The claims are also highly susceptible
to manipulation or outright fraud.
California, due to its legal
environment, for example, has
experienced growth in suspicious,
highly-litigated and expensive
cumulative-trauma claims filed after
workers leave their jobs.
In 2016, the California’s Workers’
Compensation Insurance Rating
Bureau reported that cumulative
trauma claims, as a percentage of lost-time claims, more than doubled over
the past decade. They comprised about
18 percent of the state’s indemnity
cases during 2015.
Nationwide, however, there is good
news in a Liberty Mutual Safety Index
that annually ranks the top 10 causes of
serious workplace injuries. It has shown a
gradual, long-term decline in the nation’s
total spend for cumulative trauma and
Injury prevention programs,
ergonomics, return-to-work efforts and
the automation of tasks all contribute
to the long-term decline.
That is good news because the costs
can be steep.
OSHA reported in 2014 that work-
related musculoskeletal disorders account
for one of every three dollars spent on
workers’ comp. The U.S. Bureau of
Labor Statistics estimates they account
for 34 percent of all lost workdays.
OSHA’s report states that the
disorders cost employers $20 billion
annually in direct workers’ comp costs
and up to five times that in indirect
costs. The injuries also take a personal
toll, with workers suffering and unable
to work or live full personal lives.
OUT-ENGINEER THE RISK
A first line of defense after a
cumulative trauma or musculoskeletal
claim occurs requires reviewing the
injured person’s workplace to learn
whether the injury could have been
avoided, and what measures will
prevent a similar future occurrence,
said consultant Barry D. Bloom,
managing principal at The bdb Group.
“That is just general good risk
management, but it really applies on
any injurious exposure that is costly or
type food stores so that workers move
entire pallets of products into place
with forklifts rather than manually
stocking shelves. Other industries have
increased the use of robotics.
Designing processes or engineering
in solutions to eliminate risk is now a
primary ergonomics practice that has
expanded beyond the mere physical
workstation adjustments for individual
workers that were the focus of earlier
Engineering risk out of jobs and
processes, or at least greatly reducing
it, is the goal of workplace ergonomics
evaluations, McDonald said.
Administrative controls, like job
rotations reducing the hours workers are
exposed to stressful tasks, also play a role.
“But in our opinion there is no
substitute for good design initially and
engineering controls after a process has
been implemented,” McDonald said.
“Administrative controls would fall
last on the hierarchy on how you want
to address these things.”
Engineering is critical because
you can’t rely on human behavior to
consistently perform motions in a safe
manner, Spiers added.
“What you never want to do is
depend on behavior,” he said.
Although more outcomes data
is necessary, combining safety and
ergonomics with wellness programs
also shows great potential to mitigate
repetitive motion and musculoskeletal
claims, Maynard said. That is
particularly true with the comorbidities
that impact claims severity.
“It’s a tremendous opportunity,”
“And there is good data that fitness
and overall health have a relationship
with musculoskeletal types of disorders.”
Ergonomic assessments are not the
only line of defense, Spiers said. Post-offer employment testing also has an
“I laugh because we seem to leave
out (employee) selection,” he said.
Making sure that a hire can physically
perform the job is an often overlooked,
yet obvious line of defense, Spiers said. &
ROBERTO CENICEROS is a senior editor
with Risk & Insurance®. He can be reached
physically incapacitating because we
need as many people as can be to be
employed and productive,” Bloom said.
Among other measures for
managing a cumulative trauma claim,
employers will want to obtain a
high-quality, evidence-based medical
assessment to help determine whether
the injury is work related.
“Because in cumulative trauma, it’s
not just that you have been exposed to
something,” Bloom explained.
“In other words, it’s not just that
you have used a mouse, for example,
don’t wait to see a repetitive
motion claim before working
to prevent them, Bloom added.
The range of practices they
adopt include evaluating how
work is accomplished and what
tasks they might automate.
That has led to practices
like designing warehouse-
“Engineering risk out of jobs
and processes, or at least
greatly reducing it, is the goal
of workplace ergonomics
— Sean McDonald, Workforce Strategies
Ergonomics Practice Leader, Marsh Risk Consulting
“…it’s not just that you have used a
mouse for example, but you have
to also prove that the exposure
caused the injury. You can’t do that
without a good quality medical
— Barry Bloom, managing principal, The bdb Group
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