims, 1999-2003.

OBJECTIVE: The objective of this study was to identify high-risk industry groups for effective allocation of occupational safety and health prevention and research resources. METHODS: We used all compensable Washington state workers' compensation claims to rank North American Industry Classification System (NAICS) industry groups by a "prevention index" (PI). The PI is the average of the rank orders of each industry group's claim count and claim incidence rate. RESULTS: Of the 274 industry groups ranked by PI for all compensable workers' compensation claims, the following industry groups ranked the highest: NAICS 2381 Foundation, Structure, and Building Exterior Contractors, NAICS 4841 General Freight Trucking, and NAICS 2361 Residential Building Construction. Industry group PI rankings are reported for the seven most common costly occupational injury types. CONCLUSIONS: Use of a PI can focus prevention and research resources where they can be of most benefit.

Accidental Falls↗
PubMedDate not supplied

Alleged B. anthracis exposure claims in a workers' compensation setting.

OBJECTIVES: Workers' compensation insurance in some states may not provide coverage for medical evaluation costs of workplace exposures related to potential bioterrorism acts if there is no diagnosed illness or disease. Personal insurance also may not provide coverage for these exposures occurring at the workplace. Governmental entities, insurers, and employers need to consider how to address such situations and the associated costs. The objective of this study was to examine characteristics of workers and total costs associated with workers' compensation claims alleging potential exposure to the bioterrorism organism B. anthracis. METHODS: We examined 192 claims referred for review to the Ohio Bureau of Workers' Compensation (OBWC) from October 10, 2001, through December 20, 2004. RESULTS: Although some cases came from out-of-state areas where B. anthracis exposure was known to exist, no Ohio claim was associated with true B. anthracis exposure or B. anthracis-related illness. Of the 155 eligible claims, 126 included medical costs averaging dollar 219 and ranging from dollar 24 to dollar 3,126. There was no difference in mean cost for government and non-government employees (p = 0.202 Wilcoxon). CONCLUSIONS: The number of claims and associated medical costs for evaluation and treatment of potential workplace exposure to B. anthracis were relatively small. These results can be attributed to several factors, including no documented B. anthracis exposures and disease in Ohio and prompt transmission of recommended diagnostic and prophylactic treatment protocols to physicians. How employers, insurers, and jurisdictions address payment for evaluation and treatment of potential or documented exposures resulting from a potential terrorism-related event should be addressed proactively.

Adult↗
PubMed1995

Carpal tunnel surgery outcomes in workers: effect of workers' compensation status.

One hundred thirteen workers' compensation and 53 non-workers' compensation patients who had undergone open carpal tunnel release were queried about job status and the presence or absence of residual symptoms of numbness, pain, or nocturnal awakening an average of 42 months postoperatively. Thirty-nine non-workers' compensation subjects were at their original jobs as compared to only 53 workers' compensation subjects. Seventeen of the workers' compensation subjects were unemployed versus two non-workers' compensation subjects. These differences were significant. Of patients changing jobs, 39 workers' compensation subjects and 2 non-workers' compensation subjects attributed their job change to symptoms of carpal tunnel syndrome. Residual symptoms were significantly more common in workers' compensation compared to non-workers' compensation subjects, with 92 of the former and 26 of the latter subjects reporting some residual symptoms.

Adult↗
PubMed1989

Analysis of mortality patterns and workers' compensation awards among asbestos insulation workers in Ontario.

Mortality and workers' compensation patterns were studied among 1,064 Ontario asbestos insulation workers. A proportional mortality analysis of 153 asbestos worker deaths found increased mortality from malignant diseases (65 deaths observed; 35.1 expected), cancers of the lungs and pleura (32 deaths observed; 11.5 expected), peritoneal mesothelioma (4 deaths), and respiratory diseases (14 deaths observed; 7.9 expected). Despite the publicity given to asbestos-associated diseases, dependents of many men potentially eligible for workers compensation awards have not received pensions because claims were not filed. These findings suggest that much occupationally related disease is not being recognized in Ontario.

Asbestos↗
PubMed2002

Natural rubber latex allergy workers' compensation claims: Washington State healthcare workers, 1991-1999.

Occupational reaction to natural rubber latex experienced by healthcare employees was examined using data of all workers' compensation claims filed by state-insured healthcare employees in Washington State for the period 1991-1999 (n = 65,703). As latex reaction is not a condition for which there are specific identification codes, these claims were estimated by coupling source and nature of injury records that were consistent with reactions to latex. It was found that the claim rate was on average 2.66 per 10,000 state-insured healthcare workers annually. The most common condition experienced was dermal (84.3%), and most common body part affected was the hand (70.0%). Because few claims cited respiratory or conjunctivitis as reaction experienced, little evidence was discovered to support that glove powder acted as a widespread latex allergen transmitter in healthcare environments. Most cases did not require indemnity payment for lost work time (81.2%), suggesting most reactions were minor. The average cost per natural rubber latex claim was $2,759.10, compared to $3,178.18 for the average healthcare worker claim for all causes. Overall, the average cost per state-insured healthcare worker employed during this time was under $0.74 per year. Nursing aides/orderlies were the most frequent healthcare occupation filing a claim (33.2%). The majority of claimants were female (87.9%), and unmarried workers (52.0%) filed slightly more claims than married workers (48.0%). In comparison with other workers' compensation claims filed by healthcare workers during this period, 0.34 percent of the total was potentially related to natural rubber latex, with other common healthcare workplace items cited more frequently as source of occupational injury.

Adolescent↗
PubMed2006

Workers' compensation experience of Colorado agriculture workers, 2000-2004.

BACKGROUND: Agriculture is among the most hazardous of occupations. The lack of information regarding agriculture injuries or fatalities has been recognized as an obstacle for effective injury prevention. Workers' compensation claims data for non-fatal injuries among agriculture and agri-business workers in the State of Colorado between the years of 2000 and 2004. METHODS: Workers' compensation claims are utilized to estimate injury claim incidence rates, determine the distributions of sources, causes, types and body locations of injuries, and estimate the costs of these injuries. RESULTS: Colorado agriculture and agri-business workers (e.g., cattle dealers, cattle or livestock raisers, dairy farmers) have high rates of injury claims, especially in sectors that involve interaction with animals or livestock. Grain milling operations had a high rate of injury claims among agri-business operations. Injuries related to animals, strains, machinery, and falls or slips were the most frequent among all occupations analyzed. CONCLUSIONS: Understanding the occurrence of injuries among Colorado agriculture and agri-business workers is critical to implementing and evaluating effective intervention programs for specific agriculture-related occupations. The development of safety interventions that address the worker-animal interface, fall protection systems, machinery usage, and overexertion prevention strategies is recommended.

Accidents, Occupational↗
PubMed2005

Workers' compensation claims for needlestick injuries among healthcare workers in Washington State, 1996-2000.

OBJECTIVES: To characterize accepted workers' compensation claims for needlestick injuries filed by healthcare workers (HCWs) in non-hospital compared with hospital settings in Washington State. DESIGN: Descriptive study of all accepted workers' compensation claims filed between 1996 and 2000 for needlestick injuries. PARTICIPANTS: All Washington State HCWs eligible to file a state fund workers' compensation claim and those who filed a workers' compensation claim for a needlestick injury. RESULTS: There were 3,303 accepted state fund HCW needlestick injury claims. The incidence of needlestick injury claims per 10,000 full-time-equivalent HCWs in hospitals was 158.6; in dental offices, 104.7; in physicians' offices, 87.0; and in skilled nursing facilities, 80.8. The most common mechanisms of needlestick injury by work location were as follows: for hospitals, suturing and other surgical procedures (16.7%), administering an injection (12.7%), and drawing blood (10%); for dentists' offices, recapping (21.3%) and cleaning trays and instruments (18.2%); for physicians' offices, disposal (22.2%) and administering an injection (10.2%); and for skilled nursing facilities, disposal (23.7%) and administering an injection (14.9%). Nurses accounted for the largest (29%) proportion of HCWs involved, followed by dental assistants (17%) and laboratory technicians and phlebotomists (12%) in non-hospital settings. Rates of needlestick injury claims increased for non-hospital settings by 7.5% annually (95% confidence interval [CI95], 4.89% to 10.22%; P < .0001). Rates decreased for hospital settings by 5.8% annually, but the decline was not statistically significant (CI95, -12.50% to 1.34%; P < .1088). HCWs were exposed to hepatitis B, hepatitis C, and human immunodeficiency viruses in non-hospital settings. CONCLUSION: There was a difference in the incidence rate and mechanisms of needlestick injuries on review of workers' compensation claim records for HCWs in non-hospital and hospital settings.

Cost of Illness↗
PubMed1986

U.S. Industries v. Director: "claim" versus "condition" in the analysis of workers' compensation cases.

Under most workers' compensation statutes, an injury must "arise out of " and "in the course of" employment in order to qualify as a compensable disability. In U.S. Industries v. Director, the Supreme Court held that the Longshoremen's and Harbor Workers' Compensation Act must be strictly construed to avoid transforming the compensation system into a form of social insurance. In U.S. Industries, the Court denied a disability claim based on an arthritic condition which was manifested while the worker was at home in bed. This Note contends that the Supreme Court neglected to consider pertinent medical realities when analyzing the causation question. Thus, the decision undermines the overall rationale behind workers' compensation legislation. Nonetheless, the Note argues that the case does not relax the requirement of adequately scrutinizing the causative elements underlying any reasonable claim for disability benefits. An analysis adequately accommodating both medical and legal facts, instead of relying upon the vagaries of statutory interpretation, is necessary to improve the efficiency and fairness of workers' compensation disability determinations.

Accidents, Occupational↗