Dealing with worker injuries

For as long as I have been in the business of occupational safety and health, "keep-the-injured-person-working" has been a mantra of business, physicians, insurance carriers, and educators. The U.S. Occupational Safety and Health Administration (OSHA) www.osha.govvalidated this perception with its recording requirement and statistical tracking of severity rate based solely on lost-time injuries:

Severity rate = (Lost-time injuries x 200,000) / Actual hours worked

This perception that keeping an employee working increases the probability that the employee will return to full duty quickly leads to some really creative efforts that focus on keeping the employee at workand keeping the numbers low.

A Disturbing Trend

A little over a year ago, we identified a worrisome trend at our company. Light-duty jobs are part of many cell rotations. These jobs give our associates a chance to recover from some of the more ergonomically challenging tasks. As we limited the rotation with associates who could do only the light-duty portion of the rotation, we found that at least one other associate would experience problems with the more ergonomically challenging tasks.

During that time, we replaced our on-site physician visits with physical therapists. We re-energized our ergonomics team, and we implemented patient care conferences with all of the major players in our employee treatment. These efforts ensured that our employees quickly received physical therapy, rather than waiting until after a few weeks of conservative treatment with rest, splinting, and medication. They also resulted in a change to our overtime availability for employees with cumulative injuries.

As we worked to eliminate the cause of repetitive motion injuries, we also looked into Michigan's Voluntary Protection Programs program. Derived from the Federal OSHA initiative, Michigan took a spin that supported our trend analysis, computing severity rate based on the combination of lost and restricted time injuries:

[(Lost-time injuries + Restricted-time injuries) x 200,000] / Actual hours worked

It has long been my opinion that this method of measuring the impact of injuries on a business unmasks the activities companies take to hide that impact. It levels the playing field for large and small companies.

We know that employees, who work with restrictions, many times affect the business because they are not able to do their job or to do their job as effectively as someone without restrictions. For us, when an employee cannot do the essential functions of the job, his or her injury is severe.

A New-Old Approach

With great hesitancy on the part of management, employees, medical resources, and insurance providers, we stepped back in time and decided to send home any employee with restrictions -- work-related or not -- who could not do all of the essential functions of their routine job or adequately fill an open position. We required quick and aggressive physical therapy whenever possible, and we tracked the results. After a year, we found that the changes:

• Did not affect the number of employees who required surgery, because they did not report pain until it was affecting sleep.
• Increased the number of employees who reported early because they were not taken off work.
• Reduced the average number of days that an employee was unable to do all the essential functions of his or her job by five days.
• Resulted in significantly fewer employees from a single cell reporting injuries. This may be because they were able to continue rotation, because job analysis identified and implemented changes, because of the Hawthorne Effect (see endnote), or a combination of these factors.

Positive Results

Although our lost-time injury rate increased significantly, the positive effect on the business also was significant. Employees came back sooner and with a better understanding of how to prevent recurrence of injury. The physical therapists worked with the ergonomics team to implement changes identified from their work with the injured employees. The physician and therapists, together found treatments that quickly resolved many complaints without taking the employee off work.