How to Avoid Common Workers’ Compensation Claims

March 5, 2021

21MKT207301CommonWorkCompClaimBlog_thumb-(1).pngWe sat down with Jenny Fogle, Claims Unit Manager; and Casey Cain, Risk Management Manager, to discuss some of the most common Workers’ Compensation (WC) claims they see and how they help customers avoid them.

Healthcare

“When I think about the claims I see frequently in the assisted living and long-term care industries, I think of the Certified Nursing Assistants (CNA) whose jobs are so physically demanding,” said Fogle. “These jobs often require transferring residents from a bed to a wheelchair or vice versa. The physical requirements of these transfers are often compounded by the age and health of the CNA, many of whom have spent years in these roles while developing co-morbidities over time. We end up seeing injuries from herniated disks to strains and sprains.”

Cain added that his team works closely with the claims and underwriting teams to identify claim trends, and then works directly with the policyholder to identify the underlying causes for the claims. This approach helps in recommending remediation options that address these causes.

“Our goal is to evaluate their work process, accountability systems, and programs to offer options that can help minimize the claim exposure. That can be anything from making process change recommendations to hands-on observations of staff performing their daily activities. This can result in equipment upgrades, changes to training programs, and/or the use of technology such as wearables to improve body mechanics,” Cain said.

Other considerations for minimizing strains and sprains include:

  • Assessment of residential handling, from proper/routine resident assessments, to proper use of lifting equipment.
  • Workstation assessments to eliminate hazards to the degree possible.
  • Adding administrative controls, such as job rotation or limiting exposure hours and repetitions of activity.
  • Training on proper body mechanics when performing lifting activities.
  • Utilizing multiple person lifts.
  • Recommending technology solutions, like wearables, that identify at-risk movements over a period of time while providing data for analysis and improvements.
  • Implementing flex-and-stretch programs so each shift begins with a focus on warming up the body before lifting and/or materials-handling activities.
  • Using onsite observations to provide coaching.
  • 100 percent use of lifting equipment and inspection of equipment.

Fogle added that many skilled nursing facilities conduct an initial lifting needs assessment at intake but don’t always routinely update these assessments as residents age or as an illness/condition causes a setback in the resident’s physical capabilities. She noted that having scheduled, periodic lift assessments would better align the residents’ lifting needs with their medical team’s physical abilities over time.

Construction and Manufacturing

Ladders
Cain stated, “Workers often take short cuts when working on a ladder. They are pushing to get a job done or think they can reach ‘just a little higher’ and then find themselves on the ground.”

“We find ladder-related injuries can range from broken bones to catastrophic injuries, so helping construction and manufacturing policyholders minimize this risk is critical,” Fogle added.

From a risk management perspective, Cain recommended the following:

  • Choose the correct ladder for the task at hand.
  • Make sure the ladder is set up correctly.
  • Know how to move on and get off the ladder safely.
  • Avoid reaching which can throw off your balance and lead to falls.

In addition to ladder accidents, struck-by/caught-in accidents account for another category of frequent of workplace injuries.

Struck-by/ Caught-in
When discussing this category of construction and manufacturing risk, Cain shared a proverb, “Remember the old saying that a pound of prevention is worth an ounce of cure. In the case of accidents caused by being struck by an object or being caught in a machine, planning will help minimize the potential for these types of accidents.”

Things to consider as you plan:

  • Does everyone understand the equipment being used?
  • Did training on safe use of equipment take place and, when needed, was refresher training delivered?
  • Can you implement technology solutions like sensors and use machine guarding to minimize hazards?

“In the case of guarding accidents, we see incidents where hands are damaged by equipment because a guard was removed or wasn’t available,” Fogle remarked.

“And we’ve discovered a lot of reasons for these accidents,” said Cain. “Sometimes employees remove the guards so they can see the material better. In other cases, employers leave the choice to use a guard up to the employees. When talking with management about these claims and how to avoid them, we emphasize the importance of a top-down enforcement process for consistent use of these safety tools. If it is feasible economically, we may also recommend that employers install light curtains, which immediately shut down the equipment if a hand tracks through the light,” he concluded.

Here are some machine guarding tips to prevent caught-in injuries:

  • Conduct a hazard assessment of the machine, for example, press brake.
  • Use safe distances between the employee and the point of operation.
  • Use machine guards to prevent employees from getting into the point of operation (such as light curtains or hand controls).
  • Conduct employee training on safe equipment use and the importance of machine guarding.
  • Implement consistent enforcement procedures with clear accountability for supervisors and workers.
  • Implement lockout/tagout procedures for changing dies.

Slips, Trips and Falls
“This category of claims again underscores the importance of planning because the best way to set yourself up for a safe job is to plan. Ask yourself, ‘what equipment do we need? Where will it be used? What is challenging about equipment or location?’” suggested Cain. “This exercise helps you identify potential hazards upfront and allows you to think through ways to mitigate these risks.”

Cain added the following safety tips to help minimize these accidents:

  • Identify equipment to be used to reach heights, such as scaffolding, boom and scissor lifts and ladders.
  • Make sure training is provided on any system being utilized.
  • Identify if personal fall arrest systems must be worn with appropriate tie-off points.
  • When using personal fall arrest systems, make sure employees are trained on their proper use.
  • Inspect employees and equipment throughout the course of construction to ensure proper use.
  • Implement consistent enforcement procedures and accountability systems for supervisors and workers.

Use Your Safety Committee Effectively

One of the most effective ways to ensure you can avoid the most common WC injuries for your industry is to have an active and engaged safety committee.

“We like to see safety committees meet at least monthly and use meetings as a forum to discuss recent claims. It’s powerful to have injured workers attend these meetings to share the details of their accidents and talk through ways they could have avoided them. This inclusive approach also builds buy-in across your organization by getting everyone involved. It also allows leaders to identify the weak spots in their workflow, process, training, etc. so these issues can be addressed,” noted Fogle.

Have a Clearly Defined Workers’ Compensation Claim Process

Fogle concluded by observing how important it is for every business to have a clearly defined WC claim process. Achieving successful WC claim outcomes is a shared goal for us, our policyholders, and the injured worker. We want the injured worker to get better as soon as possible and return to work when medically able to do so. That means every supervisor should know what to do when a worker is injured, from accessing initial emergency help to getting the injured worker the appropriate medical resources. The organization should then report the accident to its insurance carrier and conduct a timely accident investigation while the details are fresh. This is important since the insurance company cannot be onsite right after an accident occurs, so we depend on the policyholder to investigate the facts, obtain photographs and secure witness statements. Having a well-understood WC claim process is the first step to achieving our shared goal.”

Let our Amerisure experts know if you need any help with any of the topics they’ve discussed.  They are happy to help you find the best safety solutions for protecting workers and reducing claims.

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