Wednesday, August 12, 2015

It's Productivity Loss

We all basically know that the longer someone is off work due to a work injury, the more likely there's going to be increased disability, and the less likely there will be a return to work.

What we really don't know, exactly, is why.
Bowzer: obesity and smoking are ID'd with back pain.

There are certainly contributing factors and the analysis is complicated.

A recent series of studies underwritten by the Liberty Mutual Institute for Safety, and not specifically for the workers' compensation industry, is beginning to examine the why - though there is still a lot of work left to be done.

The researchers now call this "productivity loss" - people with productivity loss experience a hugely disproportionate level of disability, to the tune of up to 45 times those that reflect little or no productivity loss as measured by the researchers.

The latest study, published this month in the Journal of Occupational and Environmental Medicine, found five typical “trajectories” people follow over decades in productivity loss. Those who are at a consistently high risk of productivity loss during their lives and those who start out with little productivity loss in their 20s, but begin having worsening productivity in their 30s were the ones most likely to have a permanent disability or leave the workforce altogether.

One of the researchers, Glenn Pransky, said the study represents a new way of identifying people who are at risk of developing work disabilities, whether that be from a work injury or other source, and eventually leave the workforce altogether, because of a new set of risk factors of which not much is known.

And the research is too green to draw much from at this point.

“This data’s not really specific to new people just getting on a job. So we don’t really know when people were hired, when the productivity loss is relative when they’re hired, so it’s really hard to extrapolate choices about who you hire and when,” Pransky said. “And with the (Americans with Disabilities Act), you really need a lot better data before you make a non-hire decision than what we’ve got here.”

An earlier study from Pransky and co-author Elyssa Besen found that workers who are obese, have existing back or leg problems, have “emotional issues” or hypertension were all more likely to have long-term productivity loss. Even having frequent or severe cold and allergy problems was linked with productivity loss.

“When you think about work-related injury, we know that work-related injury and recovery from work-related injury is slowed by the presence of comorbidities,” Besen said. “So these people would be a group where if they got injured, it would probably be a much longer recovery time if they were able to recover at all.”

All of this makes sense. If someone has a condition, be it physical or mental, that interferes with productivity over a course of time, then certainly one would expect there to be a "trajectory" (as the researchers call it) where one could project a disability pattern.

But does this do any good? Or, the opposite, does this actually do harm?

The Americans with Disabilities Act prohibits discrimination on the basis of disability, and the courts have been defining disability for purposes of the ADA for some time now. Does a comorbidity, or series/sequence of comorbidities, that has been identified as a leading indicator of disability, fall within the prohibitions of the ADA?

And if so, where does the discrimination stop and start? Where does the employer, or other ADA vulnerable class, draw the line? At what stage can an employer safely conclude that a particular employee is not desired, or represents too much of a risk? How deep can a prospective employer delve into an applicant's life to determine whether there are risk factors that aren't acceptable to the employer?

There are many more questions.

This research is troubling in that regard - because while the science may say one thing, the law says another.

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