Characterizing worker compensation claims in long-term care and examining the association between facility characteristics and severe injury: a repeated cross-sectional study from Alberta, Canada.

BACKGROUND: Despite the physical demands and risks inherent to working in long-term care (LTC), little is known about workplace injuries and worker compensation claims in this setting. The purpose of this study was to characterize workplace injuries in LTC and to estimate the association between worker and organizational factors on severe injury. METHODS: We used a repeated cross-sectional design to examine worker compensation claims between September 1, 2014 and September 30, 2018 from 25 LTC homes. Worker compensation claim data came from The Workers Compensation Board of Alberta. LTC facility data came from the Translating Research in Elder Care program. We used descriptive statistics to characterize the sample and multivariable logistic regression to estimate the association between staff, organizational, and resident characteristics and severe injury, measured as 31+ days of disability. RESULTS: We examined 3337 compensation claims from 25 LTC facilities. Less than 10% of claims (5.1%, n = 170) resulted in severe injury and most claims did not result in any days of disability (70.9%, n = 2367). Most of the sample were women and over 40 years of age. Care aides were the largest occupational group (62.1%, n = 2072). The highest proportion of claims were made from staff working in voluntary not for profit facilities (41.9%, n = 1398) followed by public not for profit (32.9%, n = 1098), and private for profit (n = 25.2%, n = 841). Most claims identified the nature of injury as traumatic injuries to muscles, tendons, ligaments, or joints. In the multivariable logistic regression, higher staff age (50-59, aOR: 2.26, 95% CI 1.06-4.83; 60+, aOR: 2.70, 95% CI 1.20-6.08) was associated with more severe injury, controlling for resident acuity and other organizational staffing factors. CONCLUSIONS: Most claims were made by care aides and were due to musculoskeletal injuries. In LTC, few worker compensation claims were due to severe injury. More research is needed to delve into the specific features of the LTC setting that are related to worker injury.

Pre-injury health status of truck drivers with a workers' compensation claim.

Truck drivers are a vulnerable population due to the high number of workplace injuries and fatalities predominant in their occupation. In Australia, the road freight transportation industry has been identified as a national priority area in terms of creating preventative measures to improve the health and safety of its workers. With an environment conducive to poor nutritional food choices and unhealthy lifestyle behaviours, many barriers exist to creating a safe and healthy workforce. Thus, the current study aimed to describe the pre-injury hospital-recorded health conditions and health service use of truck drivers with a worker's injury compensation claim/s when compared to workers in other industries. Data was obtained from a compensation claims database and linked with hospital admissions data recorded five years prior to the injury claim. Health and lifestyle behaviour data for the occupational code of truck drivers was compared to other occupational drivers, as well as to all other occupations. Analysis was conducted via logistic regression. The results found that when compared to other occupational drivers, truck drivers were significantly more likely to have a hospital-recorded diagnosis of diabetes and/or hypertension, as well as being significantly more likely to have a hospital record of tobacco use and/or alcohol misuse/abuse. The findings show that there is a need to review and revise existing health strategies to promote the health and wellbeing of truck drivers, especially given their challenging work environment.

Development of a Computational Policy Model for Comparing the Effect of Compensation Scheme Policies on Recovery After Workplace Injury.

Introduction The direct comparison of real-world workers' compensation scheme management policies and their impact on aspects of scheme performance such as health and return to work outcomes, financial sustainability, and client experience metrics is made difficult through existing differences in scheme design that go beyond the factors of interest to the researcher or policymaker. Disentangling effects that are due purely to the result of policy and structural differences between schemes or jurisdictions to determine 'what works' can be difficult. Method We present a prototype policy exploration tool, 'WorkSim', built using an agent-based model and designed to enable workers' compensation system managers to directly compare the effect of simulated policies on the performance of workers compensation systems constructed using agreed and transparent principles. Results The utility of the model is demonstrated through and case-study comparison of overall scheme performance metrics across 6 simple policy scenarios. Discussion Policy simulation models of the nature described can be useful tools for managers of workplace compensation and rehabilitation schemes for trialing policy and management options ahead of their real-world implementation.

Workforce Reintegration After Work-Related Permanent Impairment: A Look at the First Year After Workers' Compensation Claim Closure.

Purpose The purpose of this study was to descriptively quantify experiences of injured workers with permanent impairment during their first year of work reintegration. Methods A representative survey was conducted to characterize health, disability, pain, employment, reinjury, and economic outcomes for 598 workers with permanent impairment who had returned to work during the year after workers' compensation claim closure. Survey responses were summarized by degree of whole body impairment (< 10% vs. ≥ 10%). Results Injured workers who had returned to work reported that permanent impairment made it difficult to get a job (47%) and to keep their job (58%). A year after claim closure, 66% reported moderate to very severe pain; 40% reported pain interference with work. About 13% reported new work injuries; over half thought permanent impairment increased their reinjury risk. Asked to compare current to pre-injury work status, workers with a higher degree of impairment more frequently reported working fewer hours (OR 1.60; 95% CI 1.06, 2.42), earning less (OR 1.56; 95% CI 1.04, 2.36), and being at higher risk of losing their current job due to their impairment (OR 1.66; 95% CI 1.01, 2.71). Conclusions Injured workers with permanent impairment face long-term challenges related to health limitations, chronic pain, work reintegration, and economic impacts. Workers with a higher degree of impairment more frequently reported several economic and job security challenges. Developing workplace and workers' compensation-based interventions that reduce return-to-work interruption and reinjury for workers with permanent impairment should be prioritized as an important public health and societal goal.

The Essential Types of Insurance for New Dentists.

Although these insurance options may seem overwhelming and expensive, consider the cost of not having proper coverage in place if something catastrophic happens, such as a disability or lawsuit early in your career. Being a dentist is one of the best occupations there is. The future of dentistry is bright and new dentists can make a great living with a successful career that lasts as long as they want. Part of that successful career is being sure you have the right type of coverage in place so that if something catastrophic happens the insurance company takes the risk rather than your practice, your professional reputation, or your pocket book.

Effects of social, economic, and labor policies on occupational health disparities.

BACKGROUND: This article introduces some key labor, economic, and social policies that historically and currently impact occupational health disparities in the United States. METHODS: We conducted a broad review of the peer-reviewed and gray literature on the effects of social, economic, and labor policies on occupational health disparities. RESULTS: Many populations such as tipped workers, public employees, immigrant workers, and misclassified workers are not protected by current laws and policies, including worker's compensation or Occupational Safety and Health Administration enforcement of standards. Local and state initiatives, such as living wage laws and community benefit agreements, as well as multiagency law enforcement contribute to reducing occupational health disparities. CONCLUSIONS: There is a need to build coalitions and collaborations to command the resources necessary to identify, and then reduce and eliminate occupational disparities by establishing healthy, safe, and just work for all.

Overview of Occupational Injuries Among Registered Nurses in Washington State, 2007 to 2019.

BACKGROUND: Registered nurses (RNs) represent the largest segment of the health care workforce and have unique job demands and occupational health considerations. The purpose of this study was to describe the incidence, cost, and causes of occupational injuries among RNs in Washington State and to quantify the cumulative cost and burden of each type of injury, relative to all injuries among RNs. METHODS: Annual injury claims data covered under Washington State workers' compensation (WC) fund were analyzed over a 13-year period (2007-2019). Annual mean incidence and cost of injuries were calculated and stratified by nature, source, and event/exposure. Negative binomial regression models were used to examine trends in injury incidence over time, for injury incidence overall, and by the most common injury classifications. RESULTS: Between 2007 and 2019, 10,839 WC claims were filed and accepted for Washington State RNs (annual M = 834), totaling more than US$65 million. No significant trend in overall injury incidence was observed (incidence rate ratio [IRR]: 0.99, 95% confidence interval [CI] = [0.94, 1.05]). The most common injury exposures were bodily reaction and exertion, contact with objects and equipment, falls, and assaults and violent acts. DISCUSSION: To our knowledge, this is the first broad study of the incidence and costs of occupational injuries among RNs across all workplace settings. We identified high-cost, high-frequency incidence rates of musculoskeletal, sharp, and violence-related occupational injury claims, highlighting intervention targets. Implications for Occupational Health Practice: Policy makers, health systems, and occupational health nurse leaders can use this information to identify priority areas where evidence-based occupational health and prevention programs are most needed.

Individual and organizational factors associated with injury history and patient handling behaviors: Results from a nationwide survey of healthcare workers.

With proper compliance, safe patient handling and mobility (SPHM) programs reduce musculoskeletal disorders (MSDs). To better understand individual, environmental, and organizational factors associated with both the adoption of SPHM and prevalence of MSDs, a nationwide online survey was administered. 973 healthcare workers (HCWs) completed the survey, for which 59.6% reported past work-related MSDs or pain. Among those with pain or injury, 33.3% changed roles, 79.7% worked while injured, and only 30.9% reported workers' compensation claims. Less than half of HCWs agreed that SPHM equipment is readily available, and most considered manually handling patients weighing over 91 kg acceptable. Equipment availability, ceiling lift availability, supervisor encouragement, and annual training were associated with increased use of SPHM equipment. Availability of SPHM equipment reduced the likelihood of injured nurses changing roles. Despite overall agreement that SPHM programs are beneficial, common clinical practice remains insufficient to adequately protect HCWs from risk of injury.

[General background and practical implementation of Fitness for Work Statement in the UK].

The Statement of Fitness for Work, so called Fit Note, was introduced in the UK in 2010. Physicians issue Fit Note to workers when requested. The Fit Note provides the physician's advice about the worker's fitness for work when he or she has health problems, writing their advice of either "may be fit for work" or "not fit for work" on the form. The Fit Note also records details of the functional effects of workers' condition. Then the Fit Note is used to consider and arrange support from employers in order for workers to return to work. This paper reports the general background and practical implementation of Fit Note based on a literature review and interviews from general practitioners, occupational physicians, and physiotherapists in the UK.

Relationship Analysis of Injured Workers' Average Weekly Wages and Workers' Compensation Indemnity Claims in Maine, US: 1998 to 2017.

OBJECTIVE: Explore the relationship between injured workers' average weekly wages (AWW) and their workers' compensation (WC) claims outcomes in Maine, US. METHODS: A total of 29,668 indemnity (lost-time) claims categorized into three wage-based percentile groups from a 20-year period (5-year intervals) were analyzed. WC outcomes included medical costs, number of indemnity checks, claim's duration, and claim settlements. RESULTS: Generally, claims within the lower percentile group were less likely to have high medical costs, but were more likely to have an elevated number of indemnity checks when compared to those in the middle percentile group. An inverse relationship was observed for those claims within the higher percentile group. CONCLUSIONS: Generalizations about low wage earners' claims being longer-lasting and more expensive or early return to work always reducing the medical cost of claims should be avoided.

Workers' compensation forms--a guide for GPs.

Workers' compensation provides financial benefits for injured workers. The general practitioner has a pivotal role in the completion of necessary documents such as medical certificates, medical reports and treating practitioner questionnaires. Before completing such documents, the GP must complete a thorough medical assessment. This article describes the important elements of this assessment, the information required in workers' compensation documents, and the responsibilities of the GP and worker (patient) in completing these documents.

Cohort profile: the Ontario Life After Workplace Injury Study (OLAWIS).

PURPOSE: The substantial economic burden of work-related injury and illness, borne by workers, employers and social security programmes, is primarily attributed to the durations of work disability among workers whose recovery requires a period of absence from work, with the majority of costs arising from the minority of workers with the longest duration absences. The objective of the Ontario Life After Workplace Injury Study is to describe the long-term health and labour market outcomes of workers disabled by work injury or illness after they are no longer receiving benefits or services from the work disability insurance authority. PARTICIPANTS: Workers disabled by a work-related injury or illness were recruited from a sample frame of disability benefit claimants with oversampling of claimants with longer benefit durations. Characteristics of workers, their employers and claimant benefits were obtained from baseline administrative data. Interviews completed at 18 months post injury (T1) and to be completed at 36 months (T2) measure return-to-work and work status; income; physical and mental health; case manager and healthcare provider interactions and employer accommodations supporting return-to-work and sociodemographic characteristics. Of eligible claimants, 40% (1132) participated in the T1 interview, with 96% consenting to participate in the T2 interview. FINDINGS TO DATE: Preliminary descriptive analyses of T1 data have been completed. The median age was 50 years and 56% were male. At 18 months following injury, 61% were employed by their at-injury employer, 16% had changed employment and 23% were not working. Past-year prescription opioid use was prevalent (34%), as was past-year cannabis use (31%). Longer duration claimants had poorer function, recovery and health and more adverse labour market outcomes. FUTURE PLANS: Multivariate analyses to identify modifiable predictors of adverse health and labour market outcomes and a follow-up survey of 96% of participants consenting to follow-up at 36 months are planned.

Sick leave and workers' compensation for police officers in Australia.

In Australia it has been necessary to enact specific provisions into industrial and employment laws to ensure workplace protection and coverage of police officers because at common law police officers have not been regarded as employees. Police unions in Australia have emerged as strong industrial players and have secured a range of terms and conditions of employment which do not apply to the broader workforce. However, the battle in relation to workers' compensation coverage and extended sick leave seems to be ongoing, particularly in Western Australia. The area of interaction between workers' compensation laws and sick leave entitlements is often neglected against the background of other industrial matters concerning police. This article investigates the entitlements of Australian police officers to these benefits against the historical background of industrial laws. It concludes that there is no uniformity in coverage for workers' compensation and sick leave and that the publicly available data in relation to absence from work of police officers due to sickness are generally incomplete and present challenges for cross-jurisdictional comparisons. The article points to future areas of research into police sick leave.

Analyzing Workers' Compensation Claims and Payments Made Using Data from a Large Insurance Provider.

BACKGROUND: All states in the USA have established Workers' Compensation (WC) insurance systems/programs. WC systems address key occupational safety and health concerns. This effort uses data from a large insurance provider for the years 2011-2018 to provide estimates for WC payments, stratified by the claim severity, i.e., medical only, and indemnity. METHODS: Besides providing descriptive statistics, we used generalized estimating equations to analyze the association between the key injury characteristics (nature, source, and body part injured) and total WC payments made. We also provide the overall cost burden for the former. RESULTS: Out of the total 151,959 closed claims, 83% were medical only. The mean overall WC payment per claim for the claims that resulted in a payment was $1477 (SD: $7221). Adjusted models showed that mean payments vary by claim severity. For example, among medical only claims, the mean payment was the highest for amputations ($3849; CI: $1396, $10,608), and among disability and death related claims, ruptures cost the most ($14,285; $7772, $26,255). With frequencies taken into account, the overall cost burden was however the highest for strains. CONCLUSIONS: Workplace interventions should prioritize both the costs of claims on average and the frequency.

[System and human resources for occupational health in the republic of the Philippines: Management of occupational health activities at overseas workplaces for Japanese enterprises].

OBJECTIVES: This study aimed to consider the appropriate occupational health system for Japanese enterprises in the Philippines based on information on the regulations and development of specialists. METHODS: We collected information using an information-gathering checklist. Along with literature and internet surveys, we conducted interviews by visiting local business sites, central government agencies in charge of medical and health issues, and educational institutions with specialized occupational physician training curricula. RESULTS: Occupational health administration in the Philippines is managed by the Department of Labor and Employment, which issues the Occupational Safety and Health Standards that specify the legal requirements for occupational health. A new law(Republic Act 11058),enacted in 2018 to strengthen the Occupational Safety and Health Standards, has newly established a penalty provision in case of violations. Professional personnel responsible for occupational health are grouped as safety officers and occupational health personnel, including occupational physicians and occupational nurses; training is conducted at the Occupational Safety and Health Center of the Department of Labor and Employment and educational institutions. The basic medical insurance system and the workers' compensation system are operated by the Philippine Health Insurance Corporation and Social Security Committee, respectively, both of which are government agencies. CONCLUSIONS: We confirmed that occupational health activities in the Philippines are based on government regulations, namely, the Occupational Safety and Health Standards. In addition, the enactment of a new law calls for strict compliance with corporate occupational health activities. To manage proper occupational health activities at overseas workplaces, Japanese corporations should clarify corporate-wide policies and support local employers in complying with regulations and utilizing highly specialized personnel.