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Helpful new studies, surveys and guides

Lump-sum settlements encourage employees to return to work

While some may argue that a large, lump sum settlement delays returning to work because employees do not have an immediate need for income, a four-year study by researchers from the Workers Compensation Research Institute (WCRI) of 2138 Michigan workers found lump-sum settlement of Workers' Compensation claims encourage injured employees to return to work.

They found more injured workers returned to work than left work. The exception is older workers who experienced a decline in employment after a settlement.

Study sheds light on risk factors for neck pain among office workers

A study into the work-related causes of neck-pain in office workers has found that being a woman and having a history of neck complaints are the key known risk factors.

The researchers reviewed a number of prospective cohort studies on office workers published between 1980 and 2011 to gain insight into the association between work-related risk factors (physical and psychosocial) and the onset of 'non-specific neck pain,' which is defined as 'neck pain (with or without radiation) without any specific systematic disease being detected as the underlying cause of the complaints.'

The results from their study, Office workers' risk factors for the development of non-specific neck pain: A systematic review of prospective cohort studies, was published in the journal "Occupational Environmental Medicine."

Some of the findings dispute commonly accepted beliefs:

While female gender and a previous history of neck complaints were identified as the 'only' risk factors by researchers, they conceded that literature on the development of non-specific neck pain in office workers is 'scant.' The report can help identify office workers most at risk for non-specific neck pain and enhance resource allocation to those most likely to benefit from it, according to the authors.

Coalition of healthcare organizations publish guidance for Outcomes-Based Wellness Incentives

A coalition of health care organizations has produced new guidance for the use of outcomes-based incentives in employer-sponsored wellness programs. Outcomes-based incentives provide employees with a financial reward for meeting a specific health target-or a penalty may be imposed for failure to meet a health standard-rather than simply providing an incentive to participate in the program.

While the guidance does not advocate for an outcomes-based incentive approach, it is intended to help ensure that worksite wellness programs utilizing such incentives are effective and fair to all employees, and improve health results. Outcomes-based incentives may become more common in the workplace as a result of provisions in the Patient Protection and Affordable Care Act.

Guidance for a Reasonably Designed Employer-Sponsored Wellness Program Using Outcomes-based Incentives, was published in the July 13, 2012, issue of the Journal of Occupational and Environmental Medicine and included the following ten recommendations:

  1. Consider using the four biometric target categories of weight, cholesterol, blood pressure and tobacco use. These align with the guidance provided in a 2008 Field Assistance Bulletin issued by the U.S. Department of Labor and are the most commonly used targets by employers.
  2. Factor in potential financial and time burdens for employees when determining the specific standard you are asking them to meet.
  3. Consider whether the incentive design is likely to place a greater economic burden on one race, ethnic group or other category of employees.
  4. Consider incentive designs that are reasonable goals (preferably individualized to the employee) rather than ideal targets applied rigidly to all employees.
  5. Offer (as required by law) a reasonable alternative standard to employees for whom it would be unreasonably difficult to achieve a health standard due to a medical condition, or who have a medical reason that makes it inadvisable for them to do so within the allotted time.
  6. For employees with a medical condition that makes it unreasonably difficult to achieve the health standard, or medically inadvisable to do so, consider deferring to the views of the employee's health care provider for setting and achieving a reasonable alternative standard or providing a waiver.
  7. Consider providing all employees with options for attaining the incentive, rather than only offering an alternative standard to those with a medical circumstance. This can be particularly important for employees who have legitimate hardships, outside of medical circumstances, that make it difficult for them to meet a rigid health standard.
  8. Avoid using a reward or penalty that is so large it discourages health plan enrollment, denies coverage, or creates too heavy a financial penalty on individuals who do not satisfy an initial wellness standard. Some industry experts suggest, based on extensive real-world experience administering such programs, that amounts in the range of $40 to $60 per month are capable of generating behavior changes by many participants, at least in the short run.
  9. Consider an incentive design that rewards for progress toward the standard targets, instead of just rewarding employees who meet the goal. This acknowledges the effort and behavior change that is at play, rather than focusing only on the outcome.
  10. Consider strategies that help employees integrate healthy behaviors into their personal value framework by promoting individual choice, so they are more likely to sustain healthy behavior changes over time. For example, encourage autonomy and personalization by using a health coach or other qualified health professional to tailor a standard to an individual's circumstances or to provide follow-up support in pursuit of a standard.

Physician-dispensed drugs adds to escalating Workers' Comp costs

A recent study, Physician Dispensing in Workers' Compensation, from the Workers' Compensation Research Institute (WCRI) found that many Workers' Compensation prescription drugs dispensed directly from physicians often cost significantly more than a pharmacy for the same medications.

In Illinois and Florida, physician dispensed drugs accounted for almost two-thirds of all drug costs in 2010-11. Other states with high costs include Maryland - 47%, Pennsylvania - 27%, Tennessee 25%, and Michigan - 22%.

In addition to the Workers' Compensation system absorbing the expense of physicians' boutique prices for prescription medications, the study notes:

The study compares 23 states, including Arkansas, Connecticut, Florida, Illinois, Indiana, Iowa, Louisiana, Maryland, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Virginia, and Wisconsin. Five states (Arizona, California, Georgia, South Carolina, and Tennessee) recently adopted reforms aimed at reducing the costs of physician-dispensed drugs. The data include post-reform results for Arizona and California and pre-reform baselines for Georgia, South Carolina, and Tennessee. Also included are three states where physician dispensing is prohibited in general (Massachusetts, New York, and Texas).

It is sometimes argued that convenience and control (to ensure that the claimant receives the drugs) are valid reasons for physician dispensing and that limiting reimbursement to the price of the non-repackaged drug will mean doctors won't dispense. Yet, California instituted price controls limiting reimbursement to the price of the non-repackaged drug several years ago; over half of all scripts in California are still dispensed by physicians, just as they were pre-reform and costs are in line with utilization. Perhaps most troubling is the unanswered question of a profit motive's impact on prescribed treatment.

Using criminal background checks in hiring decisions

According to a new survey by Society of Human Resource Management (SHRM), Background Checks: The Use of Criminal Background Checks in Hiring Decisions, approximately two-thirds (69%) of organizations conduct criminal background checks on all of their job candidates. Roughly one-half of organizations conduct criminal background checks to reduce legal liability for negligent hiring (52%) and to ensure a safe work environment for employees (49%). The top two convictions that are very influential in the decision not to extend a job offer are violent felonies (96%) and nonviolent felonies (74%). However, about three-fifths (58%) of organizations allow job candidates to explain the results of their criminal checks before the decision to hire or not to hire is made.

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Police stress linked to health problems

Job-related stress puts police officers at higher risk for long-term physical and mental health problems, according to a new study from the University at Buffalo. Researchers studied 464 police officers from the Buffalo Police Department over five years and found a link between stress and obesity, suicide, sleeplessness and cancer.

In many areas, officers fared worse than the general population. Officers who worked the night shift had a higher risk for metabolic syndrome, a cluster of symptoms that includes abdominal obesity, hypertension, type 2 diabetes and stroke.

Also, suicide rates were eight times higher among working police officers than retirees, and officers with 30 years of service had an increased risk of developing Hodgkin's lymphoma and brain cancer.

Researchers said police culture discourages seeking treatment for stress because officers fear they will be taken off the street or not promoted. Recommendations include addressing the signs of stress and treatment during police officer training.

The study was published in the July issue of the International Journal of Emergency Mental Health.

Why employees become whistleblowers

With OSHA's ramped up encouragement of whistle blowers, employers may want to read "Inside the Mind of a Whistleblower." According to this Ethics Resource Center (ERC) report, whistleblowers almost always make some effort to root out wrongdoing internally before going outside the organization with their concerns. The new report said that only two percent of employees go solely outside their companies to report misconduct. The research also found that employees generally turn to the government or other outside sources because the violation is substantial and the company has been slow to respond, not because of financial incentives.