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INJURED WORKER’S ATTITUDE DRIVES AMAZING COMEBACK

WE’VE GOT YOUR BACK!THE 10 MOST COMMON LOST-TIME INJURIES

TOLEDO ZOO TAKES THE BITE OUT OF WORKERS’ COMP PREMIUMS

SUMMER 2007SUMMER 2007

2 WORKERS’COMP

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S U M M E R 2 0 0 7 THE 10 MOST COMMON

LOST-TIME INJURIES BWCidentifiestheseinjuries

andoffersinformationaboutcommoncausesandprevention

HEALTH CARE

We’ve got your back

14

10

22

Eighty percent of Americans will

sufferfrombackpainatsomepoint

in their lives. What makes your

backsovulnerable?Theansweris

amatterofsimpleanatomy.

EMPLOYER Toledo Zoo takes the

bite out of workers’ comp premiums

26

Sinceopeningitsdoorsmorethanacenturyago,theToledoZoohasmadevisitorsafetyatopconcern.But serious injuries forced thepark to make employee safety apriority,too.

Contents

IN EACH ISSUE

5 FROM THE TOP

6 NEWS BRIEFS

8 CALENDAR

25 SAFETY TOOL Stayhydrated thissummer

�0 ROUNDTABLE Tipstohelphealth-care

providersserveinjured workers

18 SAFETY How to write a company safety manual Step-bystepinstructions youcanusenow!

WORK FORCE Accentuating the positive Whenanaccidentcaused

JaneHostetleradevastinginjury,shefaceditwithapositiveattitiudeandpoweredherwaybacktowork.

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Administrator/CEOMarshaRyanActing Chief Operations OfficerTinaKielmeyerActing Chief of Medical ServicesDr.GregoryJewellActing Superintendent of Safety & HygieneLynnKruseActing Chief of MarketingJeremyJacksonActing Director of CommunicationsRyanRekstis

Editorial ManagerRobertLoomisManaging EditorCharmianToddBoydArt Coordination/DesignDonnaMolnarPhotographerDawnWeber

Contributing WritersAriaAlaudini,SuzanneA.Brown,ErikHarden,BillMonaghanContributing DesignerShereenStreeter

InquiriesOhioBureauofWorkers’CompensationWorkers’ Comp QuarterlyCommunicationsDivisionP.O.Box15277Columbus,OH43215-0277E-mail:[email protected]

General information Forinformationaboutworkers’compensation,logontoohiobwc.com,orcall1-800-OHIOBWC.

Subscription Forafreesubscriptionortoreportaddresschanges,contactWCQbyfaxat(607)[email protected].

Workers’ Comp QuarterlyispublishedforOhioemployers,employeesandthehealth-careindustrybytheOhioBureauofWorkers’Compensation(BWC)basedoninformationavailableatthetimeofpublication.Pointsofview,ideas,products,servicesordevicesfeaturedinWorkers’ Comp QuarterlydonotconstituteendorsementbyBWC,anequalopportunityemployer.

WhenreprintingWorkers’ Comp Quarterlyarticles,pleasecredittheoriginalsourceofpublication.

Whiletheinformation,recommendationsandphotographscontainedinthispublicationhavebeencompiledfromsourcesbelievedtobereliable,BWCmakesnoguaranteeasto,andassumesnoresponsibilityfor,thecorrectness,sufficiencyorcompletenessofsuchinformationorrecommendations.Additionalsafetymeasuresmayberequiredunderparticularcircumstances.

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This philosophy earned Mack Iron Works a 2006 Governor’sExcellence in Workers’ Compensation Award (GEA), but thereal winners are the Sandusky-based company’s employees. Theyrecently celebrated 1145 consecutive days without a lost-time accident.

Once again, BWC is looking for employers who are committed togoing above and beyond when it comes to providing a safe workplaceand an efficient workers’ compensation program for their employees.

BWC and the governor present these awards annually to the bestof the best in three categories: private state-fund, self-insuring andpublic employers. So, if you work for or know of a deservingorganization, nominate it today for a 2007 GEA!

For more information or nomination forms, visit ohiobwc.comand click on:

• Ohio Employers;• Featured Links;• Governor’s Excellence Award.

We’re looking for the best of the best!

Safety in the workplace is not so

much a program as it is a culture,

to be encouraged and promoted

by every person in the organization.”

“

– John O. Bacon, president,The Mack Iron Works Co.

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Administrator/CEOMarsha Ryan

Introducing Marsha Ryan

FROM THE TOP

IamMarshaRyan,andI’mpleasedtointroducemyselfas

administrator/CEOofBWC.Duringthenextseveralmonths,I

hopetohearfromyouaboutthepolicyandoperationalchallenges

facingBWCandtolearnwhatyouexpectfromOhio’sworkers’

compensationsystem.

BWCplaysanimportantroleinthelivesofindividualOhio

workersandinthevitalityofthestate’sbusinesses.Wehavethe

responsibilitytohelprestorebrokenfamiliesandhelpemployers

grow.However,thereismuchworktodoforustosucceed.

Therefore,IaskforyoursupportasIundertaketheveryimportant

challengeofrestoringconfidenceinandcompetencytotheagency.

MyplanforBWCwillincludearelentlessfocusoncustomer

service,transparencyandalignmentofgoalsthroughouttheentire

organization.Iwillestablishclearperformancemetricstoresetthe

cultureandpermitthemanygoodemployeesatBWCtogiveyou

thevalueyouexpect.

Iamconfidentwecanachieveoursharedobjectivesofbringing

equityandfairnesstoOhio’sworkers’compensationsystem.Ilook

forwardtoworkingwithemployersandworkersaliketodeliver

thestraightforwardserviceandsimplesolutionsyouexpectand

deserve.

Editor’s note:Logontowww.ohiobwc.com/home/current/bios/

MRyan.asptolearnmoreaboutRyan’sprofessionalexperienceand

civicactivities.

6 WORKERS’COMP

NEWS BRIEFS

BWC extends rebate incentive to employersBWC is continuing its safety council incentive program in 2007. Private and public state-fund

employers who join their local safety councils and meet participation requirements will receive a 2-percent premium rebate. They will also earn an extra 2-percent performance rebate if they reduce the severity and frequency of injuries by 10 percent, or keep both at zero.

“This program not only saves employers millions annually, but it also helps them make their workplaces safer,” says Tina Kielmeyer, acting chief operations officer. “Because of this past year’s success, we feel it’s important to continue the program.”

To receive the 2-percent rebate, employers must join a local safety council by July 31, 2007, and:• Send a representative to at least 10 monthly meetings;

• Submit semiannual workplace accident reports;

• Have the chief executive officer attend one of the required meetings.Empoyers who meet these requirements and reduce their injury frequency and severity rates by 10

percent, or keep both at zero, will earn an additional 2-percent rebate.Last year, more than 4,300 employers shared in $22 million as a result of their successful participation

in the incentive program.While self-insured employers and state agencies can become active safety council members, they do

not qualify for the rebate. — AA

Watch for your summer payroll report in July

Private state-fund employers, watch your mailboxes in early July for the Jan. 1 through June 30, 2007, payroll repor t . When you receive the report, complete and return it to BWC — along with your premium payment — by Aug. 31, 2007.

A convenient way to file and pay

You can file your payroll report elec-tronically and pay your premium online by logging on to ohiobwc.com. It’s quick and easy. You can file your payroll report and pay your premium online 24 hours a day, seven days a week with a few clicks of the mouse. Turn to the ad on the back cover of the magazine for details. — RL

BWC provides rate relief for private sector employersEncouraging economic trends, continued rebuilding efforts cited

Premium rates for private sector employers will remain stable for the 2008 fiscal year, which starts July 1, 2007. BWC recommended this zero-percent average rate change and the Workers’ Compensation Oversight Commission approved it. It is the first time in five years that BWC did not recommend an average rate increase for private sector employers.

Mercer Oliver Wyman, BWC’s external actu-ary, examined a myriad of economic and workers’ compensation trends before providing the bureau with a premium range for the new fiscal year. The firm’s range supports BWC’s recommendation not to increase rates based on improved operational performance over the past fiscal year. Claims continue to trend downward as a result of a number of factors, including a greater focus by employers on workplace safety. Medical payments also continue to decline, as BWC has reduced expenses by $44 million over nine months.

While indemnity payments have increased, the primary driver has been lump-sum settlement payouts, which focus on settling high-reserve

permanent total disability and death claims. Temporary total disability benefits have declined by approximately $12 million.

Overall, BWC maintains combined net assets in excess of $661 million. This represents an improvement of $778 million relative to the begin-ning of fiscal year 2007. Net investment income contributed $958 million to the growth of net assets. However, an operating loss of $170 million partially offset those gains. The State Insurance Fund, which is BWC’s primary fund, maintains net assets that exceed $2 billion.

BWC’s trade combined ratio has decreased to 75.1 percent as of March 31, 2007, compared to 111.2 percent one year earlier. The trade combined ratio is an indicator of the potential profitability of BWC’s business. It includes the impact of BWC’s operating and investment revenues, and all related expenses. This means BWC incurs expenses of approximately 75 cents for every $1 it earns. BWC’s combined ratio, which excludes investment income, also declined from 139 percent to 107.2 percent

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Ohio Bureau of Workers’ Compensation

Dates and locations

This free course is a valuable tool for anyone

interested in reducing the risk of workplace

accidents due to drug and alcohol use.

Learn how to create your own drug-free workplace

program. Employers wanting the cost savings and

increased productivity of a drug-free workplace,

and employees seeking improved safety, health,

security and morale that a drug-free workplace

offers, should attend.

Enhancing Safety through a Drug-Free Workplace

is a half-day course. You can earn 0.� continuing

education units by attending.

It’s convenient, effective and free to Ohio employers.

BWC offers training course

Enhancing Safety through a Drug-Free Workplace


For more information or to register, log on to bwclearningcenter.com. You may also call 1-800-OHIOBWC, and press option 2 and then 2 again.

8.14.07 Columbus

9.11.07 Cincinnati

10.30.07 Cleveland

11.7.07 Canton

2.7.08 Youngstown

4.6.08 Columbus

5.28.08 Toledo

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Morethan4,500Ohioemployerswillsavemillionsofdollarsontheirworkers’compensationpremiums.Andyoucan,too.

Geta2-percentrebateonyourpremiumbybecominganactivememberofoneof76BWCDivisionofSafety&Hygiene-sponsoredsafetycouncils.*Reduceeithertheseverityorfrequencyofinjuriesby10percent,orkeepbothatzero,andyouwillearnanadditional2-percentperformancerebate.

• Learntechniquesforincreasingsafetyinyourworkplace.• Learnhowtobettermanageyourworkers’

compensationprogram.• Networkwithotheremployersinyourcommunity.• Accessuseful,money-savingworkers’compand risk-managementinformation.

Toqualifyforthepremiumrebate,youmustmeetthefollowingeligibilityrequirements:

1. JoinyourlocalsafetycouncilbyJuly31,2007;2.Attend10safetycouncilmeetingsorBWC sponsoredevents;**3.Sendaqualifiedsenior-levelmanagertoa safetycouncilsponsoredfunctionormeeting;4.Submitsemiannualworkplaceaccidentreports forthe2007calendaryear.

Formoreinformation,call1-800-OHIOBWCandpressoption2,andthen2again.Youmayalsovisitohiobwc.com,andclickonSafetyServices,Yoursafety,thenOhiosafetycouncils.

*Thisofferexcludesself-insuringemployersandstateagencies.However,BWCencouragesallemployerstobecomeactivesafetycouncilmembers.

**Atleasteightofthesemustbethroughthelocalsafetycouncil.YoucangetcreditforuptotwomeetingsbyattendingBWC’sWorkers’CompensationUniversity,OhioSafetyCongress&ExpooratrainingclassofferedthroughtheDivisionofSafety&Hygiene.

Don’t miss the chance to save on your premium

CALENDAR

*BWC’sDivisionofSafety&Hygienesponsorsalltrainingclasses.Formoreinformationortoregister,logontowww.bwclearningcenter.com.Youwillneedtoenterakeywordtoregister,whichyoucanfindinthetrainingclassdescription.Youmayalsocall1-800-OHIOBWC,andlistentotheoptions.

’07June National Safety Month:

Encouragesafetyawarenessinyourworkplace.

June 1 Private employer retrospective-

rating application deadline

June 6 Training class—FirstAidinthe

Workplace;SpringfieldCustomerServiceOffice,Springfield*

June 7 Training class—Ergonomics:

DevelopinganEffectiveProcess;Governor’sHillCustomerServiceOffice,Cincinnati*

June 12 Training class—Asthma!IsYour

CompanyatRisk?;OhioCenterforOccupationalSafetyandHealth(OCOSH),Pickerington*

June 1� Training class—10-Step

BusinessPlan;GarfieldHeightsCustomerServiceOffice,GarfieldHeights*

June 1� Training class—AdvancedRate

Making;Governor’sHillCustomerServiceOffice,Cincinnati*

July Private, state-fund and black-

lung employers receive semiannual payroll reportsfortheJan.1toJune30,2007,reportingperiodfromBWC.

Findoutwhichemployersreceivedthe2007Governor’sExcellenceinWorkers’CompensationAward.Logontoohiowbwc.com,andclickonOhioEmployers,thenGovernor’sExcellenceAward.

July 1 New premium year begins,and

BWCassessesprivatestate-fundemployers;stateagencypublicemployers;andself-insuringemployerstheirnewrates.

New rating year beginsforprivateemployersparticipatingingrouprating,retrospectiverating,thePremiumDiscountProgram+,Drug-FreeWorkplaceProgram,Drug-FreeEZandtheOneClaimProgram.

July 15-20 The eighth annual National

Fraud Awareness Weekissetasideasatimetoeducatebusinessesandconsumersaboutthethreatoffraud.

July 11 Training class—10-Step

BusinessPlan;Governor’sHillCustomerServiceOffice,Cincinnati*

July 25 Training class—JobSafety

Analysis;PortsmouthCustomerServiceOffice,Portsmouth*

Aug. 9 Training class—Non-Violent

StrategiesforCaregivers;OCOSH,Pickerington*

Aug. 1� Training class—Restaurantand

FoodServiceSafety;GarfieldHeightsCustomerServiceOffice,GarfieldHeights*

Aug. 16 Training class —Restaurantand

FoodServiceSafety;OCOSH,Pickerington*

Aug. 22-2� Training class —ConfinedSpace

AssessmentandWork;OCOSH,Pickerington*

Aug. �0 Training class—Temporary

TrafficManagement;OCOSH,Pickerington*

Aug. �1 Private, state-fund employers’

applicationsforthePremiumDiscountProgram+,theDrug-FreeWorkplaceProgramandDrug-FreeEZfortheJuly1,2007,ratingyearareduetoBWC.

Public employers’ group-rating application deadlineforthe

Jan.1,2008,ratingyear

Private state-fund employers’ payroll reports and premiumsforthereportingperiodof

Jan.1toJune30,2007,areduetoBWC.

Self-insuring employers’ assessment payments forthereportingperiodofJan.1to

June30,2007,areduetoBWC.

BWC’sDivisionofSafety&Hygienesponsorsalltrainingclasses.Formoreinformationortoregister,logontowww.bwclearningcenter.com.Youmustenterakeywordtoregister,whichyoucanfindinthetrainingclassdescription.Youmayalsocall1-800-OHIOBWC,andpressoption2,then2and2again.

SUMMER

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NC

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Morethan4,500Ohioemployerswillsavemillionsofdollarsontheirworkers’compensationpremiums.Andyoucan,too.

Geta2-percentrebateonyourpremiumbybecominganactivememberofoneof76BWCDivisionofSafety&Hygiene-sponsoredsafetycouncils.*Reduceeithertheseverityorfrequencyofinjuriesby10percent,orkeepbothatzero,andyouwillearnanadditional2-percentperformancerebate.

• Learntechniquesforincreasingsafetyinyourworkplace.• Learnhowtobettermanageyourworkers’

compensationprogram.• Networkwithotheremployersinyourcommunity.• Accessuseful,money-savingworkers’compand risk-managementinformation.

Toqualifyforthepremiumrebate,youmustmeetthefollowingeligibilityrequirements:

1. JoinyourlocalsafetycouncilbyJuly31,2007;2.Attend10safetycouncilmeetingsorBWC sponsoredevents;**3.Sendaqualifiedsenior-levelmanagertoa safetycouncilsponsoredfunctionormeeting;4.Submitsemiannualworkplaceaccidentreports forthe2007calendaryear.

Formoreinformation,call1-800-OHIOBWCandpressoption2,andthen2again.Youmayalsovisitohiobwc.com,andclickonSafetyServices,Yoursafety,thenOhiosafetycouncils.

*Thisofferexcludesself-insuringemployersandstateagencies.However,BWCencouragesallemployerstobecomeactivesafetycouncilmembers.

**Atleasteightofthesemustbethroughthelocalsafetycouncil.YoucangetcreditforuptotwomeetingsbyattendingBWC’sWorkers’CompensationUniversity,OhioSafetyCongress&ExpooratrainingclassofferedthroughtheDivisionofSafety&Hygiene.

Don’t miss the chance to save on your premium

’07


SUMMER

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10 WORKERS’COMP

TOP10LOST-T IMEINJURIES FEATURE

by Bill Monaghan

The10andwaystoavoidthem

most commonlost-time injuries

10 WORKERS’COMP

BWC’sreviewofapprovedworkers’

compensationclaimsinOhiofrom1996

to2005foundthatfiveofthe10most

commonlost-timeinjuriesinvolvedthe

spine.Fourofthesearespecifically

backrelated(seestoryonpage14),

andsevenofthetop10were

sprainsorstrains.

Thisarticlelistsandexplains

thesecommoninjuries

identifiedduringthestudy

period.Italsooffers

informationabout

commoncauses

leadingtothese

injuriesandhow

topreventthem.

However,BWC

intendsforthis

articletobesolely

informational.It

shouldnotreplace

medicaladvicefrom

yourhealth-careprovider.

Pleaseconsultyourphysicianfor

specificadviceabouthowtotreatany

injuriesyoumayhavesuffered.

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The lumbar region of the spine is the lower back. A sprain or strain occurs when there’s extra pressure placed on a back that is already vulnerable. Lifting and/or bending at the waist can contribute to lumbar sprains or strains. Even a particularly violent sneeze can trigger these injuries.

During the study period, 56,000 claims or 13 percent of all lost-time claims approved in Ohio included the diagnosis of a lumbar sprain or strain.

Sprain/strain, lumbar region of back01

Neck sprains and/or strains can occur when the head and neck wrench around violently, stretching the muscles or tearing the ligaments that hold the cervical vertebrae. Motor vehicle crashes, prolonged awkward posture and overhead work are common causes.

Neck sprains or strains accounted for 34,700 lost-time workplace injuries in Ohio during the study period. Defensive driving and avoiding occupational risk factors are your best protection against this type of injury. Exercises that strengthen the neck muscles can help.

Sprain/strain, neck02

Lumbosacral strains or sprains result from excessive stretching of muscles or tearing of the ligaments supporting the lower back, including those supporting the sacral vertebra — the five fused bones at the base of the spine. Common causes include traumatic events — a fall, sudden movement — and overuse of the back muscles by lifting and other stresses.

As with any sprain, the pain caused by the injury can irritate the surrounding muscles, caus-ing them to contract and causing even more pain. With lumbosacral sprains particularly, the pain can severely limit everyday activities.

Sprain/strain, lumbosacral region of the back03

Knowledgeand

exercisecanreduce

yourriskofstrains

(overstretchingof

muscletissue)and

sprains(tearingof

ligamentsofajoint,

thetissueconnecting

twoormorebones).

Reducing the risk of sprains and strains

• Strengtheningtheat-

riskpartsofyourbody

withexercisecanhelp.

Dowarm-upandcool-

downstretchesbefore

performingphysical

work.Takeabreak

whenyourbodyfeels

tired.

• Wearproperfootwear

andotherappropriate

clothingandgear.

• Wearingbracesor

similardeviceshas

notbeenshownto

preventsprainsand

strains.However,

adoctormight

prescribesuch

devicesduring

rehabilitation.

by Bill Monaghan

12 WORKERS’COMP

Shoulder and upper arm sprains involve the partial tearing of the ligaments and tissues that surround and connect the bones of the shoulder. Falling on an outstretched arm, twisting or pulling of the shoulder or arm and one-handed lifting can cause these types of sprains.

Leg and knee sprains involve the tearing of the ligaments supporting the knee. This can happen when the knee is forcefully twisted by stopping suddenly while running, stepping awkwardly while twisting, falling or being hit on either side of the knee or in the front of the knee while it is bent and the foot is planted on the ground.

The 12 vertebrae between the neck and the lower back hold the ribs and make up the thoracic region of the spine. Pushing and pulling often cause a strain or sprain here, which affects the muscles and ligaments of the middle of the back.

Sudden forceful trauma, such as being in a car crash, can cause severe cases.

Sprain, shoulder and upper arm 04

Sprain, leg and knee 05

06 Sprain/sprain, thoracic region

Between each pair of vertebrae is a disc of strong tissue that connects and cushions the ver-tebrae. The gelatinous center of the discs can dry out over time and become less effec-tive. This can eventually cause the center to squeeze out through a crack in the outer layer.

Also called a herni-ated disc, this usually occurs below the waist, in the bottom two discs of the lumbar region of the spine.

Due to Ohio work-e r s ’ c o m p e n s a t i o n requirements, lumbar disc displacement is usu-ally accompanied by an allowance of a lumbar sprain or strain. Patty Phil lips, BWC’s injury ma nagement ser v ices director, says the disc dis-placement was usually pres-ent in such cases all along. The preliminary diagnosis of a sprain or strain is appro-priate until a subsequent examination confirms the disc displacement.

Early treatments involve rest, punctuated with exer-cises to keep joint stiffness and muscle weakness from sett ing in. Treatment a lso includes anti-inf lammatory medicines and drugs to control pain. Your caregiver may try a variety of other methods to reduce pain enough to allow you to start the exercises required to return to a more normal lifestyle.

07 Lumbar disc displacement


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Treating tears, sprains and strains

Put injuries on RICEManyofthesecommonworkplaceinjurieswillhealwithoutsurgery,butit’salwaysagoodideatoconsultwithahealth-carepractitioner.Evenwhatlookslikeasimplebruisemayover-layabrokenboneorothertissuedamage.

Butformostoftheseinjuries,RICEisallyouneedtofacilitatehealing.

RICEisanacronymfor:

• Rest —Takeabreakfromtheactivitiesthatcontributedtotheinjuryoraggravatetheinjuredtissue;

• Ice —Applyicetoreducebleedingandswell-ing,controlpainandmusclespasms.Applyicefor20to30minuteswithaone-ortwo-hourbreakbetweenapplications;

• Compression—Useanelasticbandagetocompresstheinjuredarea,reducingbleedingandswelling;

• Elevation—Raisetheinjuredbodypartabovetheheart.Gravitywillhelpdrainfluidsand/orminimizeswelling.

Over-the-countermedicationstoreduceinflam-mationandpaincanalsohelpduringtheheal-ingprocess.

Equipmentisavailabletohelpspeedrecoveryaswell.Slingsandbracesimmobilizeaninjuredarm.Kneeandanklebracescansupportthosejointswhiletheyheal.Cervicalcollarstakeweightoffasprainedneck.

Somepeoplelooktoalternativemedicalpractices—relaxationtraining,biofeedback,acupunctureandchiropracticorosteopathicmanipulation—toreducepainduringrecovery.

An ankle sprain is a tear of one or more of the ligaments that support the ankle. It can happen by falling or suddenly twisting the ankle.

Contusion means bruise. It’s a swelling and discoloration of the skin caused when the underly-ing blood vessels are damaged in an injury and leak blood under the skin.

Bruises generally do not pose a medical emer-gency; nonetheless, they should receive immediate care. Severe bruising can lead to extreme swelling and bleeding and may be a sign of underlying tissue damage, such as a broken bone.

Menisci are shock-absorbing tissues between the bones in the knee. There are two in each knee, with the lateral meniscus on the outer side of the knee and the medial on the inner side.

Most injuries to the meniscus are trauma-related, a compression or twisting of the knee caused by sudden movements. The inner tissues of the menisci break down over time, so even minor events like squatting can injure the menisci in an older person.

08 Sprain, ankle

09 Contusion, knee

10 Tear, medial meniscus

WCQ


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ONYOURSIDE HEALTH CARE

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We’ve got your back!Tips for avoiding back injuries

by Charmian Todd Boyd

When it comes to back pain, it’s true what they say; misery loves company.

The American Academy of Orthopae-dic Surgeons says 80 percent of Americans will suffer from back pain at some point in their lives. And treating these kinds of injuries is costly. A Duke University Medical Center study reports Americans spent $90 billion on health care for their backs in 1998. That was 1 percent of the U.S. gross domestic product that year.

BWC research found similar results. Four of the 10 most common lost-time work injuries

from 1996 to 2005 were back related. (See story on page 10.)

That’s one reason why BWC offers its Web-based training class, Avoiding Back Trauma Online. The class is especially useful for workers whose jobs require them to do any lifting, pushing and/or pulling. It gives you a basic understanding of how the back works, types of back injuries, risk factors leading to injury and how to avoid them.

To enroll in the class, log on to bwclearning-center.com, or call 1-800-OHIOBWC, and press option 2 and then 2 again. You may also log on to ohiobwc.com, and click on Safety Services for details on this and other resources BWC offers to make your workplace safer. There you’ll find other tips to keep your back healthy, including BWC’s lifting guidelines.

Structure of the backSo what makes your back so vulnerable to

injury? As you’ll learn from the class, the answer is a matter of simple anatomy.

The spine or backbone is the basic skeletal structure of your neck, back and pelvis. It’s a series of 33 bones or vertebrae, which fit together like a puzzle. (Please see diagram.) These bones protect the spinal cord, which is the main pathway from the

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Controlling the risksIt’s important to identify the risk factors in

your workplace. Then, put controls in place to reduce or eliminate the risks.

BWC’s ergonomists can help you with this pro-cess. And there’s no extra charge for their service. Simply call the BWC customer service office nearest you to set up an appointment.

Ergonomists analyze the physical relationship between a worker and his or her workplace. Then, they suggest better ways for the worker to do the job by reducing or getting rid of risk factors that can cause injuries.

These BWC safety experts can help you figure out what types of solutions to put in place. They may suggest:

• Engineering controls or permanent work-place modifications to reduce or eliminate specific risks;

• Process controls or ways to re-design job processes to eliminate or reduce unnecessary or duplicate steps;

• Administrative controls or steps manage-ment can take to reduce worker exposure to risks. While these solutions don’t eliminate specific hazards, they can lessen the risks individual workers face.

Be aware of false controls and marketing ploys! Just because a product’s label claims it’s ergonomic does not mean it is.

brain to the body’s peripheral nervous system. In other words, it’s how the brain sends and receives messages throughout your body.

In a healthy person, a disc with a gel-like center sits between each bone in the neck (cervi-cal), mid-back (thoracic) and lower back (lumbar) regions of the spine. The discs cushion the bones so the vertebrae do not rub directly against each other. The five bones in the sacral spine usually fuse together by your early 20s. Four coccygeal bones, which are also fused, make up the tailbone section of your spine. So, hurting your “back” generally means you have injured one of these specific regions of your spine.

In addition, many muscles, tendons and liga-ments hold the spinal bones together. Add to that all the joints, nerves and other components your spine needs to function, and you start to see how complex — and painful — spinal injuries can be.

Types of back injuriesAcute disorders

These injuries result from a single incident with a clear cause and effect relationship. This means you can pinpoint exactly what caused the injury and when.

Cumulative disordersMost back injuries are cumulative or overexer-

tion disorders, which result from multiple incidents over time. Sometimes, these types of injuries can mimic acute disorders.

Risk factors for back injuryPersonal risk factors

Though back injuries can happen to anyone at any time, your physical health can be a source of risk. In other words, you may have a better chance of recovering from and maybe even avoiding certain types of back injury if you’re physically fit and healthy.

Occupational risk factorsSome jobs are more commonly associated

with back injuries, such as those requiring lift-ing, repetitive motion, forceful exertion, direct mechanical pressure, static or awkward posture, and inadequate recovery time between tasks.

Improper workplace design can also lead to or aggravate back pain.

ONYOURSIDE HEALTH CARE

WCQ

Cervical

Thoracic

Lumbar

Sacral spine

We’ve got your back!Tips for avoiding back injuries

16 WORKERS’COMP

Lifting Guidelines Spinal injuries can be avoided

Fiveofthe10mostcommonlost-timeinjuriesinOhioaffectthespine—lumbardiscdisplacementandsprainsorstrainsoftheneckandofthelumbar,lumbosacralandthoracicregionsoftheback.

BWCergonomicsexpertChrisHamricksaysBWC’sWebsiteofferstoolsforcalculatingtheinjury-riskofvariousliftingscenarios.(Followthelinksfromwww.ohiobwc.com/employer/programs/safety/Ergoliftguide.asp.)

Buthesaysit’sbetterstilltorethinkajobfromthebeginning.

First,lookforwaystoeliminateanyliftingonthejob.

Ifyoucan’teliminatelifting,tryautomatingtheprocessandhaveamachinedothework.

Ifyoucan’tautomatethetask,seeifyoucanmechanizeit.Bringinequipmentworkerscanusetohelpwiththelifting.

Ifnoneofthatworks,maketheliftingeasierontheback.Hamricksaysyoushould:

• Placetheitemsinthebestspotforlifting.Liftingbundlesfromatableiseasieronthebackthanliftingthemfromthefloor;

• Adjusttheweights.Lowertheweightoftheobjectsothatitiswithinacceptableguidelines;

• Positionmaterialclosetothebody.Thefartherawaytheloadisfromthebody,themorestressisplacedonthespineandthehighertheriskofinjury;

• Modifythejobtofitwithinworkercapabilities.Ifemployeesmusthandlematerialmanually,designthejobtoreducethestressonthebodyasmuchaspossible. — BM

• Learn common risk factors for back pain.

• Get useful tips for avoiding back injury at work and home.

• No travel time or expense to attend the class.

• Learn at your own pace.

• Class available online 2�/7.

BWC’s Web-based class can help

Avoiding Back Trauma Online

BWC’sDivisionofSafety&HygieneoffersWeb-basedandothertraditionalclassesatnoextrachargetoOhioemployerswithactiveBWCpolicies.Employerscanmaketheseclassesavailabletotheiremployees.

Find out how to lessen your chances of back injury

16 WORKERS’COMP

For more information or to register, log on to bwclearningcenter.com, or call 1-800-OHIOBWC, and press option 2 and then 2 again.

17 ohiobwc.com

For more information or to register, log on to bwclearningcenter.com, or call 1-800-OHIOBWC, and press option 2 and then 2 again.

Find out how to lessen your chances of back injury

This course is a half-day training class* available at no extra charge to employers with active BWC policies.

Find out how to start a health and wellness program in your workplace. Learn:• Strategies for promoting or improving

wellness at work;• Benefits to employees and employers;• Return-on-investment information to

win management support;• Elements of a wellness program

(weight control, fitness, nutrition, health screenings, stress management, tobacco cessation, etc.).

*Continuing education units available.

Healthyemployeescostless,aremoreproductiveandaddmoretothebottomline!


BWC presents Wellness in the Workplace

Dates and locations9.5.07 Columbus9.18.07 Cincinnati10.4.07 Portsmouth10.23.07 Toledo11.20.07 Cleveland12.18.07 Springfield1.10.08 Youngstown2.14.08 Canton3.18.08 Columbus4.16.08 Cincinnati4.30.08 Cambridge5.7.08 Youngstown5.21.08 Cleveland

18 WORKERS’COMP

ONYOURSIDE SAFETY

How to write a

Thesestepscanhelpyoutodevelopan effective safety system for yourcompany.Writingasafetymanual isjustonepartofthatprocess.

Recognize there’s no cookie-cutter approach to developing a safety system or manual for your company.

Your company has unique safety needs. And the resources it has to meet those needs (finances, staffing, etc.) are also unique.

So, what you do to develop your company’s safety processes depends on: who you are, the industry you’re in, your company’s size and available resources and its unique goals.

1

Think of safety as a system, not just as a program.

Most likely, your goal in reading this article is to learn how to write a safety manual. As you read, though, you’ll discover your goal should be about more than that.

Dan Petersen, Ph.D., is a nationally recog-nized safety management and organiza-tional behavior expert. He is the author of “Integrating Safety into TQM” (total quality management).

Petersen says for your company to have suc-cessful safety systems, it must have a culture that perceives safety as a high corporate value. Your company’s executives must provide safety leadership. And corporate procedures must involve employees both in the problem solving and decision making. In this type of progressive culture, “safety becomes a system, rather than a program.”

So, beware! If you want to have effective safety processes, you’ll have to do more than just write a safety manual. A manual that sits on the shelf collecting dust will not prevent injuries.

2

by Charmian Todd Boyd

Step-by-stepinstructionsyoucanusenow!

company safety manual

19 ohiobwc.com

Seek professional help.

Set up an appointment with a local BWC safety consultant as soon as possible. BWC employs safety consultants throughout the state to assist you in developing your own safety systems — from scratch, if needed. Their services are available at no extra charge to any employer with an active BWC policy.

Their expertise is far ranging — from general safety and health to ergonomics, and indus-trial hygiene to construction safety. What-ever your industry, BWC’s consultants can help you identify or refine your company’s unique safety goals and develop customized processes to meet your needs.

Simply call the BWC customer service office nearest you to schedule a consultation, or call the bureau’s Division of Safety & Hygiene at 1-800-OHIOBWC, and press option 2 and then 2 again. You can also log on to ohiobwc.com and click on:

• Safety Services;

• Consulting services;

• Request consulting services online.

3

4 Assess your needs.

Your BWC safety consultant will help you assess your company’s management system to see what is already in place. “The purpose is to see where your company is with safety, and then where you’d like to be,” says Mike Ely, BWC’s safety technical advisor. “The difference between the two is where we (BWC) can help.”

He underscores the fact that BWC does not take a one-size-fits-all approach. “Each and every safety assessment is based on the particular needs of a company,” says Ely. “Also, a company’s safety goals are its own, not ours. Sure, we can recommend a course of action. But we can’t dictate what a company should do. It has to come from them. Our job is to work within a company’s capabilities — using the resources they have available to them — to help them develop the best safety and health systems they can to meet their particular needs.”

5 Understand the basics.

Your BWC consultant can also help you grasp the basics of a sound safety system. “Ulti-mately, our goal in helping you develop your safety processes is to help you reduce accident frequency and severity,” says Ely. “An effective safety system is key to properly managing your workers’ compensation program. Good safety and health processes will help you reduce costs and boost employee morale.”

All of the items listed below are essential parts of an effective safety system. BWC recom-mends these 10 steps.

1. Visible, active senior management leadership

2. Employee involvement and recognition

3. Medical treatment and return-to-work practices

4. Communication

5. Timely notification of claims

6. Safety and health process coordination and employer education

7. Written orientation and training plan

8. Written and communicated safe work practices

9. Written safety and health policy

10. Recordkeeping and data analysis

Any safety manual you write needs to include all of these items. Otherwise, your safety system will not be effective.

Professional help:Close-upofanairsamplingdevicethatBWCsafetyconsultantscanusetotestairsafetyatyourfacility.

20 WORKERS’COMP

ONYOURSIDE SAFETY

6 Get specific.

Up to this point, you’ve been assessing your needs and getting to know the components of an effective safety system. You haven’t written a thing yet, and it’s still not time to start writing your safety manual. But that’s OK; you’re laying the foundation for safety success within your company. And there are a few more things to keep in mind.

First, your BWC safety consultant can help you through this process and beyond. Second, he or she can also provide practical solutions to your specific safety concerns. These include giving you information on best practices and industry standards, and providing you with solutions to maintain OSHA compliance.

Third, the list of specific safety solutions BWC consultants can provide are as varied as your unique needs. Need noise and air sampling? They can help. Need to reduce repetitive-motion injuries, such as carpal tunnel syndrome, or to design better ways to do a job? They can help.

Finally, you should never feel alone in your safety quest. In addition to your consultant, BWC gives you access to safety classes, library services and research assistance, employee training tapes, safety certification opportunities, etc. Log onto ohiobwc.com and click on Safety Services for details.

7 Develop a plan — an accountability system.

So now here’s your chance to improve your company’s safety culture, but it’s still not time to start writing the manual! You still have more work to do!

• Do you have your boss’ support? If not, get it! Involve your BWC safety consultant in making the argument. Invite him or her to meet with your boss to share how an improved safety culture can improve the company’s bottom line. With your boss’ support, you can access available resources to achieve your company’s safety goals.

• Involve the employees. Be sure to involve workers and management in identifying your company’s hazards and coming up with solutions.

• Specify accountability systems. Figure out who in the company should coordinate its safety processes. That person or those persons will coordinate safety activities for everyone — from employees to supervisors to the head of your company. Involve that person in all future planning.

These are important factors in developing your company’s safety system. Zoom past these steps, and you’ll risk failure. Follow these steps, and your safety manual will almost write itself!

8 Put it in writing.

Finally, it’s time to write your company safety manual! And now that you’ve laid a solid foundation, you’ll discover you don’t have to do it by yourself. You’ve got more help and resources than you first imagined — your boss, fellow employees and BWC.

It’s now time to refer back to BWC’s 10-step process (mentioned earlier in point 5) and to incorporate specific advice from your safety consultant. As you record the details of your approach to this 10-step process, you will be — in essence — writing your company’s safety manual. Your BWC safety consultant cannot write the manual for you. But, he or she can review what you write to ensure you’ve covered all the points.

21 ohiobwc.com

B

BWC’s Mike Ely, safety technical advisor, and Bruce Loughner, safety project manager, both with the Division of Safety & Hygiene, contrib-uted their expertise in developing recommendations for this article.

9

Activate your plan.

You’ve already started to do this by involving others in your company! Now, just make sure your safety system and manual have built-in steps to evaluate your company’s progress toward its goals.

10Your company is not static and neither is your safety system. It needs to change and grow as your company and employees’ needs change. So, continuously review your safety system and manual. Update them regularly according to your chang-ing needs.

You should also continue taking advan-tage of the services your BWC safety consultant provides and all the other resources available through the bureau. Following this process should help make your company’s safety processes self-sufficient. Your company will reap the benefits of improved safety, higher employee morale and lower workers’ compensation costs. WCQ

Seek continuous improvement.

22 WORKERS’COMP

by Erik Harden

Injured worker’s attitude, grit drives amazing comeback

positiveAccentuating

Despiteeveryone’sbesteffort,

workplaceaccidentshappen.When

anaccidentcausedJaneHostetler’s

devastatinginjury,shefaceditwith

apositiveattitude.Readabouther

determination,andaskyourself

whatyouwoulddoifthisinjury

happenedtoyou.

Conventionalwisdomsayspositivethinkingcanhaveapowerfuleffectonourlives.

Manypeoplebelieve thinkingpositively can lead toeverythingfromprofessional success and improvedpersonal relationships tobetterhealthandalongerlife.AYaleUniversityresearchprojectbacksthisup.Itfoundthatpeoplewithanoptimisticoutlooklived7.5yearslongerthanthosewithapessimisticviewofthefuture. Intermsofhealthimpacts,thestudyrankedhavingapositiveattitudehigherthanloweringcholesterolandbloodpressure.

the

ONYOURSIDE WORK FORCE

Pressing matters: Jane Hostetler works with a drill press at Cornwell Quality Tools Co. in Wadsworth.

2� ohiobwc.com

In Jane Hostetler’s case, positive thinking played a major role in helping her to overcome a devastating injury and return to work in a remark-ably short period of time.

“I didn’t have a negative attitude for one second,” Hostetler proudly states. “From the get-go, I had an attitude of what’s done is done; now let’s just get back to it. I don’t remember ever feeling sorry for myself.”

A traumatic injuryIt’s an amazing mindset considering the

trauma the drill press operator for Cornwell Quality Tools Co. suffered while working second shift on Jan. 11, 2006. While drilling holes into hand-tool components, the drill bit snagged her work glove. The machine’s pull then caused what turned out to be irreparable damage to the pinky and ring fingers of her right hand.

Vividly recalling the accident, Hostetler says: “I disengaged from the drill press and went flying into Tim’s (the shift foreman’s) office. I kicked the door open, banging it against the wall. His first reaction was shock. When he saw my hand, there was no question I was injured. I never looked at it.”

The company reported her injury to BWC immediately. And within 24 hours after the acci-dent, she had surgery to remove the two mangled fingers and part of her right hand. Diana Faris — the BWC claims service specialist assigned to Hostetler’s case — touched base with the injured machinist and company representatives the day after the accident. Within a week, Faris had allowed the claim, paid initial benefits and conducted a staffing meeting to tackle various aspects of the claim. At the same time, Hostetler began her recovery in earnest.

In terms of physical therapy, she was a quick study and totally dedicated. She recalls, “If they had given me a lump of putty and told me to work it in my hand every hour on the hour, I would have done everything short of setting an alarm clock. I have never followed instructions so well in all my life.”

Harry Walker, Cornwell’s human resources director, jokingly adds, “I’d like to go on record that this was the first time since I’ve known Jane that she did exactly what everyone told her to do.”

Back so soon? Hostetler’s positive attitude combined with

grit, determination and creeping boredom helped her get back to modified duty at Cornwell by early March — an amazing six weeks after the accident. A case worker from Cornwell’s

managed care organiza-tion also provided helpful encouragement.

“I was bored at home. Part of me was afraid to come back, and another part of me just wanted to get over the hump and get back on the job,” she explains. “I have Amish ancestry and, frankly, I think it’s the Amish in me that made me believe I could do it. It’s bad enough having an ugly hand, but I will not be disabled.”

Walker helped arrange Hostetler’s return to work through modif ied duty. During a seven-week period, she gradually increased from a four-hour shift to working a full 10 hours. Admit-tedly it was grunt work (sorting sockets) at first, but Walker says everyone benefited.

“She was able to perform a duty for us that, frankly, no one else really wanted to do, but it allowed her to ease back into working life,” Walker says. “So who lost on that? Nobody.”

Like many injured workers, Hostetler had some initial trepidation about returning to work. Most of it stemmed from her own embarrassment about the accident and the fear that her co-workers would think less of her.

“The whole thing embarrasses me a great deal. That was one of the hardest things about coming back to work,” she readily admits. “Facing these guys, knowing I did something stupid. I worried what people were going to think of me, but the people I work with have shown nothing but compassion.”

She knows the drillSorting sockets helped her get back to work,

but it was far from her ultimate goal: to get back on the drill press. By early April — a mere 12 weeks after the accident — Hostetler was back to a full-time schedule. And she was back on the drill press on her second full-time day.

She no longer uses heavy work gloves while operating the press. Now, when necessary, she opts for latex gloves to avoid irritation from metal shavings and chips while doing a job. Despite occasional f lashbacks, she is back to her normal work routines.

True grit:JaneHostetler,adrillpressoperatorforCornwellQual-ityCo.,losttwofingersandpartofherrighthandinaworkplaceaccident.Shereturnedtoworksixweekslater.

2� WORKERS’COMP

ONYOURSIDE WORK FORCE

WCQ

“It would have been entirely different if it had been the machine’s fault. I think, I would have had a whole different approach,” she explains. But knowing what I did, you know, why not go back to work? This is what I know, this is what I do. And I like it.”

However, there is one thing she will not do. “I won’t run the same job I was doing (when the injury occurred). I think that’s just a little more than I care to endure,” she states.

Walker says he and Hostetler’s fellow workers are thrilled to have her back on the job and inspired by her determination. He says, “To suffer an injury of that magnitude, to lose two fingers and not let it defeat you is truly amazing. It’s an understatement, but she is a very determined person.”

A contagious spiritHostetler’s positive approach and determina-

tion also inspired those who helped her get back to a normal life both in and out of the workplace. She had a profound effect on Faris, who guided her through the overall claims process and the inner workings of the workers’ compensation system.

Faris, who has worked as a BWC claims service specialist for 10 years, says: “I believe in providing good customer service under all circumstances. I always try to remove obstacles and barriers to people getting back to work, but when you get a case like this, it makes you really want to go that extra mile.”

And Faris’ efforts did not go unnoticed by Hostetler. In talking about Faris, Hostetler says, “I cannot sing her praises enough. She was pretty wonderful. She treated me like I was the only claim she had, and I know that’s not the case. She was just awesome. She really was.”

Faris also stresses the importance of com-munication between all parties to a claim. She explains: “That’s one thing that made such a dif-ference with this one. When the employer responds to our efforts to communicate with them, and they keep in touch with us and the injured worker, things flow so much smoother.”

In the end, Hostetler’s case was a positive team effort involving several parties all working toward one goal: getting her back to work and returning her life to normalcy. Walker calls Hostetler’s claim — which was completely settled by Dec. 11, 2006, — an example of the workers’ compensation system at its finest. Walker says, “I joke with her and tell her she should be the poster child for the workers’ compensation system and returning to work.”

Returningtoworkafterajobinjury,especiallyoneastraumaticasJaneHostetler’s,isadauntingtaskformostinjuredworkers.Herstory isevenmoreamazingwhenyouconsider the typicalbarriersmanyinjuredworkersfaceontheirroadbacktowork.Thesebarrierscaninclude:

• Physicalpain;• Depressionand/oranxiety;• Fearofre-injuryorrelapse;• Miscommunicationorlackofcommunicationwithemployer;• Pre-injuryjobdissatisfaction.Physicians must consider these factors and take a pragmatic

approachwhenhelpinginjuredworkersreturntowork.Dr.JamesB.Talmageisanorthopedicsurgeonandco-editor

ofA Physician’s Guide to Return to Work.Hesaysrisk,capacityandtoleranceoftendictateaninjuredworker’sreturntowork.

Riskisthechancethatharmcouldcometotheinjuredworker,aco-workerorthegeneralpubliciftheinjuredworkerengagesinspecificworkactivities.Tominimizerisk,manytreatingphysicianssetspecificworkrestrictions.Theseexplainbothwhataninjuredworkercandoandshouldnotdoatwork.

Capacityreferstoaninjuredworker’sabilities(e.g.,strength,flexi-bilityandendurance).Injuredworkersaren’tusuallyatfullcapacitywhentheyreturntowork,especiallyatfirst.Sointermsofareturn-to-workplan,physiciansmustconsidertheinjuredworker’sability.Exerciseandactivitycanhelptheworkerincreasehisorhercapacity.

Toleranceistheabilitytoenduresustainedworkoractivityatagivenleveldespitesymptoms,suchaspainorfatigue.Physiciansdonot agreeonquestionsof tolerancebecause they can’tmeasure itscientifically.However,Talmageexplainsaworker’s toleranceoftendependsonwhatrewardsareavailabletohimorher.Theinjuredworkerwhohasgreatermotivation,suchasbetterpayand/orbenefits,maybewillingtotoleratemoresymptomswhenreturningtowork.

“Ioftencompare it toanathlete’smentality,”Talmagesays. “Astarteronateamismuchmoremotivatedtoreturnfrominjurythansomeonewhoisareserve,becausethereisgreaterincentivetoreturn.Thesamemindsetistrueforthetypicalworkplace.”

Talmageaddsthatit’susuallyintheinjuredworker’sbestinteresttostay in thework force.Soemployers,physiciansand the injuredworkershouldallworktowardthegoalofreturntowork.

Returning to work is not always easy

25 ohiobwc.com

WCQ

SAFETY TOOL

Stayhydratedthissummer

Tips to help you stay hydrated and healthy

Returning to work is not always easy

• TheNationalInstituteofOccupationalSafetyandHealth(NIOSH)andOSHArecommenddrinkingfivetosevenouncesofwater,oraboutonecup,every15to20minutestostayhydratedandmaintainasafecorebodytemperature.It’simportanttodothisalldaylong;notjustduringrestbreaks.

Drinking enough water is vital for everyone. It’s especially important for those who work out-doors during hot summer months or whose jobs expose them to extreme heat and humidity. They need to follow proper safety precautions to limit their exposure to heat and stay hydrated.

The Occupational Safety & Health Adminis-tration (OSHA) reports workers in certain indus-tries often face hot conditions, which pose special hazards to their safety and well-being. These include those who work in foundries, laundries, bakeries, parks and on construction projects and farms, to name a few.

According to the Centers for Disease Control and Prevention (CDC), excessive heat exposure caused 8,015 deaths in the United States from 1979 to 2003. More people died from extreme heat than from hurricanes, lightning, tornadoes and earthquakes combined.

There’s good news, though. The CDC also says heat-related deaths and illness are easily prevent-able. And water is a part of the solution. Reminding co-workers and employees to drink lots of water

can help fight dehydration and lessen heat-related ill-nesses and deaths.

How the body works T he jou r na l Occupa-

tional Hazards states workers in extreme heat may lose up to 1.5 liters of water each hour from perspiration. Sweating is how the body maintains a stable internal temperature in hot conditions.

If the body cannot dispose of excess heat, it will store the heat. When this happens, your core temperature rises and your heart rate increases. As you continue to store heat, you may have difficulty concentrating, and you may become irritable or sick.

Approximately 60 percent of the body is composed of water. So when it comes to drinking fluids, your first choice should be water. You can replenish your loss of f luids through perspiration by drinking water regularly.

• Drinkwaterbefore,duringandafterlaboringorexercisingtoreplacebodyfluidslostbysweating.

• Drinkplentyofwater;don’twaituntilyouarethirsty.Bythetimeyourbodysignalsyouarethirsty,youare2-percentdehydrated.Onceyouaredehydrated,itisdifficulttoreplacethefluids.

• Keepsinglecontainersofcool,cleanwaterwithineasyreachforeveryemployee.TheAmericanCouncilofGovernmentIndustrialHygienists(ACGIH)recommendsplacingwatercloseenoughtotheworkersoheorshecanreachitwithoutleavingtheworkarea.

• NIOSHandACGIHsuggestdrinkingcoolwaterratherthanhotorverycoldwater.Coolwaterabsorbsmorequicklyintothebody.Drinkwaterof50to59degrees.

• Ifyouhaveasedentaryjob,youshouldalsodrinkeight8-ounceservingsofwaterdaily.

• Avoidcoffee,tea,alcoholorsoda.Alcoholandcaffeinecandepletethebody’sfluids.Plainwaterisoftenyourbestoption.— SB

26 WORKERS’COMP

Sinceopeningitsdoorsmorethanacentury

ago,theToledoZoohasmadevisitorsafetyatop

concern.Butseriousinjuriesforcedtheparkto

makeemployeesafetyahighpriority,too.

ONYOURSIDE EMPLOYERS

26 WORKERS’COMP

In 2000, the Toledo Zoo’s safety program was in need of an overhaul, recalls Mark Miles, an employer services specialist in BWC’s Toledo Customer Service Office.

The zoo employs animal care, food service, grounds keeping, maintenance crews and as many as 700 summer workers. However, it lacked widespread safety training for its employees and building a comprehensive safety plan was on the back burner.

After injury claims began piling up, BWC staff notified the zoo that its workers’ compensation costs would increase dramatically.

“They were surprised, to say the least,” Miles says.

Recognizing the problemZoo officials quickly realized they had to do

something to gain control of their workers’ com-pensation expenses.

The zoo used to enjoy savings 30-percent less than standard rates. Injuries not only caused the zoo to loose its discount, but the poor safety record caused premiums to jump another 20 percent.

Since the Toledo Zoo is a not-for-profit organi-zation, the rate hike was difficult to absorb. Officials knew they had to do something quickly, but weren’t sure how to get started. That’s when they contacted BWC’s Toledo Customer Service Office and looked to Miles for help.

First step“The first thing I like to do is review previous

claims with the employer,” Miles says. He sat down with zoo officials, examined their claims history and explained why they should create a compre-hensive safety plan.

“I also told them that if they take certain steps, there is no reason why they can’t lower premiums.” Miles recognized the employer was eager to take the measures needed to gain control of the zoo’s workers’ compensation expenses. So he helped zoo officials to create a road map.

The zoo also hired a dedicated safety profes-sional to change the organization’s culture. Andy Birr joined the staff as assistant director for safety. He immediately focused on making safety everybody’s business.

of workers’ comp premiumstakes the bite outToledoZoo

by Aria Alaudini

Gloves on: The Toledo Zoo’s Natalie Cooke, education specialist,carefullyremovesaprehensile-tailedskinkfromitscage.

27 ohiobwc.com

ToledoZoo

Birr teamed up with Miles and other BWC experts: Jeff Hutchins, an industrial hygienist, Michael Fahle and Frank Albright, industrial safety consultants, and Julie Reynolds, an ergonomist. They joined forces to find ways to improve the zoo’s safety program.

The group evaluated numerous tasks and made several recommendations. “I can’t say enough about the job that BWC’s consultants have done,” Birr says. “They were able to come in here, perform job audits and point me in the right direction.”

ChallengesOne of the best ways to reduce workers’ com-

pensation premiums is to put a drug-free workplace policy in place. Miles says he and Birr introduced the idea to Nancy Foley, the zoo’s director of human resources and Carol Zielinski, assistant director of human resources. Both were receptive, but needed to get the zoo employees’ union to buy in before they could institute an effective program.

Miles says after several meetings, the union agreed to take part in the plan. It includes pre-employment drug screenings, random checks and drug tests after workplace accidents.

“Nancy, Carol, and Andy worked very hard to make sure the program was a success from the get-go,” Miles says.

More stepsAside from starting a drug-free policy, Miles

helped the Toledo Zoo enroll in BWC’s Premium Discount Program + (PDP+). The program

provides experienced-rated employers with incentives to establish a safer, more cost-effective, workplace.

“This program got them moving in the right direction and got everyone from top to bottom involved in safety,” Miles says. PDP+ is a great program because it helps create a safety-focused company culture, he adds.

Birr and Miles worked together to implement BWC’s 10-Step Business Plan. Among other things, the plan provides safety training for the zoo’s diverse work force. “Now, every new employee goes through safety training before they begin their job,” Birr explains.

These two programs alone helped the Toledo Zoo lower its annual premiums by 25 percent.

“We did save money on our premiums,” Birr says. But more importantly, “it was a way for us

to show our commit-ment for safety to our employees.”

Getting involved in the local safety council also helped the zoo lower premiums.

“Local safety coun-cils are a great way for businesses to network with other businesses on what’s working and what’s not when it comes to safety,” Miles adds.

Wide load:KatieGut,largemammalzookeeper,preparesamealforanAsianelephantwhosetrunkisseenpokingthroughthedoorwayinanticipation.

Bird feed:ZooemployeeRobynPerodolesoutfeedtobirdsinacage.ManyoftheexhibitsattheToledoZooposelittledangertotheirhandlers.

28 WORKERS’COMP

ONYOURSIDE EMPLOYERS

Takestepstoloweryourworkers’compcosts

WCQ

“Plus, most safety councils offer classes … and they always try to bring high-caliber speakers to the meetings to talk about different safety subjects.”

Another new idea for the zoo is the use of transitional and modified work programs. The programs let injured employees return to work before they have completely recov-ered by allowing them to do real job duties that fit their abilities.

“It’s a great program because it lets our employees get back to work (as soon as) the next day and help us out,” Birr says.

A new attitude

All new employees, including seasonal workers, now attend a full day safety training class as well as refresher courses. Every associate also helps make the zoo safer by providing regular feedback on how the organization can improve processes.

Birr is proud that none of the zoo’s employees have suffered any severe workplace injuries in the past four years. But he is most proud that a recent survey of employees confirmed they care about safety. “The survey showed that the emphasis we place on health and safety is the number one thing they value at the zoo.”

This goes beyond working safely. Birr says he is happy to see many take advantage of a policy that allows employees to use zoo-issued personal protec-tion equipment away from work. “It’s great to know that the employees are using their safety equipment while at home. When employees prevent accidents at home, they are at work the next day. It is a win-win situation for the zoo and the employees.”

The zoo is looking to do more than just meet safety standards. It is participating in other work-place safety initiatives.

The zoo plans to take part in the Occupational Safety and Health Administration’s Voluntary Pro-tection Plan. The program acknowledges employers who have injury rates below their industry average. Birr attributes that determination to BWC. “The bureau is responsible for making us serious about safety,” he says.

Theratesyoupayforworkers’compensationcoveragedependsonthetypeofwork,numberofemployeesandyourcompany’ssafetyrecord;themoredangerousthejobsorworseyourrecord,thehighertherates.Youalsogeteitherapenaltyorcreditappliedtoyourpremiumbasedonyourclaimshistory.

However,therearemanywaysyoucanloweryourworkers’compensationcosts.ContactyouremployerservicesspecialistattheBWCcustomerserviceofficenearestyoutofindouthow.Heorshecangiveyouadviceforyourspecificsituation.Belowareideasthatmayapplytoyou.

28 WORKERS’COMP

•Joinasafetycouncil.Com-panies that belong to alocal safety council andmeet the requirementscanpursueuptoa4per-centdiscountfromBWC.

•Participate in a BWCdiscount program,suchastheDrug-FreeWorkplaceProgramorthePremiumDiscountProgram.

•The best way to loweryour workers’ compen-sationcostsistopreventinjuriesandillnessesbyeliminating the hazardsthatcausethem.UsetheservicesofBWC’sDivi-sionofSafety&Hygiene,including on-site con-sultation,toidentifyande l iminate workplacehazards.

•Design a transitionalwork program. It is inyour and employees’best interest to returnaninjuredworkerbackto work by makingtransitionalormodifieddutiesavailable.

Arms length:LeisjeMeates,herpetologykeeper,cautiouslyperformsherdailyinspectioninthezoo’sreptiledepartment.

29 ohiobwc.com

Takestepstoloweryourworkers’compcosts

• Valuableworkers’compinfoforallindustries• Safetyandhealthtrainingmaterials• Researchassistancefromexperiencedlibrarians

Formoreinformation,logontoohiobwc.com,andclickonBWCLibrary,andthenSafetyLibrary.

Butdon’ttakeourwordforit!

“

”

BWC library services offers resources toimprove your bottom line

TheBWClibraryisanexceptionalresource

toimplementengineeringcontrols,

standards,etc.,priortoinjuriesoccurring.

Thelibrariansareatremendousresource.

Ihaveusedthemto:obtaincomparisons

betweennew/oldstandardsandnon-routine

exhaustventilationsystemrequirements;

identifysourcesandstandardsregarding

UVmeasurements;obtainworkers’

compensationinformationfromother

states;measurefloorslipperiness;

andeventofindout-of-date

publicationsstillcitedasbeing

required(assafetyguidelines).

When the 20th century was in its infancy,

workers’compensationdidn’texist in theBuckeye

State.Now,atthedawnofthe21stcentury,Ohio’s

workers’ compensation system insures more than

two-thirdsofthestate’sworkforce.

Sohowdiditallbegin?

ThesystemgotitsstartonJune15,1911,withthe

signingofthefirstOhioWorkmen’sCompensation

Act.WilliamGreen,theformerpresidentoftheOhio

UnitedMineWorkers,sponsoredthebill.

Soon after, in 1913 to be exact, the newly

created Industrial Commission of Ohio (IC) began

runningthestate’sworkers’compensationsystem.

Thisincludedmanagingthestateinsurancefund.

In 1955, the Ohio Legislature created the

Ohio Bureau of Workmen’s Compensation to run

the administrative areas (e.g. setting premiums,

determining claims, etc.) of the system. The IC

became the adjudicative branch. Today, the IC

hears and resolves issues arising from workers’

compensationclaims.

TheOhioBureauofWorkmen’sCompensation

changeditsnamein1977towhatyouknowtoday

—theOhioBureauofWorkers’Compensation.

Interesting fact: On April 28, 1913, sheet-

metal worker Lemuel C. Fridley received the first

compensation check. He severed a finger while

workingfortheDelphosManufacturingCo.— EH

—BruceV.VanScoyEnvironmental,Health&SafetySpecialist

WILResearchLaboratories,LLC(Ashland)

Workers’ comp in Ohio: How it all started

Did you know?

�0 WORKERS’COMP

QA

ROUNDTABLE

What step-by-step process should providers follow to file a workers’ compensation claim?

When health-care providers know they’re treating a new workers’ compensation injury and/or occupational disease, they should file a First Report of an Injury, Occupational Disease or Death (FROI). It’s easy to file the FROI online at ohiobwc.com. They can also call in or fax the claim to the injured worker’s managed care organization (MCO). But, they must report the injury within 24 hours or one business day from a worker’s initial treatment or visit.

BWC requires minimum information to file a claim. If a provider logs on to ohiobwc.com under his or her Web account, provider information automatically appears on the screen. After receiving notification of an injury, BWC automatically assigns and immediately returns a claim number.

Providers should send medical documentation of the worker’s treatment and the ongoing treatment plan (if indicated) to the worker’s MCO within five days of the injury. This helps BWC team members to determine a claim, that is allow or disallow it, within 28 days. Remember to include the worker’s claim number on MCO documentation.

If BWC denies the claim, the employer, worker or their representative can appeal the decision. Then, the Industrial Commission of Ohio decides whether to allow or disallow the claim.

Helpful tip: When a provider has a FROI, he or she doesn’t need additional Health Insurance Portability & Accountability Act releases. The injured worker chooses a physician of record.

WCQ — summer 2007Roundtable (Workers’ comp �11 factoid should accompany this feature)FINALWord count: 811

Tips to help health-care providers serve injured workers

Roundtablefeatures

BWCstakeholderssharing

theirviewsonworkers’

compensationissues

andevents.

Here,TammieMihaly,BWC’s

providerrelationsmanager,

andJudyBrabb,directorof

return-to-workservices,share

theirexpertise.Theyanswer

questionsandoffertipstohelp

health-careprovidersnavigate

theworkers’compensation

process—fromfilingclaims

tounderstandingtheirrolein

helpinginjuredworkersreturn

towork.

The experts talk:TammieMihaly,BWC’sproviderrelationsmanager,andJudyBrabb,directorofreturn-to-workservices,sharetheirexpertise.

Tammie Mihaly

�1 ohiobwc.com

QA

WCQ

What responsibilities does a provider have for giving ongoing treatment in a claim?

Providers requesting ongoing treatment services should submit BWC’s Physician’s Request for Medical Service or Recommendation for Additional Conditions for Industrial Injury or Occupational Disease (C-9) to the worker’s MCO. To help our customers, BWC forms are available online. Don’t forget, under presumptive authorization, a physician may initiate treatment for new musculoskeletal and soft-tissue injuries within 60 days from the date of injury. For more information about presumptive authorization, log on to ohiobwc.com, and click on Medical Providers, Services and then Medical prior authorization requirements. When the worker can return to work with limitations, the treating provider should submit a Physician’s Report to Work Ability (MEDCO-14). This helps communicate these limitations to everyone — the worker, MCO and the employer. Unless the provider is treating a minor injury or catastrophic injury, he or she should begin discussing return-to-work options with the worker during initial visits. The worker should have a copy of the MEDCO-14. To help a worker return to the job, it’s important the worker and the employer understand the worker’s functional limitations on the job.

The provider can also use the MEDCO-14 to request extending temporary total compensation. This is in addition to the form designed for that purpose, the Request for Temporary Total (C-84). The MEDCO-14 also documents the inability of the worker to return to work. The provider should complete this form at each re-evaluation. Once BWC allows a claim, the provider may decide to add other diagnoses because of new findings (i.e., if testing shows an arm-sprain injury is a rotator cuff tear). The provider may then ask for consideration of additional allowances using the C-9. The provider should include supporting documentation and opinions. The MCO will then let BWC know about the additional condition request. If a physician provider talks with the employer about the worker’s return-to-work limitations and documents the call, the provider can bill for this service when it is medically necessary. Remember, the physician can’t bill for telephone call codes on the same day as other consults, team conferences or office visits.

Providers play a key role in helping injured workers return to their jobs. They have the unique responsibility to encourage injured workers to actively participate in their recovery and return to their jobs and lives.

Workers’ comp 411

RTW? What’s that?

Return to work

Aninjuredworker’shealth-careproviderandmanagedcareorganizationworktogethertodeterminetheoptimalreturn-to-workdatebasedontheworker’sinjuryandtypeofwork.Workerscanreturntojobsatfullormodifiedduty.Oftentimes,goingbacktoworkmid-weekallowsinjuredworkersmoretimetoreadjusttotheiroriginaljobdemandswithoutbeingwornoutbyafullworkweek.Italsoimprovesthechancesofinjuredworkersremainingatwork.

TheAmericanAcademyofOrthopedicSurgeonsandtheAmericanAssociationofOrthopedicSurgeonssaysafe,earlyreturn-to-workprogramsareintheinjuredworkers’bestinterest.Returntolight-duty,part-time,transitionalworkormodified-dutyprogramsareimportantinpreventingtheonsetofpsychologicalandotherbehaviorpatternsthatgetinthewayofinjuredworkerssuccessfullyreturningtoworkandnormallives.

BWC’s provider relations reaches out BWC’s provider relations department helps providers and their staff members with enrollment and certification issues, billing inquiries and general Health Partnership Program information. For customized service, representatives from BWC’s provider contact center are available from 7:30 a.m. to 5:30 p.m., Monday through Friday. Call 1-800-OHIOBWC and press options 3, and then 0.

You may also send e-mail inquiries to provider relations at [email protected]. If you prefer, log onto ohiobwc.com for online service. Just click on Medical Providers or BWC Library to view publications, features and services.

QA

�2 WORKERS’COMP

For subscription maintenance only Workers’ Comp QuarterlyBWC/OhioP.O. Box 17New Philadelphia, OH 44663 Fax (607) 273-0846Total copies 150,000 • Unit cost: $.225 • Publication date: 06/07

Quick and easy. Hassle-free. Convenient.

And paying your premium is simple, too.

BWC makes it easy for you to report payroll.

• Logontoohiobwc.com.• EnteryouruserIDandpassword,orclickonCreateE-Account.• ClickonOhioEmployersandthenPayrollreports.• EntereitheryourBWCpolicynumber,federaltaxidentificationnumberor

SocialSecuritynumber,ifapplicable,toaccessthereport.• Aftercompletingthereport,thesystemwillautomaticallypromptyouto

payyourpremium.}Just log on to ohiobwc.com at your

convenience — 2� hours a day, seven days a week. You can file your payroll report and pay your premium with just a few clicks of the mouse.

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