Tuesday, June 29, 2010

Demographics and Maritime Safety

Last week I was in New Orleans and the National Maritime Safety Association (NMSA) conference. My role was as a speaker on demographic effects and this gave me an opportunity to look at some of the demographic changes that are impacting the industry in the US and beyond. Demographics is a term that just means population characteristics (gender, age, occupation…). The association is interested in that range of activities that are involved in and about the shipping, terminal services, stevedoring and related businesses.

  • The population of dockworkers and drivers working from terminal operations in the US has some interesting characteristics. As a group, according to one California study, they have a heart disease death rate that is higher than the rest of the population—49% higher for drivers and 32% higher for dockworkers.

  • In the UK, a recent study listed the fatality rates of ‘dockers and stevedores’ at 28 per 100,000. That would make this cluster of occupations the second most deadly in the UK.

  • A report out of New Zealand noted that the current average age of ‘Able Seamen’ is 54 years. It also noted that 72% of this group has 30 years of work experience at sea, and 17% with more than 40 years’ experience at sea. The demographic issues are pretty clear: Who will replace these workers as they age and leave the industry?

  • An Australian report noted that there is a skill shortage for occupations related to their ports. It warned of a drastic depletion of skills due to the ageing workforce; moreover, the population of young people who would be available to fill those jobs is being offered many other alternative career paths.

The bottom line for this industry (and many others) is that there are going to be fewer young workers and many more older workers. Older workers may well stay beyond the ages of retirement in the past to fill the demand. It also means that many older workers will be in specific jobs they might not otherwise have performed in the past. As one attendee at the event noted, during the recession, many of the first workers to be laid off were the younger ones. This meant that many older workers had to do jobs that they had not done in years and jobs that had changed due to technology. As we know, new workers (even if they are older workers) in new jobs are generally at higher risk of work-related injury.

Two presentations at the event were of particular interest. The first was from a firm called Flight Level Solutions. The founder and leader of this group was a military fighter pilot and the team he works with includes an astronaut. They specialize in Crew Resource Management, a training approach that is origins in flight operations but is now being applied to diverse areas such as healthcare, public safety and manufacturing. The basic premise from a prevention perspective is that “Safety is a by-product of Standardized Execution”. The parallels to Six Sigma, Lean and TQM are obvious but the emphasis on cognitive and interpersonal skills is substantially higher in CRM. In the wake of the PB disaster, this approach may offer another avenue toward safety.

Finally, I was really impressed with the work being done by Louisiana Immersive Technologies Enterprises  for the Louisiana Department of Transportation. The technology demonstrated was a 3d interactive environment in which learners had to correctly position flag persons around a curve using a typical gaming controller. I subsequently found a brief article on the net. The speaker identified a couple of differences among learner groups. Learners who were gamers (mostly younger but not exclusively) immediately ‘got it’ and could apply what they had learned in lectures to this virtual world simulation. Others took a while to get the hang of it. With the gaming industry now exceeding the revenues of the film industry, the population of those who know how to game and operate in these immersive environments is likely to grow. There may be many more applications for this sort of learning in the future.

So demographics and maritime safety are linked both in the impact that demographic changes are going to have on the industry and on the technologies and training that will be needed to reach/teach/enable workers in the next couple of decades.

Friday, June 18, 2010

Will Washington state have the next Workers’ Comp system to allow competition?

In Washington State, the Department of Labor and Industries (LNI), is the publicly run workers’ compensation insurer and occupational safety and health authority for the state. It is one of only four remaining ‘exclusive’ state fund workers’ compensation insurers in the US. Exclusive state funds are the closest cousins of Canadian workers’ compensation boards and commissions. If the current campaign to get an initiative on the ballot, Washington’s LNI as it is called, will lose its exclusive insurer status and other insurers will be permitted to enter the market and compete for the sale of workers’ compensation insurance.

Citizen-based initiatives are relatively rare in Canada. In BC we have the example of a campaign to get a referendum in front of the electorate regarding the Harmonized Sales Tax. Initiatives are more common in the US. In Washington state, to take an initiative to the people ( that is, to get a proposal on the ballot for the next election), an initiative proposal must be filed with the state and then, within prescribed time frames and get endorsements from a specified number of registered voters. This year, the threshold is 241,153 signatures by July 2, 2010.

According to the information filed with the state, I-1082 has the following purpose:
This measure would permit certification of private insurers as industrial insurance insurers, and authorize employers to purchase state-mandated industrial insurance coverage through an “industrial insurance insurer” beginning July 1, 2012. It would establish a joint legislative task force to propose legislation conforming current statutes to this measure’s provisions, and would direct the legislature to enact such supplemental conforming legislation as necessary by March 1, 2012. It would also eliminate the worker-paid share of medical-benefit premiums.

The full text of the initiative is available at the following link:


Proponents of the initiative have a website www.safeourjobswa.com and opposition groups to the initiative have posted their arguments on a variety of websites and blogs including several union sites such as http://ibew191.com/node/443 and http://www.wslc.org/reports/2010/May/18.htm#Tuesday .

If the intent of the initiative sounds familiar, it should; this initiative has a similar intent to the Bill debated in the Ontario legislature late last year. As you will recall, that Bill sought to allow private insurers to enter the Ontario market and compete with WSIB for the sale of workers’ compensation insurance to employers in that market. (See my earlier post). In Canada, the US and Australia, when dissatisfaction with an exclusive state fund rises, so do the calls for privatization and competition despite strong evidence that private or competitive models will be no less costly or efficient.

Direct comparisons between Canadian Boards and individual states are difficult but from a number of research studies and analysis we can say that over the long run, the Canadian model delivers higher benefits to workers and lower costs to employers than the typical US system. We also know directly from research carried out by the late Terry Thomason and John F. Burton, that exclusive state funds (which included the BC and Ontario boards) consistently provided lower costs to employers over a two decade time frame than either purely private markets or markets where there was competition permitted with a state fund.

It remains to be seen if the proponents of I-1082 will achieve the required number of signatures. If they do, the initiative will appear on the November 2010 ballot. Whatever happens in Washington State (or Ontario), the best defense any exclusive system can mount against such initiatives is to provide incredibly customer-focused, efficient service to all our stakeholders and to work with them to reduce the human and financial costs of work-related injury, illness and disease.

Tuesday, June 8, 2010

Does the basis of calculating WC benefits influence reporting of claims?

If you miss time from work due to a temporary total disability, the amount you receive from an insurer will determine if you can put bread on the table and pay the rent. The quantum of compensation varies with the type of insurance.

Although we do not think of ‘sick leave’ as a form of insurance, in many ways it is like an insurance plan. Sick leave credits or allocations are often earned and may or may not have any residual value upon termination or retirement. In most cases, sick leave provides 100% of wages and is taxable. Sick leave plans are generally free of ‘deductibles’.

For those without sick leave plans as described above, Employment Insurance generally offers some sick leave benefits. In Canada, these amount to 55% of gross up to an insured maximum and all benefits are taxable. There is generally a two week waiting period before benefits may be paid under an EI claim.

Workers’ compensation is a form of insurance. The benefit rate for short term disability varies by jurisdiction. WorkSafeBC provides 90% of net earnings (where net equals gross earnings minus appropriate [mostly mandatory] deductions for employment insurance premiums and Canada Pension Plan contributions as well as applicable federal and provincial income tax) and compensation is tax free. BC does not have any waiting periods so benefits are payable from the day following the day of injury.

Not all workers’ compensation systems compensate at the same level. Most US states set the basis for compensation at 66 2/3% of gross earnings. A sampling of other jurisdictions reveal a range of alternatives—generally higher than the 67%:
• Maine uses 80% of worker’s ‘spendable’ earnings (or net wage after tax)
• Connecticut and Rhode Island uses 75% of worker’s spendable earnings
• Texas uses 70% of the worker’s pre-injury weekly in most cases
• Washington State’s compensation varies by marital status and number of dependents so the range is from 60% for a single to 75% (spouse adds 5% and each dependent 2%).

Most states have a waiting period of 3 to 7 days although most systems offer a ‘retroactive period’ such that the worker will be reimbursed for the waiting period if the wage-loss extends beyond (typically) 14 to 28 days.

Canadian jurisdictions generally compensate temporary total benefits at a higher level than their US counterparts. WorkSafeBC’s 90% compares well with other Canadian jurisdictions:

• Ontario, Prince Edward Island and New Brunswick use 85% of net
• Nova Scotia uses 75% of net for the first 26 weeks and 85% after that

Waiting periods are not common in Canada but do exist in New Brunswick (3 days), Nova Scotia (2 days) and PEI (3/5ths of weekly wage loss benefits to the worker.

While workers have an incentive to claim workers’ compensation benefits over EI for work-related claims, the same may not be true for work-related injuries.

Beyond the fact that waiting periods and departures from 100% of net earnings shift some of the costs of injury to injured workers, the level of compensation may influence reported injury rates. Take the case of a worker who suffers an injury that will result in two weeks away from work and a loss of $1000 net earnings (2 weeks at $500 per week). If the worker has access to a sick leave plan, the worker will likely receive 100% of usual net earnings or $1000. If the worker claims workers’ compensation benefits in a jurisdiction with a 3 day waiting period and an 85% of net benefit rate, the benefit will be $595. In a jurisdiction with no waiting period and a 90% of net benefit rate, the benefit will be $900. If the worker has the option of claiming either sick leave or a workers’ compensation benefit, it is clear that the sick leave route will minimize the burden of the injury the worker must bear. The propensity to not claim under workers’ compensation will increase (at least for shorter duration claims) the greater the financial cost the worker must bear.

This is another example where reported injury rates must be interpreted in context. As a general rule, one would expect jurisdictions with waiting periods and lower replacement of net earnings levels to experience lower injury rates for at least shorter duration injuries.

Tuesday, June 1, 2010

What's new in Canadian Research on Work and Health?

I spent part of last week at the Canadian Association for Research on Work and Health (CARWH) conference in Toronto.  The conference theme was Worker Health in a Changing World and participants included about 300 researchers from across Canada with some from the US and even Australia.

So, what was preoccupying the researchers at this event? There were so many threads, it is hard to pull them all together but here is a short list of topics that might give you a hint of the range discussed in sessions or presented in poster sessions:  asbestos, shiftwork/nightwork, vulnerable workers and those in precarious employment, stress, the heath of truck drivers, pesticides and cancer, effectiveness of OHS training and education, trends from Ontario's high risk firm intervention progam.

As with any multi-stream event, there is no way any one person can see or hear all presentations so it is a bit unfair to highlight some topics over others.  That said, I was really impressed by a couple of presentations that I did attend and think you will find them of interest as well. 

For those of you who work with larger employers, there was a great example from Fraser Health.  Shannon Atkins demonstrated how an internal call centre approach reduced the time for filing employer reports.  From the paper abstract, "Results to date are impressive. Form 7 submission timeline reduced from an average of 16.9 days to 1.72 days, with a mode of 0.04 days. Claim duration has been reduced from 49.2 days pre-call centre to 36.5 days."

Another fascinating presentation was "Long-duration claims – what is driving increases in duration and locked-in claims in Ontario?".  Sheila Hogg-Johnson's analysis showed that both duration and locked-in claims increase coincidentally with January 1998's Bill 99 legislative and policy change.  Now work is going in to examining exactly why. 

Several speakers discussed qualitative research examining topics like Joan Eakin's "The stigmatization of injured workers: The construction of "unworthiness" in the compensation process".  The care and concern for workers generally was reflected in every presentation.

Cameron Mustard's  work on comparing BC and Ontario long-term care injury rates and durations was preliminary but demonstrated the great power in using large data sets from different jurisdictions to ‘tease out’ differences (and that may lead to new approaches for fewer injuries and shorter duration).

One of the most insightful comments from the two days was contained in a presentation by Genevieve Baril-Gingras from Laval. She and a dozen other colleagues reviewed the occupational safety and health law in Quebec by examining its provisions with those of other jurisdictions elsewhere in Canada and the world. Their findings resulted in a set of recommendations, each one backed by what they found from the science and experience elsewhere.  And each recommendation was based on a proven provision in place in one or more of the other jurisdictions examined.  Clearly, there will be lessons for other OHS and workers' compensation agencies in this paper.

Beyond the findings and the recommendations, her presentation contained one line that really impressed me. She said: "Academic freedom = Responsibility".  Researchers need the freedom to gow where the research leads them, and if it leads them to conclusions that are uncomfortable or inconvenient, researchers still have a responsibility:  to tell it like it is. 

Just how research will be used by legislators and policy makers will depend on many factors.  The likelihood of making the best public policy decisions, however, depends on accurate, well researched information.  I'm glad there are people out there who take that responsibility in the study of work and health so seriously.