Rousmaniere: Injured Worker Blues

What can we conjecture about the experience of American workers with the work injury risks they endure? After reading a flock of reports, one has the sense that about one out of every five injured workers has had a bad experience, either due to poor worksite safety, and/or due to a souring time on workers’ compensation benefits, whether or not caused by the claims payer, which may be blamed. 

In other words, if you randomly select injured workers in the private sector, it’s reasonable to expect that one out of five will have an unhappy story.  If you count injuries that result in at least one day of lost time, that comes to about 180,000 unhappy stories a year. Each creates a bad memory and tarnished reputation. Dissatisfaction is probably skewed towards workers on prolonged work disability.

Compare this one in five bad story ratio with what Americans may encounter in other stressful experiences, such as buying a home, a serious illness, or relocating.  If a well-run company found that just five percent of its customers had a bad experience, you’d expect concern at the top. The injured worker, however, is the customer of nobody.

The point here is not to cast any blanket judgments, but to think through the several ways that being on workers’ comp can be an experience that no worker would want to have to go through.

When work safety is poor

We know little in a systematic way about patterns of safety performance among employers. But it is known that safety diligence varies among worksites.

When OSHA released data on the injury frequency for more than 59,887 worksites for 2007, a golden opportunity opened to find patterns of safety diligence.  And what a find I came upon, by digging into this database.

Twenty hotels in Las Vegas had an average lost time injury rate per 100 workers of 0.9.  However, the worst performing 20% of these hotels had an average rate of 2.0.

United Airline’s lost time injury rates for 25 of the airport it flew into averaged 3.6 per 100 workers.  The average rate for its worst five locations was 7.5.

Get the picture?  The injury rate of the worst fifth of worksites is double that of the entire population of similar worksites. I saw this pattern wherever I looked in the database, including home supply stores.

It now appears that lower safety standards may lead not only to more injuries but also to less use of the workers’ compensation system for legitimate injuries.  In a remarkable study of work injury risk, researchers closely studied a number of trucking companies by interviewing drivers.  Their article was published in the August, 2017 issue of the American Journal of Industrial Medicine. In what the researchers defined what they called a poor “safety climate,” injury rates were higher. Furthermore, these injured workers were less likely to file workers’ compensation claims.  

Thus, lower safety standards spawn injuries and lead to less use of the benefit safety net.  In contrast, better safety reduces injuries and a higher claiming rate — a vote of confidence in the workers’ compensation system.

Blues when on comp

It’s not hard to conjecture that a fifth of workers with lost time compensable claims get a sour taste from being on comp. That rate could be much higher. 

Among the ways the experience could be poor is the wage replacement system. When the household take-home income of an injured worker declines by 15% or more from the pre-injury level, it’s safe to infer that the household is disrupted financially.  This probably is especially painful for claimants on prolonged disability. It may induce these workers to be more critical of anything to do with workers’ comp.   

We can infer this from the Workers’ Compensation Research Institute (WCRI) survey of injured workers in fifteen states. Take North Carolina, where those surveyed had roughly the average experience. Fourteen percent of North Carolina workers with more than seven days of lost time reported not returning to work for at least three years mainly due to the injury. Some 18% reported no substantial return to work within one year of the injury.

Thirteen percent of North Carolina workers went out a second time due to the same injury. Eight percent of injured workers reported earning “a lot less” than pre-injury at the time of the interview. 

Access to treatment triggers either positive or negative experiences. The negative ones are typically about lengthy delays in care while the injured worker waits for approvals.  The WCRI’s North Carolina survey reported that 18% of workers had big problems getting the medical care which they and their primary provider wanted.  Seventeen percent said they were very dissatisfied with their medical care.  This rate of dissatisfaction is similar to that which the Texas Department of Insurance found among surveyed injured workers in its 2017 report.

Other research teams have asked injured workers about the quality of their experience with the benefit system. The findings of 13 probes of injured workers were reviewed by researchers in an article in the Journal of Occupational Rehabilitation in May, 2014. The workers are mainly Canadian, and none are American.  But my personal knowledge of claims, and some American studies not included in the 13, argue that key points are applicable here. 

On a positive note, when claims adjusters adopt a what the worker sees is a supportive problem-solving approach, workers view the adjuster, and the claims organization, as an ally. Injured workers like when they get clear explanations, timely indemnity payments, and prompt referrals for medical services and vocational assistance.

But workers give interviewers an earful about adjusters who do not listen, and as they see it don’t fully understand the impact of their injuries on their lives, or take into account their individual needs.  Some feel they have to justify themselves and prove that their injuries were real. They can acquire a strong sense of an injustice being done.   

Several studies reported that injured workers say that adjusters are difficult to contact.  They say they feel helpless, do not know the system rules yet are dependent on the system for financial support.

One out of five 

Listening to injured workers, and observing how benefits work, one can plausibly sense that one out of five workers who incur an injury would give poor marks, either to their workplace for lax safety, to their workers’ comp insurer, or to the “comp system” for a painful time on comp.

ABOUT THE AUTHOR

Peter Rousmaniere is widely known throughout the workers’ compensation industry, both for his writing and consulting experience. Based in the picture perfect New England town of Woodstock, VT, he is a regular on the conference circuit, and is deeply in tune with trends and developments within the industry. His passion is writing and presenting on issues largely related to immigration, and he maintains a blog on the subject at www.workingimmigrants.com.

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