What happened at the IAIABC Convention – Part 2

Celebrating the centenary of workers’ compensation in the U.S. was the major theme at IAIABC Convention. The opening session was a specially commissioned play depicting the events running up to the establishment of the first workers’ compensation system in the U.S. In Wisconsin, as elsewhere, the need for greater certainty for workers and employers was high on the list of features both sides wanted.  Just as important was the idea that workers’ compensation would act as a major driver of safety changes. 

It is also important to recognize the context of the times. By 1911, modern workers’ compensation law was already part of the landscape in Germany, so it had a track record that was beneficial to understanding the value proposition of the proposed new legislation. It was also a time of great tension between labour and capital.

As depicted by the play, the new legislation was not universally praised. As with most compromises, there were those who wanted more out of the deal. That tension has always been present, and there are few signs that the future will see that tension disappear. Retiring Executive Director, Greg Krohm, of the IAIABC made this point in his opening remarks. While generally positive about workers’ compensation, Greg believes some workers still fall through the cracks. He also points to broader changes in society that are forcing workers’ compensation systems to adapt. As he put it in his opening remarks, it would be odd if workers’ compensation did not change to adapt to trends such as a declining unionized workforce, aging population, and growing medical costs. On this point, Greg quoted NCCI as saying the “Medical/Indemnity pie” that describes workers’ compensation expenditures now registers more than 60 percent on the medical side. 

Greg’s remarks highlighted a belief that recent changes in workers’ compensation law do not really change anything for the large central population of injured workers. He noted a troubling trend in some states where claims are made that lack any likely work-relatedness, yet are pursued to try and reach a settlement. This drives up costs, and creates an impetus for restrictive legislation for these marginal cases. 

While Greg could see no definite pattern of “take-aways” from labour in recent workers’ compensation reform, Professor John F. Burton had a very different view. He noted that workers’ compensation premium costs are often raised as an issue, and pointed out that in the workers’ compensation context declining premiums may or may not be a good thing. In a bid to drive down premium rates, benefits have been cut in his view. He noted that replacement rates on permanent partial disability claims in several states are well below the 50 percent level in states such as California, Oregon, Washington, and even the host state of Wisconsin (among others). He also pointed to the issue of apportionment [apportioning causation in part to work and in part to other causes] in California, and the rise in large deductible policies as being further changes that undermine the system. 

Apportionment of permanent disability on the basis of causation in California terms, accepts the principle that an injured worker has a right to be compensated for a disability that is work-related, but limits the employer’s obligation to compensate an injured worker for a disability that is not work-related.

[Under California Labor Code Section 4663, “(a) Apportionment of permanent disability shall be based on causation. (b) Any physician who prepares a report addressing the issue of permanent disability due to a claimed industrial injury shall in that report address the issue of causation of the permanent disability.”] 

Professor Burton felt strongly that the apportionment issue was a significant shift from the dictum of “taking the worker as you find him.” Greg felt the shift was less pronounced, and noted the “as the employer finds him” position was more related to Arthur Larson’s influence, which he characterized as “very liberal”, than any fundamental principle of workers’ compensation itself. 

The debate over large deductibles included one point of view that suggested firms with such large deductible policies are really self-insured for part of their loss. Some argued that this provides greater incentives to invest in safety. On the other hand, many administrators pointed out that such policies may result in unintended consequences including under-reporting of injuries [why report if there is no insurance to be paid?]. 

Others suggested greater numbers of large deductible policies make funding of oversight, appeal, inspection and prevention initiatives more difficult. These functions are typically funded through assessments on the premiums paid (large deductibles mean lower premiums paid, therefore, lower assessment income to fund other programs). 

There were many more issues discussed at this event and I will raise some of these in future posts to this blog.

What happened at the IAIABC’s Convention-Part 1?

A few weeks ago I attended the International Association of Industrial Accident Boards and Commission’s 97th annual convention in Madison, Wisconsin. Wisconsin was the first state to have a constitutional worker's compensation law and that centenary was a central theme of the convention. While other states in the U.S. have some claim to concurrent or even earlier laws, Wisconsin probably wins by virtue of the first fatality claim being paid under legislation declared valid by the state’s Supreme Court.   

As a speaker, I was honoured to receive a commemorative coin specially minted for the centennial. The antique bronze medallion bears the image of the Wisconsin capital building and the state’s motto, “Forward” on one side. On the obverse, a stylized “W” and character illustrate the compromise that was reached a century ago. The presentation case included a card stating I would also receive a printed commemorative volume of the “reflections” on the history and development of workers’ compensation in the U.S., but you can read the content of those reflections online. By the way, the placement of the apostrophe on the coin is correct. Wisconsin’s system is the “worker’s compensation” system; all others in Canada and the U.S. use the plural possessive “workers’ compensation.” (More trivia: another exception to the plural-possessive rule is the title of the legislation in British Columbia, which omits the apostrophe altogether).   [gallery]

The importance of workers’ compensation as social legislation as opposed to pure insurance, was also underscored in part by reference to the 50th anniversary celebrations held in 1961. While in the present environment it may not be possible to garner the same attention, for that anniversary the U.S. Post Office issued a stamp, and President Kennedy gave an address in recognition of the half century milestone.

What was fascinating about the various sessions exploring the development of workers’ compensation in the U.S. was the focus on its nature as a compromise, and its intent as mechanism to improve the health and safety of workers. I was impressed how often the theme of occupational health and safety was presented both in its historical sense and as the present and yet undiscovered land (after all, we have been at it for 100 years and we have yet to achieve safe workplaces free of work-related injury, illness and death). Several presenters made reference to the 1972 Report on National Commission on Workmen’s Compensation. The commission was chaired by John F. Burton, Jr. who was an honoured guest at the convention. It is interesting to note the commission’s view on prevention: 

"We recommend that insurance carriers be required to provide loss prevention services, and that the workmen's compensation agency carefully audit these services. State-operated workmen's compensation funds should provide similar accident prevention services under independent audit procedures where practicable."

A hundred years on, one has to wonder how much of a priority prevention services really are.

On a similar note, OSHA in the U.S. appears to be evaluating if state OSHA programs are living up to their requirements to offer occupational safety and health programs at the state level that are of equivalent effectiveness as those offered by the national agency. The enhanced Federal Annual Monitoring and Evaluation (FAME) reports make interesting reading for any agency that has a prevention mandate. Timeliness of reports, what’s included in databases, and how enforcement is being done are all included. In the ones I’ve read, there are also responses from the state agencies with concrete actions and commitments.   

I’ll have more from this event in a later post.

A few weeks ago I attended the International Association of Industrial Accident Boards and Commission’s 97th annual convention in Madison, Wisconsin. Wisconsin was the first state to have a constitutional worker's compensation law and that centenary was a central theme of the convention. While other states in the U.S. have some claim to concurrent or even earlier laws, Wisconsin probably wins by virtue of the first fatality claim being paid under legislation declared valid by the state’s Supreme Court.   

As a speaker, I was honoured to receive a commemorative coin specially minted for the centennial. The antique bronze medallion bears the image of the Wisconsin capital building and the state’s motto, “Forward” on one side. On the obverse, a stylized “W” and character illustrate the compromise that was reached a century ago. The presentation case included a card stating I would also receive a printed commemorative volume of the “reflections” on the history and development of workers’ compensation in the U.S., but you can read the content of those reflections online. By the way, the placement of the apostrophe on the coin is correct. Wisconsin’s system is the “worker’s compensation” system; all others in Canada and the U.S. use the plural possessive “workers’ compensation.” (More trivia: another exception to the plural-possessive rule is the title of the legislation in British Columbia, which omits the apostrophe altogether). 

The importance of workers’ compensation as social legislation as opposed to pure insurance, was also underscored in part by reference to the 50th anniversary celebrations held in 1961. While in the present environment it may not be possible to garner the same attention, for that anniversary the U.S. Post Office issued a stamp, and President Kennedy gave an address in recognition of the half century milestone.

What was fascinating about the various sessions exploring the development of workers’ compensation in the U.S. was the focus on its nature as a compromise, and its intent as mechanism to improve the health and safety of workers. I was impressed how often the theme of occupational health and safety was presented both in its historical sense and as the present and yet undiscovered land (after all, we have been at it for 100 years and we have yet to achieve safe workplaces free of work-related injury, illness and death). Several presenters made reference to the 1972 Report on National Commission on Workmen’s Compensation. The commission was chaired by John F. Burton, Jr. who was an honoured guest at the convention. It is interesting to note the commission’s view on prevention: 

"We recommend that insurance carriers be required to provide loss prevention services, and that the workmen's compensation agency carefully audit these services. State-operated workmen's compensation funds should provide similar accident prevention services under independent audit procedures where practicable."

A hundred years on, one has to wonder how much of a priority prevention services really are.

On a similar note, OSHA in the U.S. appears to be evaluating if state OSHA programs are living up to their requirements to offer occupational safety and health programs at the state level that are of equivalent effectiveness as those offered by the national agency. The enhanced Federal Annual Monitoring and Evaluation (FAME) reports make interesting reading for any agency that has a prevention mandate. Timeliness of reports, what’s included in databases, and how enforcement is being done are all included. In the ones I’ve read, there are also responses from the state agencies with concrete actions and commitments.   

I’ll have more from this event in a later post.

What can you learn from an old name tag?

I was cleaning out a drawer the other day and came across an old name tag. Time has yellowed its face a little and the pin clip has separated from the back, but the old logo and print are still very readable.  

When I started at WorkSafeBC as a vocational rehabilitation consultant (VRC), this was an essential part of my kit. Before lanyards, swipe cards, and security gates became the norm in industry and at WorkSafeBC, this little name tag was something I wore when I went to visit injured workers in hospitals, schools, and jobsites. 

Back then VRCs were expected to make at least two presentations every quarter. I took this requirement as a challenge. I would arrange to speak to employer groups, chambers of commerce, and rotary luncheons (not as easy as it sounds). My presentations focused on rehabilitation and return-to-work outcomes but the questions always strayed into areas of assessments, experience rating, claims policy and prevention/regulation. I usually wore my own name tag to such events. It was my introduction and it drew a little more attention than those sticky “Hello, my name is” labels ubiquitous at such events.    

You will note the name tag doesn’t say “Vocational Rehabilitation Consultant.” Even if it did, I am certain every audience I spoke to considered me “that guy from WCB.” I think this reaction was cunningly intentional on the part of the vocational rehabilitation leadership of the day.  I learned very quickly that in order to have credibility with these audiences, I had to live up to that billing — I had to know more about every aspect of our business. 

As anyone who has tried presenting or teaching something knows, the process of preparation and delivery deepens your knowledge. I read and could quote from George Nelson Wright’s Total Rehabilitation — the vocational rehabilitation bible of its day. I prepared examples from my own experience of successful training-on-the-job initiatives. I  also learned to anticipate the questions that would be asked including those outside my own role. 

When I could, I would co-present. I would bring along others to answer the tough questions and I would learn from them. My credibility depended on giving correct answers and on delivering on any commitments for further information I would make; more importantly, that credibility would make a difference in creating return-to-work opportunities and fostering a safety culture that ultimately protects workers.    

Finding that name tag reminded me that regardless of my role, I am the face of WorkSafeBC to every employer, service provider, worker or representative I meet. The lesson, however, is not specific to me. If you work in the world of workers’ compensation, you need to know about primary prevention, walk the talk when it comes to safety, understand how insurance works, and believe in rehabilitation/return-to-work. No one can know all the answers but every time you facilitate an answer from another part of the worker's compensation system and listen to the answer, your understanding and potential to make a difference increases.  

Not a bad reminder from an old name tag.