Workers' Compensation (workers' + compensation)

Distribution by Scientific Domains

Terms modified by Workers' Compensation

  • workers' compensation board
  • workers' compensation data
  • workers' compensation system

  • Selected Abstracts


    Physician Shopping in Workers' Compensation: Evidence from California

    JOURNAL OF EMPIRICAL LEGAL STUDIES, Issue 1 2006
    Seth A. Seabury
    Physician evaluations of impairment severity have a significant impact on the size of permanent disability benefits awarded to injured workers in workers' compensation. This gives both parties in a disputed claim the incentive to "shop" for physicians who will provide them with sympathetic evaluations. In this article we use data from the California workers' compensation system on competing physician evaluations for the same injury to study the extent to which the ability to select a physician results in a more favorable disability rating. We find that disability ratings based on evaluations from physicians selected by the applicant are 23 percent higher than those based on a neutral evaluation, while ratings based on a defense physician's evaluation tend to be about 5 percent lower. Moreover, we match these data to earnings loss data and estimate the extent to which applicant, defense, or neutral ratings best predict the outcomes of injured workers. The neutral ratings appear to do the best job of predicting earnings losses overall, though not by a substantial margin. [source]


    Costs by industry and diagnosis among musculoskeletal claims in a state workers compensation system: 1999,2004

    AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 3 2010
    Kari K. Dunning PhD
    Abstract Background Musculoskeletal disorders (MSDs) are a tremendous burden on industry in the United States. However, there is limited understanding of the unique issues relating to specific industry sectors, specifically the frequency and costs of different MSDs. Methods Claim data from 1999 to 2004 from the Ohio Bureau of Workers' Compensation were analyzed as a function of industry sector (NAICS industry-sector categories) and anatomical region (ICD-9 codes). Results Almost 50% of the claims were lumbar spine (26.9%) or hand/wrist (21.7%). The majority of claims were from manufacturing (25.1%) and service (32.8%) industries. The industries with the highest average costs per claim were transportation, warehouse, and utilities and construction. Across industries, the highest costs per claim were consistently for the lumbar spine, shoulder, and cervical spine body regions. Conclusion This study provides insight into the severity (i.e., medical and indemnity costs) of MSDs across multiple industries, providing data for prioritizing of resources for research and interventions. Am. J. Ind. Med. 53:276,284, 2010. © 2009 Wiley-Liss, Inc. [source]


    Impact of publicly sponsored interventions on musculoskeletal injury claims in nursing homes,

    AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 9 2009
    Robert M. Park MS
    Abstract Background The rate of lost-time sprains and strains in private nursing homes is over three times the national average, and for back injuries, almost four times the national average. The Ohio Bureau of Workers' Compensation (BWC) has sponsored interventions that were preferentially promoted to nursing homes in 2000,2001, including training, consultation, and grants up to $40,000 for equipment purchases. Methods This study evaluated the impact of BWC interventions on back injury claim rates using BWC data on claims, interventions, and employer payroll for all Ohio nursing homes during 1995,2004 using Poisson regression. A subset of nursing homes was analyzed with more detailed data that allowed estimation of the impact of staffing levels and resident acuity on claim rates. Costs of interventions were compared to the associated savings in claim costs. Results A $500 equipment purchase per nursing home worker was associated with a 21% reduction in back injury rate. Assuming an equipment life of 10 years, this translates to an estimated $768 reduction in claim costs per worker, a present value of $495 with a 5% discount rate applied. Results for training courses were equivocal. Only those receiving below-median hours had a significant 19% reduction in claim rates. Injury rates did not generally decline with consultation independent of equipment purchases, although possible confounding, misclassification, and bias due to non-random management participation clouds interpretation. In nursing homes with available data, resident acuity was modestly associated with back injury risk, and the injury rate increased with resident-to-staff ratio (acting through three terms: RR,=,1.50 for each additional resident per staff member; for the ratio alone, RR,=,1.32, 95% CI,=,1.18,1.48). In these NHs, an expenditure of $908 per resident care worker (equivalent to $500 per employee in the other model) was also associated with a 21% reduction in injury rate. However, with a resident-to-staff ratio greater than 2.0, the same expenditure was associated with a $1,643 reduction in back claim costs over 10 years per employee, a present value of $1,062 with 5% discount rate. Conclusions Expenditures for ergonomic equipment in nursing homes by the Ohio BWC were associated with fewer worker injuries and reductions in claim costs that were similar in magnitude to expenditures. Un-estimated benefits and costs also need to be considered in assessing full health and financial impacts. Am. J. Ind. Med. 52:683,697, 2009. © 2009 Wiley-Liss, Inc. [source]


    Characteristics of occupational burns in Oregon, 2001,2006

    AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 5 2009
    Jaime K. Walters MPH
    Abstract Background Occupational burns are known to be a serious public health concern. This article describes work-related burns in Oregon between 2001 and 2006. Methods Oregon Workers' Compensation (WC) burn claims were analyzed; data from a commercial insurance carrier (CIC) was used to characterize non-disabling burn claims. To ensure that our primary data source (WC) captures as many burn cases as possible, we compared hospitalized cases to a regional burn center (RBC) and Oregon hospital discharge index (HDI) data. Results The WC burn injury rate ranged from a high of 1.8 per 10,000 workers in 2001 to a low of 1.4 per 10,000 in 2004. We identified 2,165 accepted burn claims in CIC data, of which 85% were non-disabling. We matched data from a regional burn center to a subset of hospitalized claims from WC data and found an additional 44 cases of occupational hospitalized burns representing a 3% increase in total cases captured. Conclusions Occupational burns continue to be a problem for working Oregonians, and the use of additional data sources outside of WC augments our surveillance system. Am. J. Ind. Med. 52:380,390, 2009. © 2009 Wiley-Liss, Inc. [source]


    Workers' compensation in Canada: a case for greater public accountability

    CANADIAN PUBLIC ADMINISTRATION/ADMINISTRATION PUBLIQUE DU CANADA, Issue 1 2000
    Therese Jennissen
    The changing nature of occupational risks has created a range of workplace injuries against which current workers' compensation programs do not adequately insure. The existence of workers' compensation alongside the other components of the social-safety net may have created significant numbers of individuals who are either not receiving compensation when they should be or are receiving compensation when they should not be. The implication is that other programs bear some of the costs that should be borne by workers' compensation and, conversely, that some of the costs borne by workers' compensation should be borne by other social programs. These "gaps and overlaps" indicate that workers' compensation should be better integrated with the rest of the programs that make up the Canadian social-safety net. The article concludes with a menu of reforms, including the establishment, through legislation, of a formal reporting relationship; changes to the composition and size of governance structures; the introduction of strategic planning; and the establishment of performance measurement processes. Sommaire: Selon les auteurs de cet article, les politiques concernant les accidents du travail au Canada devraient relever davantage des gouvernements élus. L'évolution des risques professionnels a Créé toute une gamme d'accidents du travail pour lesquels l'assurance des régimes actuels d'indemnisation est inadéquate. L'existence des régimes d'assurance contre les accidents du travail parallèlement aux autres éléments de sécurité sociale aurait pour effet de multiplier le nombre de personnes quisoit ne reçoivent pas de prestations lorsqu'elles devraient en recevoir, soit l'inverse. Par conséquent, d'autres programmes défraient certains des coûts qui incombent au régime des accidents du travail, tandis que ce dernier défraie des coûts imputables a d'autres programmes sociaux. Ces lacunes et chevauchements indiquent que le régime d'assurance contre les accidents du travail devrait être mieux intégré au reste des programmes qui constituent le filet de sécurité sociale au Canada. L'article propose une série de réformes, dont l'adoption légiférée d'une relation formelle de compte rendu, la modification de la composition et de la taille des structures de gouvernance, l'adoption de la planification stratégique, et l'établissement de processus de mesure du rendement. [source]


    The prognosis of occupational contact dermatitis in 2004

    CONTACT DERMATITIS, Issue 5-6 2004
    Jennifer Cahill
    The prognosis of occupational contact dermatitis (OCD) takes into account the extent of healing, effect on quality of life and employment, and financial costs for both the individual and the wider community. We reviewed 15 studies published between 1958 and 2002, reporting the complete clearance of dermatitis (range of 18,72%). 9 of the 15 studies reported a clearance rate of between 18 and 40%. Improvement was reported as an outcome in 3 studies between 1991 and 2002 (range of 70,84%). A number of common variables were identified as of possible influence. These include age, sex, atopy, patient knowledge, disease aetiology, duration of symptoms and job change; clinical, financial and social issues are also described. All of these factors need to be considered when managing a patient with OCD. Improved patient knowledge and early diagnosis may be associated with improved prognosis, whereas job change does not make a significant difference. Some patients will develop persistent post-occupational dermatitis, which has important implications for prognosis and workers' compensation. Only a small proportion of eligible patients receive workers' compensation, even though financially supported healing time soon after diagnosis may result in an improved prognosis. [source]


    FS07.2 Occupational contact dermatitis and workers' compensation

    CONTACT DERMATITIS, Issue 3 2004
    Kathryn Frowen
    Statistics for occupational contact dermatitis (OCD) in Australia are gathered from workers' compensation (WC) data and research has indicated that occurrence is underestimated by as much as 400%. This study investigated reasons which might influence decisions whether to claim WC or not. A questionnaire was posted to 168 individuals diagnosed with significantly work related OCD at a specialised occupational dermatology clinic, therefore fulfilling valid claim criteria under the WC scheme operating in the state of Victoria. 70 completed responses were analysed. Ages ranged from 18,65 and only 40% had claimed workers' compensation, with those under 45 y less likely to claim. Females were significantly (P < 0.05) less likely to claim, as were respondents who had dermatitis present for less than 6 months. At the time of diagnosis, 37% of respondents were health care workers, 10% hairdressers, 7% food handlers, and 29% worked in hospitals, 24% manufacturing, 10% hairdressing salons, and 7% each vehicle maintenance, food service and trades. 31% no longer worked for the same employer, however 90% of respondents were still employed. Those who did not claim WC lost less time from work than those who claimed, but more non-claimants still had skin problems quite often or constantly than did claimants. 28.6% of non-claimants had all or some of their medical and/or lost time costs paid by their employer, and only 18% of claimants had all of their costs paid by their employer or WC insurer. Although the sample size was small, interesting data was also obtained from the qualitative responses. [source]


    Physician Shopping in Workers' Compensation: Evidence from California

    JOURNAL OF EMPIRICAL LEGAL STUDIES, Issue 1 2006
    Seth A. Seabury
    Physician evaluations of impairment severity have a significant impact on the size of permanent disability benefits awarded to injured workers in workers' compensation. This gives both parties in a disputed claim the incentive to "shop" for physicians who will provide them with sympathetic evaluations. In this article we use data from the California workers' compensation system on competing physician evaluations for the same injury to study the extent to which the ability to select a physician results in a more favorable disability rating. We find that disability ratings based on evaluations from physicians selected by the applicant are 23 percent higher than those based on a neutral evaluation, while ratings based on a defense physician's evaluation tend to be about 5 percent lower. Moreover, we match these data to earnings loss data and estimate the extent to which applicant, defense, or neutral ratings best predict the outcomes of injured workers. The neutral ratings appear to do the best job of predicting earnings losses overall, though not by a substantial margin. [source]


    Ethical Issues for Psychologists in Pain Management

    PAIN MEDICINE, Issue 2 2001
    Mary Lou Taylor PhD
    Pain management is relatively young as a specialty. Although increasing attention is being paid to issues such as pain at the end of life and pain in underserved populations, only recently has an open discussion of ethical issues in chronic pain treatment come to the fore. Psychologists specializing in pain management are faced with a myriad of ethical issues. Although many of these problems are similar to those faced by general clinical psychologists or other health psychologists, they are often made more complex by the multidisciplinary nature of pain management and by the psychologists' relationships to third-party payers (health maintenance organizations, workers' compensation), attorneys, or other agencies. An open forum exploring ethical issues is needed. This article outlines major ethical considerations faced by pain management psychologists, including patient autonomy and informed consent, confidentiality, reimbursement and dual relationships, patient abandonment, assessment for medical procedures, clinical research, and the interface of psychology and medicine. American Psychological Association ethical principles and principles of biomedical ethics need to be considered in ethical decision making. Further exploration and discussion of ethics for pain management psychologists are recommended. [source]


    Disparities by ethnicity, language, and immigrant status in occupational health experiences among Las Vegas hotel room cleaners

    AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 10 2010
    Stéphanie Premji PhD
    Abstract Objective We examined disparities in workers' occupational health experiences. Methods We surveyed 941 unionized Las Vegas hotel room cleaners about their experiences with work-related pain and with employers, physicians, and workers' compensation. Data were analyzed for all workers and by ethnicity, language, and immigrant status. Results Hispanic and English as second language (ESL) workers were more likely than their counterparts to report work-related pain and, along with immigrant workers, to miss work because of this pain. Hispanic, ESL, and immigrant workers were not consistently at a disadvantage with regard to their own responses to work-related pain but were so with respect to reported responses by workers' compensation, physicians, and employers. Conclusions There are indications of disparities in occupational health experiences within this job title. The use of different group classifications, while implying different mechanisms, produced similar results. Am. J. Ind. Med. 53:960,975, 2010. © 2010 Wiley-Liss, Inc. [source]


    Language preference and non-traumatic low back disorders in washington state workers' compensation

    AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 2 2010
    David K. Bonauto MD
    Abstract Background Workers in the United States with limited English proficiency likely perform more hazardous work, experience higher rates of work-related injury and illness, and have worse disability outcomes. Methods We conducted a descriptive study of employment characteristics, timeliness and utilization of workers' compensation (WC) insurance benefits, cost and occupational health outcomes for Washington State WC state fund, non-traumatic low back disorders (LBD) claimants by language preference. Results A greater proportion of Spanish language preferring (SLP) LBD claims filed were accepted and resulted in lost work time than English language preferring (ELP) LBD claims. There were significant differences in the demographic, employment, and occupational characteristics between the SLP and ELP compensable claimant populations. The SLP LBD compensable claimants had greater time loss duration, greater medical and total claim costs, more use of physical therapy and vocational services than the ELP LBD compensable claimants. With the exception of the timeliness for providing the first time loss payment, the time periods for provision of insurance benefits did not differ between the SLP and ELP populations. SLP compensable claimants received less back surgery and had comparable permanent partial disability payments to the ELP population. Employers were more likely to protest the acceptance of a SLP compensable than one in an ELP LBD compensable claim. Conclusion For those injured workers accessing the Washington State WC system, we observed differences based on language preference for pre-injury, and workers compensation outcomes. Further research is needed to explain the observed differences. Am. J. Ind. Med. 53:204,215 2010. © 2009 Wiley-Liss, Inc. [source]


    The law and incomplete database information as confounders in epidemiologic research on occupational injuries and illnesses,

    AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 1 2010
    Arthur Oleinick MD
    Abstract Background Capture,recapture studies report undercounting of work injuries/illnesses with days away from work (DAFW) in the Bureau of Labor Statistics annual Survey of Occupational Injuries and Illnesses (BLS SOII) by 25,68% depending on the state and undercounting by various state workers' compensation (WC) systems of eligible claims by 5,35%. Methods Statutory/regulatory criteria defining eligible cases are used to adjust counts in the 1998,2001 Minnesota's WC system and the BLS SOII to permit comparison and to evaluate the recent studies. Missing information in the employer database used in the capture,recapture studies is tabulated. An attempt is made to harmonize results with two additional databases counting work injuries. Results Counts in the BLS SOII moderately undercount by 10,16% the number of WC cases. We believe that matching in capture,recapture studies is adversely affected by misperceptions regarding the application of statutory/regulatory eligibility criteria and by missing data. The result is that the reported undercounts in both the BLS SOII and several state WC databases are overstated in the capture,recapture studies. Although three of four databases can be approximately harmonized, the fourth cannot. Conclusions More precisely targeted information is needed before decisions regarding redesign of the BLS survey are made or before legislative or administrative changes in the WC are contemplated. Am. J. Ind. Med. 53:23,36, 2010. © 2009 Wiley-Liss, Inc. [source]


    Work-related carpal tunnel syndrome in Washington State workers' compensation: Utilization of surgery and the duration of lost work

    AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 12 2009
    William E. Daniell MD
    Abstract Background Work-related carpal tunnel syndrome (CTS) is a leading cause of lengthy disability. Methods This population-based retrospective cohort study used Washington State workers' compensation claims for CTS to characterize associations between utilization of CTS surgery and duration of lost work. The sample included all claims (n,=,8,224) filed during 1990,1994 (followed through 2000) and receiving lost-work compensation. Results Sixty-four percent of studied workers had CTS surgery. Among workers with >1 month of lost work, the total duration was much shorter when workers had surgery, versus those who did not (median 4.3 and 6.2 months, respectively; P,<,0.001); there was no difference when disability extended >6 months. When workers had surgery, disability was less likely to end before 6 months if non-CTS conditions were present, surgery occurred >3 months after claim filing, or employment was in an industry with high incidence of CTS; disability was more likely to end if the diagnosing provider and operating surgeon had higher CTS claims volume. Physical and rehabilitation medicine services were associated with lower probability of returning to work, with or without surgery. Conclusions There is a need to scrutinize the role of surgery and physical-rehabilitation medicine modalities in the management of CTS covered by workers' compensation. The findings suggest disability can be minimized by establishing the CTS diagnosis as early as possible and, if surgery is appropriate, conducting surgery without substantial delay and maximizing post-operative efforts to facilitate return to work. Use of surgery >6 months after filing should be considered with great caution. Am. J. Ind. Med. 52:931,942, 2009. © 2009 Wiley-Liss, Inc. [source]


    Ergonomic and socioeconomic risk factors for hospital workers' compensation injury claims

    AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 7 2009
    Jon Boyer ScD
    Abstract Background Hospital workers are a diverse population with high rates of musculoskeletal disorders (MSDs). The risk of MSD leading to workers' compensation (WC) claims is likely to show a gradient by socioeconomic status (SES) that may be partly explained by working conditions. Methods A single community hospital provided workforce demographics and WC claim records for 2003,2005. An ergonomic job exposure matrix (JEM) was developed for these healthcare jobs from direct observation of physical workload and extraction of physical and psychosocial job requirements from the O*NET online database. Occupational exposures and SES categories were assigned to workers through their O*NET job titles. Univariate and multivariate Poisson regression analyses were performed to estimate the propensity to file an injury claim in relation to individual factors, occupational exposures, and SES. Results The jobs with the highest injury rates were nurses, semi-professionals, and semi-skilled. Increased physical work and psychological demands along with low job tenure were associated with an increase in risk, while risk decreased with psychosocial rewards and supervisor support. Both occupational and individual factors mediated the relationship between SES and rate of injury claims. Conclusions Physical and organizational features of these hospital jobs along with low job tenure predicted WC injury claim risk and explained a substantial proportion of the effects of SES. Further studies that include lifestyle risk factors and control for prior injuries and co-morbidities are warranted to strengthen the current study findings. Am. J. Ind. Med. 52:551,562, 2009. © 2009 Wiley-Liss, Inc. [source]


    Would a "one-handed" scientist lack rigor?

    AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 3 2008
    How scientists discuss the work-relatedness of musculoskeletal disorders in formal, informal communications
    Abstract Background When research results concerning occupational health are expressed ambiguously, compensation and prevention can be affected. This study examined the language used by scientists to discuss the relation between work and musculoskeletal disorders (MSDs). Methods Language regarding work and MSDs in twenty articles from two peer-reviewed journals was compared with that in 94 messages on MSDs posted by published scientists to an internet list. Results Almost all the articles found some link between work and MSDs. However, few articles expressed belief in such a link unambiguously in the title or abstract, and language on links was often hard for a non-health scientist to interpret. Language and methods gave excess weight to negative results. On the listserve, many scientists expressed unambiguous views on linkages between work and MSDs. Conclusions Scientists must express their opinions more forthrightly if they wish their results to be used to favour prevention and to foster access to workers' compensation. Am. J. Ind. Med. 51:173,185, 2008. © 2008 Wiley-Liss, Inc. [source]


    Workers' compensation experiences of computer users with musculoskeletal disorders

    AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 7 2007
    Shona Fang SM
    Abstract Background Computer-related musculoskeletal disorders (MSDs) are of concern as computer use continues to increase. While MSDs are among the most disabling conditions in the United States, the workers' compensation (WC) experiences of individuals with these occupational disorders are not well described. Methods We conducted a study among 149 adults with work-related MSDs of the neck, upper back, or upper extremity related to computer use. Questionnaires were used to obtain information on subjective experiences with WC and economic issues. Results Seventy-four percent filed for WC. Twenty-five percent of all participants reported major financial difficulties after developing their MSD, though the majority filed for WC. Despite filing for WC, a large proportion relied partially on government, employer, or personal financial sources. Sixty-two percent reported that overall satisfaction with the WC insurer was poor. Conclusions Findings indicate that a majority of participants filed for WC. Despite filing for WC financial difficulties after developing their MSD were considerable. Am. J. Ind. Med. 50:512,518, 2007. © 2007 Wiley-Liss, Inc [source]


    Work-related carpal tunnel syndrome in Washington State workers' compensation: Temporal trends, clinical practices, and disability

    AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 4 2005
    William E. Daniell MD
    Abstract Background Work-related carpal tunnel syndrome (CTS) is a leading cause of disability. There is a need for information about temporal trends, clinical practices, and treatment outcomes. Methods A population based, retrospective cohort study of Washington State workers' compensation claims for CTS was initiated focusing on claims filed during 1990,1994, followed through 2000 (n,=,16,710). Results Half of the claims were filed for conditions other than CTS, but were eventually identified to be or include CTS. The first CTS diagnosis occurred more than 3 months after claim filing in 20% of claims. The longer that the CTS diagnosis occurred after claim filing, the more likely that CTS was accompanied by other problems, and disability tended to be longer. Conclusions Making an accurate diagnosis of CTS and initiating appropriate actions earlier than might otherwise occur could reduce the disability and costs in a large fraction of claims that are ultimately determined to involve CTS. © 2005 Wiley-Liss, Inc. [source]


    Work-related carpal tunnel syndrome (WR-CTS) in Massachusetts, 1992,1997: Source of WR-CTS, outcomes, and employer intervention practices,

    AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 2 2004
    Helen Wellman MS
    Abstract Background The Massachusetts Sentinel Event Notification System for Occupational Risks (MASS SENSOR) receives reports of work-related carpal tunnel syndrome (WR-CTS) cases from (1) workers' compensation (WC) disability claims for 5 or more lost work days; and (2) physician reports (PR). Methods From 1992 through 1997, 1,330 WC cases and 571 PR cases completed follow-back surveys to provide information on industry, occupation, attributed source of WR-CTS, outcomes, and employer intervention practices. Results Sixty-four percent of the respondents had bilateral CTS and 61% had surgery, both of which were proportionally more frequent among WC cases. Office and business machinery was the leading source of WR-CTS (42% of classifiable sources) in every economic sector except construction, followed by hand tools (20%). Managers and professional specialty workers were the most likely to report employers' interventions and were up to four times more likely to report equipment or work environment changes than higher risk groups. Conclusions State-based surveillance data on the source of WR-CTS provided valuable information on how and where to implement interventions. New occurrences of WR-CTS are likely, especially in the highest risk industries where very few cases reported primary prevention measures (e.g., changes to equipment or work environment) implemented by their employers. Am. J. Ind. Med. 45:139,152, 2004. © 2004 Wiley-Liss, Inc. [source]


    Health care utilization of carpenters with substance abuse-related diagnoses

    AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 2 2003
    Hester J. Lipscomb PhD
    Abstract Background Persons in the construction trades in the US have high rates of alcohol and substance abuse. We had the unique opportunity to evaluate health care utilization through private insurance and workers' compensation for a group of carpenters at high risk of injury and substance abuse. Methods We identified a cohort of union carpenters. Their claims for medical care through union insurance and workers' compensation, and appropriate measures of time at risk were documented. Using methods of indirect standardization, we compared utilization and costs between carpenters with and without alcohol and substance-abuse related diagnoses (ASRD). Results Through private insurance, those with ASRD had 10% higher outpatient utilization and 2.1 times higher rates of hospitalizations for injury care; 2.6 times higher rates of outpatient care; and 2.9 times higher inpatient admissions for non-injury care. Individuals with ASRD had only modestly increased rates (10%) of outpatient utilization through workers' compensation. Conclusions These findings support the need for alcohol and drug abuse prevention and treatment services for this workforce. Operationalizing this among highly mobile workforces, such as the construction trades, is a challenge. While not intending to minimize the problems of alcohol or substance abuse on the job among carpenters, the focus of prevention should not necessarily be in the workplace. Am. J. Ind. Med. 43: 120,131, 2003. © 2003 Wiley-Liss, Inc. [source]


    Workers' compensation in Canada: a case for greater public accountability

    CANADIAN PUBLIC ADMINISTRATION/ADMINISTRATION PUBLIQUE DU CANADA, Issue 1 2000
    Therese Jennissen
    The changing nature of occupational risks has created a range of workplace injuries against which current workers' compensation programs do not adequately insure. The existence of workers' compensation alongside the other components of the social-safety net may have created significant numbers of individuals who are either not receiving compensation when they should be or are receiving compensation when they should not be. The implication is that other programs bear some of the costs that should be borne by workers' compensation and, conversely, that some of the costs borne by workers' compensation should be borne by other social programs. These "gaps and overlaps" indicate that workers' compensation should be better integrated with the rest of the programs that make up the Canadian social-safety net. The article concludes with a menu of reforms, including the establishment, through legislation, of a formal reporting relationship; changes to the composition and size of governance structures; the introduction of strategic planning; and the establishment of performance measurement processes. Sommaire: Selon les auteurs de cet article, les politiques concernant les accidents du travail au Canada devraient relever davantage des gouvernements élus. L'évolution des risques professionnels a Créé toute une gamme d'accidents du travail pour lesquels l'assurance des régimes actuels d'indemnisation est inadéquate. L'existence des régimes d'assurance contre les accidents du travail parallèlement aux autres éléments de sécurité sociale aurait pour effet de multiplier le nombre de personnes quisoit ne reçoivent pas de prestations lorsqu'elles devraient en recevoir, soit l'inverse. Par conséquent, d'autres programmes défraient certains des coûts qui incombent au régime des accidents du travail, tandis que ce dernier défraie des coûts imputables a d'autres programmes sociaux. Ces lacunes et chevauchements indiquent que le régime d'assurance contre les accidents du travail devrait être mieux intégré au reste des programmes qui constituent le filet de sécurité sociale au Canada. L'article propose une série de réformes, dont l'adoption légiférée d'une relation formelle de compte rendu, la modification de la composition et de la taille des structures de gouvernance, l'adoption de la planification stratégique, et l'établissement de processus de mesure du rendement. [source]