Business of workers’ comp in education

By: | May 19, 2015

A “culture of safety”—at all levels of a district—is the first and most critical step in dealing with occupational injury. It also guides the prevention of, response to and mitigation of hazards in the workplace, including staff behavior.

Students arrive in three days. A staff meeting starts in five minutes. A teacher wants to hang a picture high on top of a bulletin board, so he hoists his chair onto the desk. The wheels lock, so he should be safe. Standing on the chair, he reaches up to hang the last picture. Then the seat swivels.

What happens next depends on how much your district values safety, says John Stephens, senior vice president with Keenan & Associates, which provides private workers’ compensation insurance for all California districts.

A “culture of safety”—at all levels of a district—is the first and most critical step in dealing with occupational injury, Stephens says. It also guides the prevention of, response to and mitigation of hazards in the workplace, including staff behavior.

“If someone is injured, investigate not to find fault … but investigate it as, ‘We want to figure out how we make sure this doesn’t happen again,’ ” Stephens says.

Safety pays off

Ensuring that everyone understands the importance of safety is essential to reducing the overall cost of work-related injuries. That begins with leadership. Modest budget increases enabled California’s Beaumont USD to hire a safety manager and to implement prevention strategies, Superintendent Maureen Latham says.

This full-time position is responsible for visiting every facility in the district to identify potential hazards that need to be remedied before accidents occur. It might mean suggesting a teacher move furniture in a classroom to facilitate the safe flow of people or recommending ergonomically correct tools for the grounds crew.

Workers’ Comp Best Practices in a Nutshell

1. Cultivate a safety culture

  • Leadership promotes safety awareness
  • Non-punitive policies and procedures encourage safety
  • Establish infrastructure for reporting, investigating and remediating near-misses (potential hazards), incidents (no injury) and accidents (injury)
  • Appoint or hire a school risk manager
  • Provide regular, targeted training for everyone

2. Eliminate the “mystery”

  • Task all staff with safety of students, staff and visitors
  • Make sure reporting guidelines and assistance available are clear
  • Provide open, non-punitive communications about safety

3. Support care and return to work

  • Clearly define roles at building, department, district
  • Use software that provides workflow, keeps records
  • Leverage resources through insurance provider

4. Clearly define investigation and remediation procedures

  • Delineate abuse and fraud with staff
  • Set triggers for an investigation
  • Work with claims adjuster for details about circumstances, any employee issues

5. Consider:

  • Analyzing data to identify issues
  • Adding wellness programs, because healthy people are less likely to be injured, and return to health sooner

The manager also serves as a clearinghouse for all things safety-related so that staff can ask for assistance or raise concerns with the person who can solve the problem. This focus is paying off. A comparison of the 2014-15 and 2013-14 school years reveals an 82 percent reduction in severity of claims, or dollars paid, and a 43 percent reduction in frequency, or number of claims filed.

Beaumont also regularly reviews injury data, looking for trends or potential issues. “Slip-and-falls” are the most frequent claims made by teachers; however, more serious injuries are more common for maintenance and operations staff due to the physical nature of their work.

The risk manager customizes training to address recurring injuries or works with staff in high-risk positions to improve safety conditions and equipment. For teachers, that might mean special training in preventing the most common injuries. For example, if falls occur when moving books or supplies, teachers will be trained in techniques for safely carrying heavier items.

Grounds crews can be shown safer techniques for tree trimming or squatting to fix sprinklers.

“Eliminate the mystery”

Because injuries will still occur, schools must strive to get employees the care they need so they’re back on the job as soon as possible.

Stephens suggests eliminating “the mystery of workers’ comp” by making sure staff knows what to do when an injury occurs, including how to access the resources available to help. That means making claims-reporting easy, says Rick Toepfer, treasurer of the Forest Hills School District in the Cincinnati suburbs.

His district qualifies to opt out of the state workers’ comp insurance, due in part to its low number of claims. Forest Hills purchases private insurance, which most states allow. Their annual premium dropped by $100,000 a year, Toepfer says.

The district used some of the savings to replace the cumbersome paper claims process with an electronic system. It made filing mandatory state reports easier and accident reporting simple for staff.

Forest Hills uses PublicSchoolWORKS’ electronic reporting and tracking software. All the usual paper forms, such as injury and investigation reports, are digital.

Employees have access to the web-based service and can log in to find policies, procedures and training modules, and to file reports. In reporting an on-the-job injury, everyone knows they’re expected to file a report as soon as possible.

Risk Management Resources

Applications (computer programs) the guide and automate reporting, investigation, remediation and training

Professional associations offering best practices, tools, conferences

Risk Manager training and certification

Working with your insurance provider (public and private)

  • Program resources – site safety review checklist, training materials.
  • Risk investigation/consulting.

The system automatically notifies administrators when a claim is filed. The entire claims/resolution process is mapped out by the workers’ comp staff or another administrator so the necessary steps—such as reviewing the claim, starting an investigation and monitoring recovery of the employee—are followed quickly.

“We’re involved to help get that person back as soon as possible,” Toepfer says. “I think this is where districts make mistakes—if they don’t manage that process, it will manage them.”

Investigate to mitigate

Medical fraud happens to the tune of $5 billion annually in the United States, Stephens says. Legitimate medical care accounts for 70 percent of workers’ comp costs, but fraud garners headlines.

Steve Hovey, chief personnel officer and associate superintendent of schools for the Riverside County Office of Education in California, says most of his teachers and support staff members work with troubled or special-needs students. Common claims for his staff include injury while lifting a child from a wheelchair or preventing a troubled student from hitting or punching others.

But an employee who files frequent claims covering a host of injuries should raise a red flag and careful investigation should follow, Hovey says.

When accidents happen without witnesses and the employee’s story varies, they become suspect. “Someone who has had previous injuries of suspicious or unverified origin—they’re experiencing some pain as opposed to being able to see some injury,” he says.

But it’s also important to see recurring injuries as an opportunity. “Recognize those frequently injured employees may need special attention to ensure they’re getting the training designed to prevent those types of injuries,” Hovey says.

A seamless process

Whether the teacher trying to hang a picture safely hops down when his chair wobbles (a “near miss”), falls off the chair and desk but is unhurt (an “incident”) or breaks his wrist on the way down (an “accident”), the district needs to addresses that risk effectively.

When an injury occurs, teachers must know to quickly report the incident to their supervisor or to make a workers’ comp claim so it can be investigated immediately. The administrator on-site can begin gathering information to support the claims administrator’s work.

A well thought-out and executed safety plan can help make the education workplace a less risky environment.

Margo Pierce is a freelance writer in Cincinnati.