THE SOARING INCREASE IN workers' compensation costs is an equal opportunity plight that pervades the bottom line of government as well as private industry. The Massachusetts National Guard would at first glance seem an unlikely victim of workers' compensation difficulties. However, with over 2,000 full-time federal personnel, the majority of whom are significantly exposed to the risk of on-the-job injuries in the areas of aircraft and heavy equipment maintenance and material handling, the possibility becomes much more real. The Guard responded to its own workers' compensation cost spiral as they would to any other natural or man-made disaster: by meeting it head-on with a carefully planned three-pronged approach aimed at reducing costs.
In 1988, the Massachusetts National Guard initiated an aggressive program to control and reduce its escalating workers' compensation costs based on intensive case management, an institutionalized accident prevention program and a carefully managed return-to-work program. In turn, this program had the full commitment of a management and labor team devoted to cost reduction, accident avoidance and back-to-work goals.
To control medical care costs the Guard contracted the intensive case management of some workers' compensation cases to occupational health nurses at a hospital in Eastern Massachusetts. These particular cases required specialized knowledge and communication skills in dealing with the attending physicians and the injured workers. The cost of employing the nurses was small compared to the savings associated with assisting the injured workers in the recovery process and in their return to work.
The Guard's accident prevention program resulted in more than a 36 percent reduction in lost-time injuries over the four-year period from fiscal years 1988 through 1991. The main components of this program were setting safety standards and holding line managers and supervisors responsible for accidents or unsafe conditions in their managerial areas. Management and bargaining unit personnel were apprised that nearly 80 percent of workplace accidents are the result of human error, and that in nearly 70 percent of industrial accidents one of the contributing causes is a supervisory deficiency. This awareness rapidly changed the mind-set of both employees and supervisors who were in a position to reduce accidents.
The program also relied on the use of written safety standards, accident and performance appraisals, and quarterly safety council meetings in which accidents and unsafe practices were reviewed and corrective action taken. In addition, safety and occupational health training was promoted to assist in accident prevention.
To ensure compliance with safety standards, the Guard incorporated job safety elements in the performance evaluation and appraisal standards used to evaluate both supervisory and non-supervisory personnel. The required duties for Guard workers include support of the safety and occupational health programs and observation and compliance with all safety rules and regulations established for the facility. Responsibility and accountability were the key factors leading to the success of the accident prevention program.
A safety council, made up of personnel involved in workers' compensation issues, reviewed National Guard claims and attempted to determine causes and remedial action for each accident. In a recent analysis, the council found that workers' compensation costs stemming from back strain were three times higher than costs associated with any other injury. Consequently, the Guard purchased commercial videos and brochures on back injury prevention and instituted safe lifting programs to be used in curbing the occurrence of disabling injuries. …