Why a Healthier Workforce Means Less Workers’ Compensation

| | Utilization Review

Healthier Workforce
As long as human beings work, workers’ comp claims will exist. Occupational injuries and illnesses are one aspect of business that employers will always face. But employers can reduce the number of workers’ compensation claims their employees submit – and the legal and financial hurdles that come with them – by encouraging their employees to live healthier lives, in body and in mind.

How Pre-Existing Conditions and Unhealthy Lifestyles Contribute to Workplace Injuries

Employers may not know it, but their employees’ lifestyles can contribute to workplace injuries. For example, employees who eat poorly or fail to exercise may become obese. Obese people may be more likely to get injured, because obesity can damage the body in imperceptible ways, making people more susceptible to ailments such as back problems, knee pain, and leg injuries. Often, the effects of obesity are not discovered until after an employee is injured on the job. Then, examining the injured area may reveal pre-existing damage.

Obesity also makes it more difficult for employees to recover from injuries via physical therapy. They may experience residual symptoms after their injuries exacerbate their pre-existing conditions, resulting in longer periods of disability leave, more treatment, and more expenses for employers.

Smoking is another lifestyle choice that makes workers more injury prone – especially for workers with physically demanding jobs. Employees who smoke are more likely to experience heart attacks, strokes, and respiratory problems. Employees who experience these symptoms at work could submit workers’ comp claims.

While not necessarily unhealthy, some athletic employees are also more prone to workplace injuries. Old sports injuries can exacerbate workplace injuries and make them more likely. For example, a worker with a bad knee from years of playing soccer may fall and hurt her knee, whereas another employee may not be harmed by such a fall. The athlete’s damaged knee is more prone to injury; thus an otherwise non-serious fall could become a serious workers’ comp claim.

Are Your Employees Telling the Truth? How Unethical Employees Can Drive Claims

Sometimes, employees make fraudulent workers’ compensation claims. This is fairly rare, but it is something employers need to watch for. For example, an employee may arrive at work on a Monday with an injury he received over the weekend. He may claim the injury was work-related in order to receive workers’ comp benefits. This is why employers and their insurer should investigate Monday injuries with extra care.

Similarly, workers may submit pre-existing conditions as workplace injuries. Consider the following hypothetical scenario: One employee in the office is a woman who played baseball in her youth. During her years as an athlete, she dislocated her shoulder and has since experienced regular dislocations, sometimes multiple times a month. This woman is aware of her condition, and doctors have told her she needs surgery. If this employee dislocates her shoulder while on the job, she could fraudulently declare it a job-related injury in order to have her surgery covered through workers’ compensation. These kinds of claims place an undue financial burden on the system.

Encourage Healthy Bodies and Minds: What Employers Can Do to Reduce Claims

Employers can take a number of steps to cut down on their workers’ comp claims:

Encourage healthy lifestyles. Employers can sponsor smoking cessation programs or subsidize employee gym memberships. They can also incentivize fitness. For example, an employer might give employees pedometers and reduce insurance premiums for employees who walk more than 4,000 steps a day. Employers can also bring in fitness instructors to teach yoga and Pilates classes in the workplace.
Implement prevention programs. These are especially useful in places where workers perform physically arduous tasks. Employers can provide training that helps people avoid injury. For example, employers can teach employees the proper mechanics of lifting heavy objects.
Perform ergonomic evaluations: In workplaces where many employees spend their days sitting, employers should perform ergonomic evaluations. Ensure that employees’ chairs are at the right heights, so their postures don’t contribute to injuries. Employers should also evaluate the ergonomics of keyboards and screens, and consider implementing standing desks and other non-traditional workspaces that encourage physical activity.
Incentivize injury avoidance: Offer rewards to employees for going a specified length of time without any workplace injuries. For example, for every month that no one is hurt on the job, give employees a pizza party.
Use Surveillance: In order to discourage employees from reporting false injuries, employers should use cameras. This way, employers can confirm or dispute reported injuries.
Encourage better relationships with supervisors: Supervisors can help keep work environments safe and secure. They can also deter employees from reporting false claims. Employees who trust and respect their managers are less likely to attempt to defraud their employers.

Employee lifestyles contribute a great deal to injuries in the workplace, but the good news is that employers are uniquely positioned to help their employees live healthier lives. This, in turn, creates safer work environments where injuries are less likely to occur or to be falsified. Taking a holistic approach to helping keep employees healthy is in both employers’ and employees’ best interests.

Zenia Cortes, MD, Orthopedic Surgeon

Dr. Zenia Cortes brings her combined expertise in sports and orthopaedic medicine to UniMed Direct, along with insights from her experience in peer and utilization review.