Workplace Drug Use

Safety First

Knowing whether someone used marijuana recreationally or for medicinal purposes is not really the point. Making sure workplaces are safe, is.
By: | February 20, 2017 • 7 min read

Transportation companies are taking a hard look at their zero tolerance policies now that 28 states have legalized the medical and/or recreational use of marijuana.

Knowing when to discipline an employee and when to stay one’s hand though, is going to be difficult. Traces of the nonactive ingredients of marijuana can remain in a person’s system for days, even months. It will be hard to determine whether an employee was getting high on the job or is simply testing positive after a long weekend.

One thing experts agree on is that the goal of any kind of test should be to determine whether a worker can do their job safely and effectively.

“No matter what type of drug, whether it’s legal or illegal, including prescribed medication, we need to understand how they can impact workers’ ability to perform job functions, especially when operating vehicles or machinery,” said Paul Baute, a vice president within Marsh Risk Consulting’s fleet safety practice in Indianapolis.

“We need to keep safety paramount.”

“The principal question they want to determine is whether the drugs can affect job performance, and particularly whether safety can be affected because an employee is working under the influence.” — Paul Baute, vice president, Marsh Risk Consulting

Commercial drivers are allowed a certain threshold of marijuana in their system by the U.S. Department of Transportation (DOT).

That threshold cannot exceed 50 nanograms of THC per milliliter of urine, Baute said.

Under DOT requirements, employers will also conduct confirmatory tests with a cutoff of 15 ng/ml. If a worker exceeds the initial cutoff, their case is referred to a substance abuse professional.

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That consultant in turn works with the employee and their doctor to determine whether there is a prescribed or over-the-counter medication that could have been the reason for the positive result.

If the employee still tests below the 50 ng/ml cutoff no matter the drug, then that would mean for work purposes, the substance is not in their system — zero tolerance really means that an employee cannot have an amount above the cutoff, he said.

For workers testing positive, employers could have a zero tolerance policy or they could have a rehabilitation policy, which is allowed by the DOT.

Employers can have separate drug testing policies for non-CDL drivers and operators of machinery, and still another for all other types of employees, such as office workers, Baute said.

“The principal question they want to determine is whether the drugs can affect job performance, and particularly whether safety can be affected because an employee is working under the influence,” he said.

Hair sampling is relatively inexpensive and the results are quick, but it tests for the longest time frame that the drugs could be found in the body, Baute said.

Which Test is the Right One?

The DOT’s primary test is a urine test, but the agency will accept a blood sample if a worker is involved in a collision and is unable to provide a urine sample at the time of the accident.

David Mitchell, director of risk control and safety, Aon Risk Solutions

David Mitchell, director of risk control and safety for Aon Risk Solutions’ transportation and logistics practice in Little Rock, Ark., said the DOT determined that the urine tests would not change because of all of the new state laws legalizing marijuana.

Some fleets use hair testing in addition to urine testing, but the method is at a “tentative stage right now,” as the Motor Carrier Safety Administration has not approved hair testing.

“It’s a very sensitive safety risk management position at this time,” he said.

“Hair testing adds costs and that would be an additional fleet determination if they think it’s worth it for their own company culture.”

Regarding random testing, the federal agency last year reduced the percentage of drivers that are required to have such tests by 50 percent, because the previous years’ positive results “were so low there was no justification in the higher test rate,” Mitchell said.

“Drug use among truck drivers is not high, and drugs are not the cause of many crashes,” he said.

“To prevent serious crashes, fleets that reduce driver fatigue, alcohol use, inattention and tailgating are having great results.”

Barry Sample, senior director of science and technology at Quest Diagnostics Employer Solutions in Seneca, S.C., said that there really hasn’t been much, if any, change in drug test cutoffs from the firm’s employer clients operating in the states that now allow for medical and/or recreational use of marijuana.

For those states that have had these laws for a longer time — Colorado and Washington — Quest’s clients have inquired whether they can remove marijuana from the panel or change the cutoff, but to date haven’t changed their policies.

“These inquiries are more from employers that are having difficulty finding qualified employees and they are now making a risk determination,” Sample said.

“Right now, they are not willing to take the risk of changing their drug testing policies because they don’t know the impacts to productivity and safety.”

Still, Quest is continuing to monitor possible changes in ordering patterns by employers.

“I would advise employers to continue to look at their employee base and make risk-based decisions as to what drug testing is important to help ensure that they have a safe as well as a productive workforce,” Sample said.

Mark A.R. Kleiman, professor of public policy at New York University, said that some companies use drug testing to screen employees for other characteristics that might be correlated with drug use, such as whether the person “has a taste for breaking the law.” Some employers just believe that marijuana users “are not good people.”

“But then you have to ask whether it’s an employer’s rule to enforce the law, or moral views, with respect to employees’ private lives,” Kleiman said.

It’s Not Drug Testing; It’s Impairment Testing

Ellen Komp, deputy director, California NORML

Ellen Komp, deputy director of the cannabis advocacy group California NORML in San Francisco, said that urine testing has never been scientifically shown to be safe or effective at improving workplace safety or productivity.

Komp cited a 1985 consensus report of medical expert opinion in the “Journal of the American Medical Association,” concluding that drug tests are an inherently unreliable indicator of drug impairment.

“Workplace drug testing programs are essentially spying on workers outside of the workplace, because they do not necessarily show whether a person is actually impaired if they smoked marijuana days earlier and traces of the drug have remained in the system,” she said.

“Hair sampling in particular can pick up marijuana use months earlier. It’s not a good way to ensure safety in the workplace, but rather a way to discriminate against workers.”

The advocacy group does support impairment testing “as a better way to ensure safety without discriminating against workers,” Komp said.

Bowles-Langley Technology Inc. developed an impairment testing application, and a 2009 study of the application under a grant by the National Institute for Occupational Safety and Health showed that such testing for fatigue and impairment in the workplace is both feasible and practical, said Henry M. Bowles, CEO of the Alameda, Calif. firm.

He also is a board member of Predictive Safety in Centennial, Col., which merged with Bowles-Langley last year and is now “leading the charge” for commercialization, conducting pilot studies with several companies including mining companies in South Africa.

It launched a mobile app, AlertMeter, which measures reaction time, decision-making and pattern recognition. The quick minute-plus test can be taken before or just as a person gets to work, and the results are transmitted to a common database that can be monitored by a safety manager.

Individuals take the test 10 times to establish personal baselines and then are tested against their own baseline. The software adjusts the baseline as people get better and better at taking the tests, but if people score significantly below their baseline both on an initial test and a retest, then their supervisor is alerted.

“Company policy should be in place to help a manager make a decision about what should happen,” Bowles said. “It could be that the individual stayed up with a sick child and maybe just needs to work on a computer instead of a forklift for the day.”

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Bowles stressed that the firm is not trying to “overthrow the chemical drug testing regime” because it is pretty well-embedded in law, particularly for DOT-regulated companies. However, fatigue is not detected “or considered important” in the current system of drug testing.

“We’re seeing that a lot of impairment occurs because of fatigue as well as from the use of drugs, both legal and illegal,” he said.

“More and more companies are telling us, especially with the legalization of marijuana, that impairment testing makes the most sense.” &

Katie Kuehner-Hebert is a freelance writer based in California. She has more than two decades of journalism experience and expertise in financial writing. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

Lead Story

Improving the Claims Experience

Insureds and carriers agree that more communication can address common claims complaints.
By: | January 10, 2018 • 7 min read

Carriers today often argue that buying their insurance product is about much more than financial indemnity and peace of mind.

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Many insurers include a variety of risk management services and resources in their packages to position themselves as true risk partners who help clients build resiliency and prevent losses in the first place.

That’s all well and good. No company wants to experience a loss, after all. But even with the added value of all those services, the core purpose of insurance is to reimburse loss, and policyholders pay premiums because they expect delivery on that promise.

At the end of the day, nothing else matters if your insurer can’t or won’t pay your claim, and the quality of the claims experience is ultimately the barometer by which insureds will judge their insurer.

Why, then, is the process not smoother? Insureds want more transparency and faster claims payment, but claims examiners are often overburdened and disconnected from the original policy. Where does the disconnect come from, and how can it be bridged?

Both sides of the insurer-insured equation may be responsible.

Susan Hiteshew, senior manager of global insurance and risk management, Under Armor Inc.

“One of the difficult things in our industry is that oftentimes insureds don’t call their insurer until they have a claim,” said Susan Hiteshew, senior manager of global insurance and risk management for Under Armour Inc.

“It’s important to leverage all of the other value that insurers offer through mid-term touchpoints and open communication. This can help build the insurer-insured partnership so that when a claim materializes, the relationships are already established and the claim can be resolved quickly and fairly.”

“My experience has been that claims executives are often in the background until there is an issue that needs addressing with the policyholder,” said Dan Holden, manager of corporate risk and insurance for Daimler Trucks North America.

“This is unfortunate because the claims department essentially writes the checks and they should certainly be involved in the day to day operations of the policyholders in designing polices that mitigate claims.

“By being in the shadows they often miss the opportunity to strengthen the relationship with policyholders.”

Communication Breakdown

Communication barriers may stem from internal separation between claims and underwriting teams. Prior to signing a contract and throughout a policy cycle, underwriters are often in contact with insureds to keep tabs on any changes in their risk profile and to help connect clients with risk engineering resources. Claims professionals are often left out of the loop, as if they have no proactive role to play in the insured-insurer relationship.

“Claims operates on their side of the house, ready to jump in, assist and manage when the loss occurs, and underwriting operates in their silo assessing the risk story,” Hiteshew said.
“Claims and underwriting need to be in lock-step to collectively provide maximum value to insureds, whether or not losses occur.”

Both insureds and claims professionals agree that most disputes could be solved faster or avoided completely if claims decision-makers interacted with policyholders early and often — not just when a loss occurs.

“Claims and underwriting need to be in lock-step to collectively provide maximum value to insureds, whether or not losses occur.” – Susan Hiteshew, senior manager of global insurance and risk management for Under Armour Inc.

“Communication is critically important and in my opinion, should take place prior to binding business and well before a claim comes in the door,” said David Crowe, senior vice president, claims, Berkshire Hathaway Specialty Insurance.

“In my experience, the vast majority of disputes boil down to lack of communication and most disputes ultimately are resolved when the claim decision-maker gets involved directly.”

Talent and Resource Shortage

Another contributing factor to fractured communication could be claims adjuster workload and turnover. Claims adjusting is stressful work to begin with.

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Adjusters normally deal with a high volume of cases, and each case can be emotionally draining. The customer on the other side is, after all, dealing with a loss and struggling to return to business as usual. At some TPAs, adjuster turnover can exceed 25 percent.

“This is a difficult time for claims organizations to find talent who want to be in this business long-term, and claims organizations need to invest in their employees if they’re going to have any success in retaining them,” said Patrick Walsh, executive vice president of York Risk Services Group.

The claims field — like the insurance industry as a whole — is also strained by a talent crunch. There may not be enough qualified candidates to take the place of examiners looking to retire in the next ten years.

“One of the biggest challenges facing the claims industry is a growing shortage of talent,” said Scott Rogers, president, National Accounts, Sedgwick. “This shortage is due to a combination of the number of claims professionals expected to retire in the coming years and an underdeveloped pipeline of talent in our marketplace.

“The lack of investment in ensuring a positive work environment, training, and technology for claims professionals is finally catching up to the industry.”

The pool of adjusters gets stretched even thinner in the aftermath of catastrophes — especially when a string of catastrophes occurs, as they did in the U.S in the third quarter of 2017.

“From an industry perspective, Harvey, Irma and Maria reminded us of the limitations on resources available when multiple catastrophes occur in close succession,” said Crowe.

“From independent and/or CAT adjusters to building consultants, restoration companies and contractors, resources became thin once Irma made landfall.”

Is Tech the Solution?

This is where Insurtech may help things. Automation of some processes could free up time for claims professionals, resulting in faster deployment of adjusters where they’re needed most and, ultimately, speedier claims payment.

“There is some really exciting work being done with artificial intelligence and blockchain technologies that could yield a meaningful ROI to both insureds and insurers,” Hiteshew said.

“The claim set-up process and coverage validation on some claims could be automated, which could allow adjusters to focus their work on more complex losses, expedite claim resolution and payment as well.”

Dan Holden, manager, Corporate Risk & Insurance, Daimler Trucks North America

Predictive modeling and analytics can also help claims examiners prioritize tasks and maximize productivity by flagging high-risk claims.

“We use our data to identify claims with the possibility of exceeding a specified high dollar amount in total incurred costs,” Rogers said. “If the model predicts that a claim will become a large loss, the claim is redirected to our complex claims unit. This allows us to focus appropriate resources that impact key areas like return to work.”

“York has implemented a number of models that are focused on helping the claims professional take action when it’s really required and that will have a positive impact on the claim experience,” Walsh said.

“We’ve implemented centers of excellence where our experts provide additional support and direction so claim professionals aren’t getting deluged with a bunch of predictive model alerts that they don’t understand.”

“Technology can certainly expedite the claims process, but that could also lead to even more cases being heaped on examiners.” — Dan Holden, manager, Corporate Risk & Insurance, Daimler Trucks North America

Many technology platforms focused on claims management include client portals meant to improve the customer experience by facilitating claim submission and communication with examiners.

“With convenient, easy-to-use applications, claimants can send important documents and photos to their claims professionals, thereby accelerating the claims process. They can designate their communication preferences, whether it’s email, text message, etc.,” Sedgwick’s Rogers said. “Additionally, rules can be established that direct workflow and send real time notifications when triggered by specific claim events.”

However, many in the industry don’t expect technology to revolutionize claims management any time soon, and are quick to point out its downsides. Those include even less personal interaction and deteriorating customer service.

While they acknowledge that Insurtech has the potential to simplify and speed up the claims workflow, they emphasize that insurance is a “people business” and the key to improving the claims process lies in better, more proactive communication and strengthening of the insurer-insured relationship.

Additionally, automation is often a double-edged sword in terms of making work easier for the claims examiner.

“Technology can certainly expedite the claims process, but that could also lead to even more cases being heaped on examiners,” Holden said.

“So while the intent is to make things more streamlined for claims staff, the byproduct is that management assumes that examiners can now handle more files. If management carries that assumption too far, you risk diminishing returns and examiner burnout.”

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By further taking real people out of the equation and reducing personal interaction, Holden says technology also contributes to deteriorating customer service.

“When I started more than 30 years ago as a claims examiner, I asked a few of the seasoned examiners what they felt had changed since they began their own careers 30 year earlier. Their answer was unanimous: a decline in customer service,” Holden said.

“It fell to the wayside to be replaced by faster, more impersonal methodologies.”

Insurtech may improve customer satisfaction for simpler claims, allowing policyholders to upload images with the click of a button, automating claim valuation and fast-tracking payment. But for complex claims, where the value of an insurance policy really comes into play, tech may do more harm than good.

“Technology is an important tool and allows for more timely payment and processing of claims, but it is not THE answer,” BHSI’s Crowe said. “Behind all of the technology is people.” &

Katie Dwyer is an associate editor at Risk & Insurance®. She can be reached at [email protected]