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Higher costs, slower return to work

Unfortunately, higher costs and slower return towork are hallmarks of injuries involving America’s aging workforce. According to the Centers for Disease Control (CDC) and the BLS, older workers tend to have longer durations of work absences due to injuries or illness and a higher incidence of work injuries overall, including falls, contact with objects and overexertion. Each year, one in three people ages 65 and older will experience a fall.

Further, aging workers are simply more prone to accident and injury, requiring employers to pay special attention to prevention, ergonomics, and re-entering the workforce to avoid re-injury. In fact, CDC and BLS found that injured workers ages 55 and older report a median of 12 lost work days—twice the amount of lost work days among injured workers ages 20 to 24. This means more lost-time, higher wages and higher indemnity costs for older workers.

Finally, the prevalence of co-morbidities—that is, two or more disorders or illnesses in the same person at the same time—increases with age. They can be related to behaviors and lifestyle, or simply result from pre-existing illnesses. Align Networks’ data demonstrates that 90% of patients in the physical therapy outpatient setting have at least one additional medical co-morbidity, such as diabetes, which can impact a patient’s ability to quickly and adequately recover from an injury or illness. Addressing and proactively managing co-morbidities allows for reduced lost work days and improved long-term health for patients.

[Related: California workers' comp benefits will increase in 2016]

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Recognizing the risks for older employee injury, illness

As workers’ compensation professionals, we know that all jobs pose some risks of injuries. Whether an office job with high repetitive motion and awkward, sustained postures or an industrial setting requiring forceful exertion and contact stress, it’s a fact that older workers are especially at risk for injury or illness.

There are a number of physical changes that take place as workers age and can impact their ability to successfully complete physical tasks on the job without injury. Muscle weakness is a major concern among aging workers as most people experience some age-related loss in muscle tone and strength, which has a direct correlation to loss of strength and increase for fall risk. In fact, by the age of 80, more than half of a body’s muscle has been lost.

Concerns related to joint health also increase with older workers. Weight-bearing and movable joints are at the highest risk for age-related degenerative changes that could increase a worker’s risk for a workplace injury, like a fall, and can also lead to slower recovery rates. In fact, Align found that 80% of all surgical rotator cuff tears (part of the shoulder joint) occur among workers over the age of 45. In many cases, simple changes to ergonomic factors in a job can reduce the stresses put on the shoulder by workers and potentially reduce the frequency of such joint injuries as rotator cuff tears.

Further, lack of sleep, vision problems, confusion, agitation or mental status changes, and changes in eating habits can all be signs that employees are at increased risk for injury or illness. Recognizing these risk factors and helping employees or injured workers to seek assistance early can help to identify problems before they become more serious.

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Managing costs and time away from work

When managing the recovery of an aging injured worker, it’s important to not only focus on the short-term costs and return-to-work metrics, but also on the long-term recovery and risk reduction for re-injury.

Clinical oversight throughout the entire continuum of care for each workers’ compensation claim has demonstrated enormous benefit in reducing costs-per-claim and more quickly facilitating an injured worker’s return-to-work. In fact, in a review of Align clients, those whose physical therapy treatments were most closely managed through the Gold Standard Review (GSR) comprehensive clinical oversight program saved an average of 8.9 visits per referral and, when looking specifically at older workers, those 55 and older saved nearly 10 visits on average. This program also contributed to a total savings of $1,675 from fee schedule per referral among workers ages 55 and older.

Workers’ compensation professionals also should:

• Seek out high-performing doctors,
• Identify and involve all appropriate specialists early in the recovery process, and
• Follow appropriate clinical guidelines for improved long-term outcomes.

Studies have shown that high-performing doctors—those considered “top doctors” with extensive experience in a given specialty—produce improved medical outcomes and, ultimately, lower indemnity costs in workers’ compensation claims.

In looking at the long-term management of an injury and prevention of re-injury, employers also should consider the role of physical therapy in resolving claims and appropriately returning older employees to work. For injuries common among older workers, such as joint injuries, back and joint pain and muscle loss, physical therapy can be a critical element of a worker’s recovery. Often underestimated, physical therapy helps return employees to work more quickly with improved coordination and overall health, also supporting the long-term health of those employees.

Michelle Despres, PT, CEAS II, is the Executive Director and National Product Leader at Align Networks, a division of One Call Care Management, a leading organization in physical medicine for workers’ compensation. She can be reached at [email protected].

Editor’s Note: For further information, tips and best practices for managing the aging workforce, click here to download One Call Care Management’s white paper, “The Aging Workforce: Challenges and Opportunities.”