Ms. Nevin said the company is rolling out a detailed ergonomic assessment tool. Employees take an exam and are given a personalized assessment categorizing them as high-, medium- or low-risk for repetitive stress. The test looks at desk height, keystrokes, keyboard, level of discomfort watching the screen and headaches. The tool, she said, "allows our safety people to focus our energy on the high-risk individuals."

Ms. Nevin said a preliminary testing of the program done earlier this year found that of those employees that had previously tested in the high-risk category, 60 percent were moved into the medium- or low-risk categories within 30 days. "And we further moved more out of the medium- to low-risk in the following 30 days," she said. "These were quick and dramatic results" that garnered "very positive feedback from our employees."

The program is also beneficial in helping the company roll out its California operations. "Because California has an OSHA training requirement," she said, "all of our California employees will be required to take the assessment on a regular basis, so we can use it to meet our ergonomic training requirements under Cal-OSHA."

Ms. Nevin added that part of the program's success has been in interfacing with the company's furniture-buying group. "When new furniture is purchased, it's flexible enough to meet the needs of about 95 percent of any special accommodation required," Ms. Nevin said. Since the desks are adjustable, desk height can be readjusted, or a keyboard tray can be moved to meet safety recommendations.

Ms. Nevin said the company is essentially self-nsured because its workers' comp insurance program has a $1 million retention. "The results we see will have a big impact," she said.

Also helpful, she said, is the fact that the company charges down to the individual business units for their workers' comp costs. "This gives them more incentive to cooperate with programs," she said.

Robert Cartwright, loss prevention manager, Northeast Zone, for BFS Retail/Commercial Operations, LLC, in Exton, Pa., has a different set of workers' comp issues. At the retail automotive service and tire sales company with more than 2,200 U.S. locations, Mr. Cartwright said the current focus is on the causes of an accident.

"As we've identified them, we've been eliminating the factors that cause the accidents to happen," he said.

One of the causes of accidents, the department discovered, was that "people were doing things without the proper training." To alleviate this, he said a more hands-on, interactive training program was developed, involving more role-playing.

Once the training program was underway, "we got ideas from the people coming in for the training," he said. "We found that wearing protective equipment was one of the major factors," he said. As a result, a safety glass program was initiated in 2005. Since then, eye injuries have dropped 35 percent, he said.

The program provides protective prescription eyeglasses at no cost to employees and mandates that they be worn. "We found that eye injuries were due to people putting glasses over glasses, and once we discovered that was a problem, we came up with the program," he said.

Protective eyeglasses need to be worn by employees when they're working under vehicles, working with fluids, repairing brakes, "or anything that [has] to do with any foreign objects that could be in or around their work area," he said.

After this training phase, he said they would dig even deeper, focusing on "near misses," or the things that almost caused an accident.

"This creates a safety culture, and we're trying to create ownership for the individual, rather than just a company policy of mandates," he said.

Getting employees to identify near-misses "isn't as hard as you would think," he said. Near-misses are identified by documenting processes. They come from "skipping a step," he said. "When you skip a step, somewhere down the line comes an injury. The honesty comes with admitting that a step was skipped."

The company's focus, he added, is on "getting it right the first time and not firing someone the first time something happens."

At Harrah's Entertainment Inc., where back injuries are among the most prevalent sources of workers' comp claims, an ongoing effort to reduce employee injuries resulted in the lowest injury rate in the company's history for the first quarter.

Lance Ewing, vice president of risk management for Harrah's and past president of the Risk & Insurance Management Society, told National Underwriter earlier this summer that injuries high on the scale include "soft tissue and back injuries" from hotel employees who make beds and slips and falls of "back-of-the house" employees, including kitchen staff and wait staff. "They're what you would find in a service industry," he noted, adding that the company cross-trains staff to work in several jobs to further reduce exposure to injury.

Earlier this year, Harrah's reported that its first-quarter injury rate had dropped more than 40 percent below the gaming industry's average. The injury and illness frequency rate reported to the U.S. Department of Labor Occupational Safety and Health Organization was 3.1 for the quarter, representing the percentage of employees expected to be seriously injured over the course of one year's employment. This is below the casino industry average of 5.5 as reported by the Bureau of Labor statistics, Harrah's said.

The good news for the company, Mr. Ewing added, is that workers' comp rates have "steadily declined." One reason for this is that "we actually bring underwriters out to our properties and give them a back-of-the house tour, from engineering to housekeeping, where they meet supervisors and directors."

Underwriters also can view the training program. He said the organization tries to make loss control entertaining for employees by using such things as a "Jeopardy"-type game, where employees answer questions about safety and are awarded prizes.

Harrah's said at the center of its program are risk control managers (RCMs) located at each of the company's properties. These safety professionals are responsible for the overall loss prevention and claims handling of guests and employees, with support from corporate risk managers, Harrah's said.

Teri Flynn, risk manager for Fairfax County Government in Fairfax County, Va., said her department has oversight of 15,000 county employees, which does not include schools. The risk management program oversees all exposures for county operations including police, fire, parks and recreation, human services, as well as several other county agency exposures related to those lines of services, she added.

"We have an effective claims management program," she said. "Our numbers as of June 2005 were 2,360 claims. That's a relatively small number for the number of exposures, to include employees that we have." So far, she said the trends are similar for 2006.

Most workers' comp injuries occur in those agencies who have a greater risk inherent to their type of job--including fire, police, public works and park authorities.

The majority of accidents are slips and falls, overexertion, being struck by flying objects and motor vehicular, Ms. Flynn said. She added that risk management is focused on the key trends and on developing programs to prevent such trends.

Ms. Flynn said total incurred claims costs as of June 30, 2005 was $4.9 million--workers' comp "is about $3.6 million of that."

"Our claims are relatively stable in that it's unusual for us to have any peaks," she said. "When we do have peaks, they are clearly on our medical costs side. The frequency of claims has remained stagnant. Where we're seeing the costs is from some of the severity issues."

Ms. Flynn attributed the low incidence of claims to "some very proactive programs in place with our agencies. We have several hundred agencies that make up our employee base," she said.

The programs focus on injury prevention, working in partnership with these agencies.

She added that they have also focused on injury prevention by developing a trending initiative, responding to specific claims trends in the various departments. With strains or sprains, for example, "we have a licensed nurse and a risk management team who works with the agencies in developing accident prevention and loss control training, specifically tailored to whatever trend we're seeing."

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