Tier distinction no longer clearcut
Lost-time and no-lost time claim categories are not as valuable as they once were in evaluating how well workplaces are performing in primary prevention, according to a study from the Toronto-based Institute for Work & Health (IWH).
The study — "The Relationship Between Worker, Occupational and Workplace Characteristics and Whether an Injury Requires Time Off Work: A Matched Case-Control Analysis in Ontario, Canada" — was published by the American Journal of Industrial Medicine in April 2015.
The distinction between lost-time and no lost-time injuries is no longer clearcut, said Peter Smith, an IHW scientist and lead author of the study.
"Our data suggest that we need to improve the way we assess safety performance by moving beyond lost-time claims as the only performance metric," he said.
"We need to include all injuries in assessing performance, and when a claim does not result in time off work, we should collect information that tells us whether no time was lost because the injury was relatively minor or because modified or alternative duties were available. This is important, as preventing absences does not tell us whether we are preventing serious injuries, only that we are preventing absences."
The need to distinguish between lost-time and no-lost-time claims is imposed on Ontario employers by the Workplace Safety and Insurance Board (WSIB). When assessing a firm’s safety performance, the WSIB weighs lost-time injuries more heavily than no-lost-time injuries, Smith said.
This is because, traditionally, lost-time claims have been viewed as more severe injuries and are therefore expected to incur greater future costs. However, more active workplace accommodations and claims management following injuries has blurred the line between time-lost and no-time-lost claims, said Smith.
The IWH study examined about 7,000 no lost-time claims using WSIB data. Researchers matched each no lost-time claim with as many as four lost-time claims that were similar in terms of the type of injury, the event leading to the injury, the part of the body injured and the year the injury took place.
The study found factors that were expected to affect time-lost injury claims were, in reality, inconsequential.
Researchers assumed workers who were young or new to the job would be less likely to take time off work following an injury. There was no evidence of this in the findings.
Additionally, researchers found no relationship between employer size and whether a claim was reported as a time-lost or no-time-lost injury.
What the study did conclude, Smith said, was the physical demands of the job and the workers’ compensation premium rate as paid by the employer have just as much of an effect on whether or not time is lost as a result of an injury as the nature of the injury itself.
"If you have a high premium rate, you have the potential to receive the largest rebates or the largest surcharges," Smith said. "Firms with the highest premium rates have the most financial incentive to reduce the number of lost-time claims."
Workplace policies such as accommodation and claims management are often used to reduce lost-time claims, Smith explained, but do not necessarily reduce injuries. This makes the use of lost-time and no-lost-time claims to monitor the success of workplace safety programs challenging.
Change needed
Safety consultant Alan Quilley said a move away from counting time-lost and no time-lost injuries would be an improvement for workplace safety.
"It’s much more important to know what a company does to create safety than how many injuries they may or may not have had," Quilley said. "We will always count injuries and their related human and financial costs. Giving this data meaning that it doesn’t have makes us do inappropriate and ineffective things."
Providing meaningless busy-work for employees unable to perform their regular duties because of an injury and claims management — where a worker is told to report that no time off work occurred even though it did or is told not to report the claim at all — are methods used by employers to minimize time-lost claims, said Quilley.
"There is a lot of good that comes from early return-to-work plans if they help the worker recover," he said. "If the goal is to only minimize your misguided ‘safety stats,’ it’s a very bad idea."
More effective methods to minimize time-lost injury include job modifications or accommodations. Something as simple as changing a worker’s tasks or schedule can allow her to do meaningful work despite any limitations she may have due to her injury.
Smith agreed that proactive efforts to minimize workplace hazards and encourage a workplace culture that prioritizes employee participation in health and safety are the best way to control time-lost injury claims.
As Quilley put it, "Working on behaviours to reduce at-risk behaviour and encourage safe behaviour has proven to be highly effective. It’s better to count the locked gates at the end of the day rather than the missing cows in the morning."
