Monday, February 17, 2014
Are there systemic barriers to reporting injuries and filing claims?
A worker gets injured in a work-related incident yet there is no record of a work-related injury with the state or federal agency responsible for recording this information. Unfortunately, this scenario gets played out every day in workplaces everywhere and leads to complaints about “under-reporting.” Tracing the causes behind the under-reporting can be complex; some are very personal while others are systemic and should be addressed.
Why is full reporting of work-related injuries important in the first place? An accurate, timely injury report is an indicator of failures in the safeguards, defenses and barriers in the workplace that prevent hazards from injuring workers. Training, supervision, adherence to safe work procedures and design are what control the risks associated with any enterprise from shop-floor manufacturing to teaching a college course. When an injury occurs, it reveals a pathway or trajectory between the hazard and the worker. The failures may be inherent or active but knowing about them is important is the first step to fixing them. Failure to report the incident to the responsible agency (OSHA, State OSHA, Provincial Ministry of Labour, WorkSafeBC, etc.), may place other workers at risk.
The failure to attribute a work-related injury to work activity means the healthcare costs for diagnosis, emergency treatment and rehabilitation may be externalized to taxpayer-funded universal healthcare or premium supported medical plans. That lets the specific industry that gave rise to the injury off the hook and can drive up premiums and costs of taxpayers and non-occupational medical coverage. Even if the non-occupational health plan is paid for by the employer, the attribution of work injuries to non-work activity may influence premiums for all participants in private or taxpayer-supported health plans.
Why would anyone not want to report a work-related injury? From a worker perspective, particularly if the worker is young, new in the job, or in some form of precarious employment, there may be fear about the consequences of reporting the injury or making a claim. In some cases, despite real and often quite severe injury, the worker will deny a work connection to a physician or emergency room staff. I have heard workers say, “getting injured is just part of the job” and unless they are taken away in an ambulance they just shrug it off. Nurses, doctors, fire fighters, police and corrections officers, and construction workers are among those most susceptible to this line of thinking. Surveys have found that many workers believe getting injured or developing an occupational disease is just an inevitable consequence of work. Getting injured is not inevitable or just part of the job, but these sentiments are often perpetuated by workplace culture.
Even well-meaning initiatives can result in suppression of work-related injury reporting. “Safety incentive programs” that reward groups for injury-free status fall into this category.
Sometimes the systemic barriers are an unintended consequence of procedures designed to make a system fair or more efficient. Although combining worker and employer reports of injury into one may be seen as a means of streamlining and reducing duplication, it may have the unintended consequence of putting the employer in a heightened power position over a vulnerable worker; the worker may seek to avoid that situation and, as a consequence, the injury goes unreported. Even features such as filing claims by telephone or over the internet may pose barriers for workers with language or communication challenges.
Scheme design can also create barriers. Many knowledgeable commentators are concerned about premium incentives such as experience rating that may contribute to suppression of injury and workers’ compensation reporting. A rational or unjustified fear of the consequence of injury reports on experience rating may inadvertently encourage managers to “absorb” the cost of work absence and health care due to work-related injury under other leave and care plans. Every review of an experience rating system should include an examination of its consequences on injury and claim reporting.
Active suppression of injury reporting and worker’ compensation claim filing is prohibited in most jurisdictions. Beyond the illegality of these actions, they have the consequence of putting others at risk, increasing the cost of work-related injury to the injured worker (family and community), and increasing the costs to other public and private insurance plans—creating an unintentional subsidy to the industry giving rise to the injury.