January 26, 2001

UPDATED APRIL 2002

Incident Intervention-- A Powerful Resource in Loss Control for Health and Safety Managers

Peter P. Greaney, MD
Board-Certified Occupational Physician
President, WorkCare

For most health and safety managers, work responsibilities encompass more than complying with OSHA standards and overseeing tailgate meetings. Aside from ensuring a safe and healthful workplace, managers must keep a close eye on the costs of their programs. They must identify and establish best work practices that maximize company resources and integrate cost-avoidance strategies.

To help meet this challenge, incident management services are available from qualified doctors, nurses and outsourcing firms. These services are designed to support company safety goals and targets--while reducing runaway-costs associated with workplace injuries/illnesses.

This practice--also known as Incident Intervention©--generates positive, and measurable results that cut lost-time accidents, reduce the number of OSHA recordables, lower workers' compensation costs and return recovered employees back to work in an expedient manner.

Incident Intervention is a two-phase process, involving pre-loss and post-loss services. Pre-loss Incident Intervention focuses upon using protocols to minimize the escalation of the incident, reducing the risk that it becomes a workers' compensation claim, lost work day(s) or OSHA recordable.

In this phase, the supervisor notifies an occupational doctor or nurse upon the occurrence of an accident. The supervisor provides information on the type, possible cause and scope of the incident. The occupational physician provides responsive evaluation of the incident, determines the most appropriate course of action and consults with the treating physician to design a quality care treatment plan that meets the needs of the employee and employer--in cases where the incident is work related.

The physician used to provide this service should be experienced in incident management. The doctor should have the expertise and training to serve as a "medical advocate" for the employee, recommending the "right" treatment plan that ensures appropriate patient care, while returning the employee to work as early as possible.

How Incident Intervention Works

This common back injury case illustrates how Incident Intervention works. A worker injured his back while lifting an object at a job site. The supervisor responded by sending the employee to a clinic. The clinic's doctor determined that the worker suffered a mild back strain and prescribed prescription-strength Motrin for one week. The doctor sent the employee back to work, but the treatment he prescribed caused the incident to be an OSHA recordable injury, as defined in OSHA's revised recordkeeping rule (29 CFR 1904), which went into effect on January 1, 2002 .

One of the key provisions of OSHA's recordkeeping rule is the revised definition of first aid. Understanding what constitutes first aid is critical because " any medical treatment that goes beyond first aid meets the general recording criteria and is thus recordable. "

The rule states: "For medications available in both prescription and non-prescription form, a recommendation by a physician or other licensed health care professional to use a non-prescription medication at prescription strength is considered medical treatment for recordkeeping purposes ."

A doctor with expertise in incident management could have "intervened" to use their medical expertise to look at the full range of treatment options-some which may not be OSHA recordable. The doctor's goal is to provide workers with appropriate, effective care, while never losing sight of how their medical decisions affect employers.

And the key to successful Incident Intervention is to establish contact with an occupational physician as close to the time of injury as possible. There is a real window of opportunity to affect the outcome of a case. The sooner an occupational physician gets involved, the greater the impact that doctor can have on the case.

The post-loss phase (after incident) is aimed at returning a recovered employee back to work as quickly as possible. Employers should consider adopting disability-management systems that use a proactive approach to return employees back to work. These systems are critical in reducing workers' compensation and other disability costs. Research indicates that most companies experience a 25-30 percent reduction in disability costs in the first year after implementing a disability-management system that includes return-to-work programs.

Such programs include "transitional employment," a process in which the employer and employee agree on a scheduled plan with incremental steps (duration, production speed, lift capacities and other job functions) that are designed to encourage the full productivity of a returning employee.

Transitional employment is not light duty. It is a process in which the employee has expressed the desire to return to full capacity work or the treating physician recommends a return to work. In transitional employment, the employer and employee agree to a working plan that allows the employee to work at a level that is safe and tolerable. An occupational physician can assist in setting up this plan.

Incident Intervention Versus Typical Patient Treatment

Typically, a physician will rely exclusively on the employee 's perspective to determine if the worker should return to work. Without input from the employer, doctors often prescribe time-off for work-related injuries.

Through Incident Intervention, corporate medical directors who work on behalf of clients can consult with the treating physician to establish alternative patient treatments. The corporate medical director will ask the treating physician what type of work the employee can perform and recommend a modified work plan-instead of time off. These "doctor-to-doctor" calls have proven to be effective in reducing workers' compensation claims, preventing lost workdays and getting the employee back into a productive role.

The Disability Mindset

Occupational doctors have reported that it takes less than a few days for a person to buy into the "I-can't-work-syndrome."

"Getting employees back to work as quickly as possible helps avoid the disability mindset," said WorkCare Physician Dr. Peter Wald.

Measurable Results

Mike Luker , Industrial Hygiene Manager for US Filter, discussed the benefits of Incident Intervention. According to Luker, his company has avoided 8-10 lost-time accidents a year by using this practice.

"In most cases, employees are back to work on restricted or full duty. This is a service our workers' compensation carrier can not perform," he said.

Insurance companies only provide case management services after an incident becomes a claim and they have been informed, which is typically 6-10 days after the incident.

Summary

Incident Intervention provides critical resources that support health and safety corporate goals-providing managers with measurable results in cost avoidance.

If you would like further information on Incident Intervention, please contact www.workcare.com or email info@workcare.com .