For This Award-Winning County, Employee Safety Begins Before the Job Offer

Monmouth County, New Jersey, used a combination of advanced technology and safety-and-wellness programs to lower claims 44 percent and losses by 76 percent from 2009 to 2017.
By: | October 30, 2018 • 6 min read

As a man lifts weights over his head, an ergonomist carefully analyzes his movements: Are the feet spread far enough apart to distribute weight evenly? Are there any weak points that seem out of the ordinary? Is the shoulder angle correct?

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Rather than watching and taking their best guess, the ergonomist uses motion capture technology that displays a likeness of the man’s skeleton and real-time movements on a computer screen — offering precise information about posture, capabilities and limitations. It’s the kind of technology used in filmmaking and digital gaming — but in Monmouth County, New Jersey, it’s being used to mimic the actual day-to-day tasks of a parks department employee.

The test is one of many innovative solutions implemented by Monmouth County leadership to spur a dramatic turnaround in its workers’ compensation program. Back in 2009, the County saw over 400 new claims and losses of $5.5 million. They hired too many people not physically capable of the job tasks. Injured workers could get full pay and benefits for up to a year. Light duty was underutilized.

Departments hardly communicated. Newly appointed manager of benefits and workers’ compensation William McGuane knew something needed to change — fast.

“When I got here, I saw a workers’ compensation policy that actually lessened the employees’ ability to return to work safely and consistently,” said McGuane. “When you can stay home and make full pay, there’s not a lot of incentive to come back to work.”

Through a combination of safety-and-wellness programs, advanced technology and modernized labor union agreements, Monmouth has seen a dramatic turnaround. From 2009 to 2017, claims dropped by 44 percent and losses dropped 76 percent. The effort led Monmouth County to receive a 2018 Teddy Award, for excellence in workers’ compensation risk management.

Digging In

First things first — who is getting hurt? There are 4,100 workers in the County doing incredibly varied jobs. There are corrections officers and librarians. There are maintenance workers and nursing home employees. So who’s driving these massive comp claims?

William McGuane, manager of benefits and workers’ compensation, Monmouth County, N.J.

After digging into the data, McGuane found workers in their first 90 days were particularly susceptible to injury — especially those working the most strenuous jobs like building, grounds, corrections, highway, law enforcement and in the parks departments.

“We were hiring people incapable of doing the jobs,” said McGuane. “It became evident that they couldn’t do it safely.”

To combat that, the County had ergonomists and physical therapists from Hackensack Meridian Health measure the dynamic forces employees endured while doing their normal job functions. Then came motion capture.

“We have them do all those job functions in front of a physical therapist, guiding them on proper technique. If they don’t pass, they don’t get the job — and that weeds out a lot of potential injuries down the road,” said Dr. Jared Schulman, corporate medical director, occupational health, Hackensack Meridian Health.

The parks department was a particularly high driver of injuries — generating nearly half of the County’s total incurred costs in some years.

“We consistently saw seasonal injuries. Tick bites in summer are unavoidable, heat exposure and poison ivy are pretty consistent, too,” said Schulman. “Overall, musculoskeletal complaints are most frequent — low back injuries, shoulders, knees.”

So the County piloted a safety-and-loss-prevention program in the parks department, working with risk management solutions firm PMA Companies to teach workers and supervisors how to lift and move ergonomically. They also conducted a safety survey and the results were clear — there were serious discrepancies between employees’ and supervisors’ views of safety policies. And that led to a major lack of communication.

“We helped train their supervisors to understand their role in the safety process,” said Justin Wilkinson, account executive at PMA Companies. “You’re not disciplining an employee by telling them they’re doing something wrong, you’re helping them stay safe.”

“What they’ve been able to do is phenomenal. A big part of that is Monmouth County being transparent with their employees and respectful. It sends a message to the whole organization that health and safety are important to them.” — Dr. Jared Schulman, corporate medical director, occupational health, Hackensack Meridian Health

The safety-and-loss-prevention program is a winner, as new claims volume for the parks department has declined 22 percent from 2011 to 2017. The pilot program will soon be rolled out to other departments in the County.

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Another population that represented heavy claims were people returning to work after injuries. Part of the problem was antiquated job descriptions. Revamping them to accurately portray the physicality of each position led to an expansion of light duty. Getting them to light duty greatly increased the chance of a return-to-work success story.

“Bringing them back early hurt them to a greater degree. That’s when claims got out of control and employees didn’t return to work and ugly scenarios emerged that we didn’t want to see,” said McGuane.

Changing a Culture

Another major hurdle: Existing labor union contracts provided full salary continuation for up to a year for an employee’s work-related injury. Workers could then get FMLA leave tacked on afterwards. It damaged morale, strained overtime budgets and — most importantly — kept people out of work far too long.

“They can develop what I call the I Love Lucy syndrome, where sitting on the couch and getting atrophied becomes their lifestyle,” said McGuane. “It’s no way to have a fulfilling life. It does a disservice to the injured worker and a disservice to all levels of the organization.”

Over three years of negotiations with 32 labor unions, they brought that number down to six months.

“We explained the unintended consequence of what was happening. Getting them back in the building in some type of capacity was far more humane than having them sit on the couch someplace,” said McGuane.

Another major initiative was the wellness program — highlighted by the “Pledge 10” initiative aimed at getting employees to lose 10 pounds over a 12-week period. For the naturally thin or people already in shape, they could maintain their ideal weight. They also offered free biometric screenings, flu shots, wellness seminars and an annual physical — where employees were entered into a raffle to win a free personal day.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better,” said McGuane. “We’ve had people lose 30 and 40 pounds.”

Changing Lives

Monmouth saw tremendous results from its efforts. Overall claims costs fell from over $5.5 million incurred in accident years 2009 and 2010 to under $2.1 million in 2016 and $1.3 million in 2017.

Total new claim volume decreased 44 percent, from 410 in 2009 to 230 in 2017. Lost-time claims decreased from 80 in 2009 to 34 in 2017. Open outstanding claims decreased from 332 in 2010 to 254 claims today. The County’s calendar year paid totals have been trending downward from $5.1 million in 2010 to $4.4 million in 2017.

“Over the course of 10 years, the program has just gotten better,” said Wilkinson. “We hope to drive our clients to have the kind of success Monmouth County is having. We use them as a model when we market to other counties. We’ve had success with other accounts, but this one stands out.”

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Schulman is equally impressed: “What they’ve been able to do is phenomenal. A big part of that is Monmouth County being transparent with their employees and respectful. It sends a message to the whole organization that health and safety are important to them.”

For McGuane, the workforce and workers’ comp program he inherited years ago feels incredibly different. It’s a safer place to work. Injured workers are more likely to get better. Claims are no longer out of control.

“I’ve seen people’s lives change as a result of the program we’ve done,” he said. “It’s one of the most gratifying things I’ve ever seen professionally.” &

Jared Shelly is a journalist based in Philadelphia. He can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.

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That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.

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Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]