NIOSH Center for Workers' Compensation Studies (CWCS)

In this NIOSH Center for Workers’ Compensation Studies (CWCS) webinar, Dr. Marianne Cloeren discussed proposed changes to improve workers’ compensation patient encounters and care. The American College of Occupational and Environmental Medicine (ACOEM) supports modifying the rules for documentation of care in workers’ compensation in order to provide reimbursement and other incentives to deliver care that adheres to best practices, including focus on assessing and improving patient function. The recommended changes include alternative ground rules for documentation and coding evaluation and management encounters, physician case management services and consultation services as they relate to workers’ compensation care. These alternative rules may be adopted by states or payers seeking to realign incentives toward improved functional and clinical outcomes and decreased costs.

The initiative is also described in the ACOEM Guidance Statement.

Speakers:

• Marianne Cloeren, MD, MPH, FACOEM

The recording is available online for viewing. For a copy of the presentation, please email cwcs@cdc.gov.

In this NIOSH Center for Workers’ Compensation Studies (CWCS) webinar, a panel of speakers discussed return to work strategies and the International Association of Industrial Accident Boards and Commissions (IAIABC) paper, “Return to Work: A Foundational Approach to Return to Function.” The paper authored by the Disability Management and Return to Work Committee of the IAIABC discusses the link between return to function and return to work as equally important in restoring a person to health. The paper speaks directly to the various stakeholders in workers’ compensation, including the worker/union, the employer, the government/regulator, the caregiver/provider, the insurer, and the attorney. The paper shares benefits and possible strategies for each group to work toward developing, implementing, and/or supporting return to work as an integral part of return to health. A copy of the IAIABC paper can be accessed here: https://www.iaiabc.org/images/iaiabc/Return-to-Work_Foundational-Approach-to-Return-to-Function_Final.pdf.

Speakers:

• Peter Federko
  Saskatchewan Workers’ Compensation Board
• Vickie Kennedy
  Washington State Department of Labor and Industries
• Dr. Kathryn Mueller
  Colorado Division of Workers’ Compensation
• Michael Stack
  Amaxx LCC
• Sarah Tayts
  Eastern Alliance Insurance Group

The recording is available online for viewing. For a copy of the presentation, please email cwcs@cdc.gov.

In this NIOSH Center for Workers’ Compensation Studies (CWCS) webinar, Bradley Evanoff, MD, MPH and Ann Marie Dale, PhD from Washington University in St. Louis, School of Medicine presented results from the Upper Limb Musculoskeletal Disorders Consortium study. Most studies of upper extremity musculoskeletal disorders (MSDs) among workers are limited by small sample sizes or restricted to a small subset of jobs. To overcome this, six U.S. research centers pooled data from their prospective studies of musculoskeletal outcomes, in what’s known as the Upper Limb Musculoskeletal Disorder Consortium. The consortium is a collaborative research program initiated by the U.S. National Institute for Occupational Safety and Health (NIOSH) in 2000. Speakers shared what the consortium has learned about the risk factors for carpal tunnel syndrome. Following 4,300 workers from more than 50 workplaces for at least three years, the consortium uses pooled data making it the largest study of carpal tunnel syndrome to date. The speakers discussed what we now know about the risk factors for carpal tunnel syndrome and what they mean for the future prevention of this painful condition among workers.

Speakers:

• Bradley Evanoff, MD, MPH
  Professor of Occupational and Environmental Medicine
  Washington University in St. Louis, School of Medicine
• Ann Marie Dale, PhD, OTR/L
  Associate Professor
  Washington University in St. Louis, School of Medicine

The recording is available online for viewing. For a copy of the presentation, please email cwcs@cdc.gov.

In this NIOSH Center for Workers’ Compensation Studies (CWCS) webinar, Vicki Missar from AON and Candy Raphan from Broadspire, described the development of a standardized coding system for patient handling injuries. The webinar provides insight into the journey and development of a national standard for Patient Handling Injury coding. The standardized coding once implemented universally, may provide a mechanism to measure and benchmark injuries and fully support further prevention and research.

Speakers:

• Vicki Missar, MS, CPE, CSPHP, CHSP, SSBB
  Associate Director
  AON
• Candy Raphan, RN, BSN, ARNP, MOAM
  Regional Vice President, Client Services
  Broadspire

The recording is available online for viewing. For a copy of the presentation, please email cwcs@cdc.gov.

In this NIOSH Center for Workers’ Compensation Studies (CWCS) webinar Dr. Ben Amick provided an update on research he has been leading at the Institute for Work and Health (http://www.iwh.on.ca/) on leading indicators of occupational health and safety performance. He discussed the history and science of the IWH-Organizational Performance (OPM) metric and its use across Canada. The OPM is a short, easy-to-use, tool. He discussed on-going research on the development of an app based on the IWH-OPM to support organizational change in small and medium businesses to improve occupational health and safety performance. As part of this research, the IWH research group conducted a survey of a representative sample of organizations in Ontario to determine what the best leading indicators may be and he presented the results of this research as well as the advantages of benchmarking. He then presented the recommendations of the IWH leading indicators research team about what to use going forward.

Speakers:

• Benjamin Amick III, B.A., B.S., PhD
  Director, Professor and Chair of the Department of Health Policy and
  Management at Florida International University
  Senior Scientist, The Institute for Work & Health

The recording is available online for viewing. For a copy of the presentation, please email cwcs@cdc.gov.

In this webinar from the CWCS series, the CWCS’ own Matt Haviland discussed the use of visual analytics to make workers comp data more explorable and useable for developing prevention strategies. The presentation covered a basic introduction to the Center and to WC data in general.  It touched on the huge variety of data visualization tools, and important features and limitation to keep in mind. There was also a demonstration of how comp data could be explored, with some additional real world examples of existing, published data, being visualized for added value.

Speakers:

• Thomas (Matt) Haviland, B.S., MSPH
  Data Analytics Fellow
  NIOSH, Center for Workers Compensation Studies

The recording is available online for viewing. For a copy of the presentation, please email cwcs@cdc.gov.

Speakers from the Saskatchewan WC Board and British Columbia’s WorkSafeBC discussed prevention strategies used by their provincial workers’ compensation insurers. The presentation covered how the Saskatchewan WC Board uses data to focus on important issues in their system and how they use the four pillars of their strategy: partnerships & leadership, targeting, education & training, and awareness to generate results. WorkSafeBC’s portion of the webinar described how it uses partnerships, direct employer consultation, outreach, education, funding, incentive programs, and the creation and provision of multi-media OH&S educational products and services to achieve its mission of injury prevention.

Speakers:

• Phillip Germain, B.S.
  VP Prevention & Employer Services
  Saskatchewan Workers’ Compensation Board
• Dale Walker, J.D.
  Director, Industry & Labour Services
  WorkSafe BC

The recording is available online for viewing. For a copy of the presentation, please email cwcs@cdc.gov.

Speakers from the Minnesota Department of Labor and Industry described how MN WC claims data are used in a variety of ways to inform administration of the system and produce information of value to stakeholders and the general public. A detailed description of cost adjustments was covered, to explain how MN attempts to accurately measure the real costs of claims across time.

Speakers:

• David Berry and Brian Zaidman
  Minnesota Department of Labor and Industry

The recording is available online for viewing. For a copy of the presentation, please email cwcs@cdc.gov.

Speakers from the International Association of Industrial Accident Boards and Commissions (IAIABC) presented information on an interstate collaboration through the IAIABC that is designed to lay the groundwork to build measures for comparing claims data across states.

Many states workers’ compensation administrative agencies collect data on WC claims that can be used for comparison with other states. But consistent definitions have frequently been a hurdle to comparability. Comparability across jurisdictions isn’t perfect, but Canadian provinces have demonstrated that working together with a patient approach can pay major dividends over time in the form of meaningful comparative data. In this webinar the speakers discussed a new survey through which the IAIABC is attempting to take a few steps toward the long-term goal of using state-collected claims data for comparison purposes.

Speakers:

• Heather Lore, B.A., MBA
  Senior Manager, Membership and Communications
  International Association of Industrial Accident Boards and Commissions (IAIABC)
• Mike Manley, B.A.
  Research Coordinator
  Oregon Department of Consumer and Business Services

The recording is available online for viewing . For a copy of the presentation, please email cwcs@cdc.gov.

Speakers from the state workers’ compensation insurance funds in Minnesota and California discussed prevention strategies. Details of each presentation are given below.

• Injury in our Schools- a Workers’ Compensation Perspective
  This presentation included an in-depth look at the causes and risk factors for injury to school district staff, with a special focus on the growing concern of student-perpetrated violence toward staff. The presentation also featured other current research as well as injury prevention strategies.
• California State Compensation Insurance Fund (SCIF) Prevention Strategies
  This presentation included a review of the latest prevention approaches at SCIF and a planned analysis of the quantitative impact of loss prevention services on losses of insureds receiving loss control services.

Speakers:

• Katherine Schofield, PhD, CSP, ARM, CHST, CSRM
  Risk Consultant
  Research Principal Investigator
  SFM-The Work Comp Experts
• Craig Stroinski, MBA
  Large Strategic Business Operations
  SFM-The Work Comp Experts
• Len Welsh
  Consultant to the President for Workplace Safety
  SCIF
• Lauren Mayfield
  Safety and Health Services Program Manager
  SCIF

Jointly sponsored by the NIOSH Center for Workers’ Compensation Studies (CWCS)(http://wwwdev.cdc.gov/niosh/topics/workercomp/cwcs/default.html) and the NIOSH Office for Total Worker Health™ (TWH), this webinar featured the latest in disability prevention research and lessons learned from secondary prevention in Colorado and Washington. Topics included: trends in medical care provision, the links between quality of care and development of long-term disability, and the far-reaching impacts research in this area may have beyond workers’ compensation systems.

Speakers:

• Kathryn Mueller, MD MPH,
  Medical Director, Colorado Division of Workers’ Compensation
  President, American College of Occupational and Environmental Medicine
• Gary Franklin, MD MPH
  Medical Director, Washington Labor and Industries
  Research Professor, University of Washington

The recording is available online for viewing . For a transcript of the live captions from the session, please email vqq3@cdc.gov

In this NIOSH Center for Workers’ Compensation Studies (CWCS) webinar, speakers discussed several ongoing and new prevention initiatives sponsored by the Ohio Bureau of Workers’ Compensation. The OHBWC has a long history of providing a number of prevention programs to prevent occupational injury/illness. For example, since 1999 OHBWC has offered a Safety Intervention Grant (SIG) program where employers are provided matching funds to implement engineering controls. Recently, OHBWC and CWCS found that the program significantly reduced affected employee injuries and costs and OHBWC greatly expanded the annual budget. This past year, the SIG program provided $15 million to 535 employers and OHBWC allocated an additional $45 million for fiscal years 2015-17. OHBWC also allocated another $4 million to fund four major initiatives designed to enhance the safety, health and wellness of Ohio’s workforce.

Speakers:

• Abe Al-Tarawneh
• Mike Lampl

In this NIOSH Center for Workers’ Compensation Studies (CWCS) webinar, speakers discussed the value of the International Association of Industrial Accident Boards and Commissions (IAIABC) Electronic data interchange (EDI) claims data collected by many states today. In addition, examples were provided to illustrate how some states are leveraging those assets through technology (analytic dashboards) to gain deeper insight into the WC system.

Speakers:

• Andre De La Fuente (Louisiana Workforce Commission)
• Nicholas Floeck (ISO)

A main purpose of the recent NIOSH Workers’ Compensation Surveillance Funding Opportunity (http://grants.nih.gov/grants/guide/pa-files/PAR-14-227.html ) is to encourage states to combine WC data with state employment data to determine trends in rates of claims by specific industry group, and by cause of injury to focus prevention efforts.

This NIOSH Center for Workers’ Compensation Studies (CWCS) webinar described the preferred methods of:

1. Joining state WC claim data (first reports of injury) and employment data (employee counts and NAICS industry from state unemployment compensation insurance system records) at the employer level using the federal employer identification number (FEIN)
2. Adjusting employee counts with hours per employee data from sources such as the Current Population Survey (CPS), American Community Survey (ACS), the Bureau of Labor Statistics Labor, Productivity, and Costs program (LPC), and the Current Employment Survey (CES) to estimate full-time equivalents (FTE)
3. Calculating rates of WC claims per FTE for more specific NAICS industries and employer size classes, and for industries with more regional variation
4. Conducting sensitivity analyses of rate estimates based on differences in estimates from the different data sources above and choosing key rates to focus upon

Speakers:

• Martha Jones (Vanderbilt University)
• Tim Bushnell (NIOSH)
• Steve Wurzelbacher (NIOSH)

Prescription drug abuse and overdoses are a major public health concern. The CDC reports that opioid overdose deaths in particular have quadrupled since 1999, with more than 16,600 deaths in 2010 alone. Many states have taken steps to control opioid use in their workers’ compensation systems by limiting opioid availability, educating health care providers on responsible opioid prescribing, and increasing awareness among injured workers. http://blogs.cdc.gov/niosh-science-blog/2014/05/14/opioid-abuse/

This webinar described prescription drug abuse prevention activities, emerging issues, and opportunities for future collaborations from the perspective of several organizations. Speakers included Noah Aleshire (National Center for Injury Prevention and Control), Gary Franklin (Washington Labor and Industries), Kathryn Mueller (American College of Occupational and Environmental Medicine), and John Hanna (Ohio Bureau of Workers’ Compensation).

Predictive analytics is an area of data mining that deals with predicting trends and behavior patterns. Workers’ compensation data includes detailed claims-based information (injury cause, nature) and survey-based information (employer workplace hazards and controls) that can be used to predict and prevent future injuries/ illnesses.

This webinar described some recent predictive analytic approaches being used on workers’ compensation data to develop evidence-based prevention strategies. Speakers included Griffin Schultz (Predictive Solutions), Joel Schneider (CNA Insurance) and Steve Wurzelbacher (NIOSH).

This webinar continued the topic of auto-coding presented 1/16/2014. Although material covered in the previous webinar is not a pre-requisite for attending this webinar, attendees will find it useful to watch the recording of the previous webinar beforehand. Speakers included Alexander Measure (BLS), Herman Tolentino (CDC), Gaurav Nanda (Purdue University), and Mark Lehto (Purdue University).

Workers’ compensation claims data usually includes a useful free-text (unstructured) data field that describes the cause of the claim and can be a rich source of information. However, manual coding these data fields is resource intensive and becomes impractical when the scope of a project includes a large number of claims. This webinar continued to introduce the audience to useful auto-coding techniques that utilize computer learning algorithms to code unstructured data.

The second webinar sponsored by the Center for Workers’ Compensation Studies held on Thursday, January 16, 2014 is now available online. Experts from the Liberty Mutual Research Institute for Safety (Helen L. Corns and Helen Marucci-Wellman, the National Institute for Occupational Safety and Health (Stephen J. Bertke and Alysha R. Meyers) and Purdue University (Mark R. Lehto) presented on the topic of auto-coding.

Workers’ compensation claims data usually includes a useful free-text (unstructured) data field that describes the cause of the claim and can be a rich source of information. However, manual coding these data fields is resource intensive and becomes impractical when the scope of a project includes a large number of claims. This webinar introduced the audience to useful auto-coding techniques that utilize computer learning algorithms to code unstructured data.

CWCS Webinar – WC Denominators 

This webinar described sources of denominators for workers’ compensation data analysis. Several researchers provided presentations that highlighted their recent analyses and methods for identifying appropriate denominators (e.g. person hours or employee counts) for workers’ compensation trending. Speakers included Martha Jones (Vanderbilt University), Mike Lampl (Ohio Bureau of Workers’ Compensation), Tim Bushnell (NIOSH), and Steve Wurzelbacher (NIOSH). Copies of the presentation are available by request by emailing: cwcs@cdc.gov

This NIOSH numbered document describes workers’ compensation insurance, the industry, its records, and the potential uses of relevant information for public health purposes. A need for the document was identified at the second workshop on workers compensation data use for occupational injury and illness prevention. The document was prepared with broad stakeholder input and published in 2013.

Occupational safety and health research and surveillance are essential for the prevention and control of injuries, illnesses and hazards that arise from the workplace. Research and surveillance can fill gaps in knowledge about where hazards exist and what interventions are effective at preventing workplace injuries, illnesses and fatalities. Workers’ compensation insurance records are a resource used for these primary prevention purposes. In addition, workers’ compensation records may be used for early detection of health outcomes in populations of workers which is part of secondary prevention. They may also be used to help identify effective medical treatment which is part of tertiary prevention.

Workers’ Compensation Insurance: A Primer for Public Health

Several government agencies and private organizations sponsored a workshop on the use of workers’ compensation data for occupational safety and health purposes which was held in June 2012. The workshop fostered discussions on opportunities for collaboration in the analysis of workers’ compensation data in order to help reduce the risks of occupational injuries and illnesses. Stakeholders from private insurance carriers, insurance associations, self-insured corporations, academic institutions and government agencies participated. This second workshop on this topic included discussions of 6 draft white papers along with 35 platform and poster presentations on research with workers’ compensation data. The following can be found within this document, NIOSH Publication Number 2013-147 :

• Bhattacharya A, Schulte PA, Anderson V. Workers’ Compensation Costs in Wholesale and Retail Trade Sectors in US.
• Krohm G, Wolf-Horejsh J, Aeillo T. Using Workers’ Compensation Administrative Data to Analyze Injury Rates.
• Morin J, Utterback DF, Shor G, Welsh L, Bogyo T, Wurzelbacher SJ. Workers’ Compensation Loss Prevention.
• Meyers AR, Wurzelbacher SJ, Bertke SJ, Lampl M, Robins DR, Bell J. Using workers’ compensation data for surveillance of occupational injuries and illnesses — Ohio, 2005–2009.
• Wurzelbacher SJ, Meyers AR, Bertke SJ, Lampl M, Robins DR, Bushnell PT, Tarawneh A, Childress D, Turnes J. Comparison of cost valuation methods for workers compensation.

The Use of Workers’ Compensation Data for Occupational Injury and Illness Prevention Workshop was convened to discuss opportunities for collaboration in the analysis of workers’ compensation data in order to help reduce the risks of occupational injuries and illnesses. Stakeholders from private insurance carriers, insurance associations, self-insured corporations, academic institutions and government agencies participated. Presentations described differences among state laws, proper interpretation of common industry terms, proprietary interests in insurance data, public release of internal analyses, and methods for linking workers’ compensation data with other health and employment data. The summary section describes the discussion sessions that identified some of the key advantages, limitations and future opportunities for collaborative research and surveillance using workers’ compensation data. The proceedings may be accessed at https://www.cdc.gov/niosh/docs/2010-152/ .