Return To Work?
Feb 16, 2017

Think about the following statement: "The US Social Security Administration estimates that just over one in four of today's twenty-year-olds will become disabled before they retire (Social Security Basic Facts, 2015)." Still thinking? This is from the introduction to a new whitepaper published by the The International Association of Industrial Accident Boards and Commissions (IAIABC). The paper focuses on the need for the US, as well as other OECD countries, to get serious about return to work.

You don't need to be an economist to understand that the roughly 25% rate of disability forecast by the SSA is not sustainable, even without the added pressures of the aging workforce and growing numbers of retirees. Those of us who deal with workers' comp claims every day can get a form of tunnel vision about RTW and see it as a claim by claim concern. The IAIABC paper is reminding us that RTW is a major societal concern as well. In effect, it's everyone's business, not just an issue for a coterie of professional claims people.

The whitepaper is long and detailed at 127 pages. The takeaway points are, however, summarized fairly quickly in the list of 32 guidelines provided by the International Social Security Association (ISSA). These, in turn, can be condensed into a few very important considerations:

  • RTW should be comprehensive, not narrowly targeted
  • RTW should begin as part of medical treatment, not as an afterthought months later
  • RTW is the whole point of medical management (and not penny-pinching treatment costs)
  • Empower and motivate the claimant
  • Get serious about workplace accommodation
  • Remember that each claimant is an individual

In short, RTW is a first principle, not a last resort when a six week claim hits six months and everyone finally starts to pay attention. As the paper notes, "effective return to function is a societal obligation that must be embraced by employers, regulators, injured workers, co-workers, carriers, caregivers, and vendors; all the parties that play active roles in an injured person's life are responsible for helping them return to a productive, contributory role in society."

Further, the costs of not rising to the challenge are ultimately prohibitive as fewer and fewer active workers struggle to carry the costs of more and more disabled and retired citizens. That is called catastrophic system failure.


2016 had no Katrina-sized hurricanes, Loma Prieta-style earthquakes, or other headline "nat cats", as underwriters call them. As twelve month chunks of time with their attendant natural disasters go, 2016 was fairly average, but with its own twists. CoreLogic has just published its annual Natural Hazzard and Risk Summary & Analysis for 2016 (a neat overview from Property Casualty 360 is found here). A few highlights from our disaster hit parade:

  • Flood losses were up substantially from 2015 and may presage an even wetter year for 2017.
  • Hurricane damage was modest while non-tropical storm wind damage ticked up a bit. The windiest city in the US in terms of insured damage? Nashville, TN, with 21 significant wind events.
  • 2016 was the year that Oklahoma became the earthquake capital of the US in frequency and severity with one rock n' roller hitting 5-8.
  • Wildfires were pretty tame, relative to recent years, with one of the worst fires in terms of damage occurring in Tennessee and not the drought-stricken west.
  • Tornadoes were also modest, but snow and ice hammered parts of the US in February, setting local records.

In all, a very mixed year. 2016 was the warmest year on record, but there was little clear evidence of disasters following in the wake of the heat waves in the US. On the other hand, 2016 was the worst year for natural disasters since 2010 worldwide, according to Munich Re, led by the earthquake in Kumamoto, Japan. Do we see any trends? The best answer so far comes from Torsten Jeworrek of the Munich Re Board of Management who said: "After three years of relatively low nat cat losses, the figures for 2016 [worldwide] are back in the mid-range, where they are expected to be. Losses in a single year are obviously random and cannot be seen as a trend."

In sum, be optimistic, but keep an eye on the sky.


Our friends at and Terry Bogyo have put together the definitive worry list for workers' comp for 2017, all in one place for your convenience and reading pleasure. Most of the issues outlined here have been touched on in earlier issues of the GB Journal, but this summary brings together the six big trends which are in the process of reshaping workers' comp:

  • The gig economy and its handmaiden (people performing multiple jobs every week or month) upends our conventional concepts of everything from benefit determination to disability allocations and brings many basic assumptions about how comp is supposed to work into question.
  • Disruptive technologies are making RTW ever more complex. How do we do RTW in "sunset" industries where jobs are disappearing all the time? How do we define vocational opportunities in today's rapidly changing job environment?
  • Social media and workers' comp make a troublesome combination as blogs about poorly handled claims and other carrier or TPA alleged misdeeds proliferate, driving an online atmosphere of growing mutual distrust.
  • The diverging spread of "vulnerability" and safety concerns between the youngest and the oldest workers raise numerous questions, as aging employees remain on the job while their millennial grandkids join the workforce. What does this radical spread mean for loss engineering and RTW?
  • Our constantly growing understanding of the links between work and aging or disease processes—physical and mental—calls into question existing definitions of AOE/COE and relatedness.
  • The growing discussion of "nationalization" calls into question the ongoing governance of comp. The divergence of processes, benefits, even basic concepts from one state to another challenges ideas of fairness and equity. Why is a severed hand, for example, worth more in one state than another?

These and related issues will shape the national and local discussion about comp, comp reform, and even the basic concepts of the Grand Bargain, going forward. Bogyo's essay is a great thought piece for those who care about workers' comp and its future.


One more item for your worry list if you manage risk for a large fleet: are the DOT health certificates for your drivers legitimate? Consider the case of "Dr. Tony" and his cert mill outside Atlanta, as profiled in the Boston Globe. In short, all a driver needed to get a new cert from this fraudster was a pulse and a fee. Dr. Tony cranked out more certs in a day that most doctors on the registry did in a month - and it all looked legit until a driver complained. As of the time the Globe article was written, no one seemed to know whether any of Dr. Tony's fraudulently certified drivers had been involved in a serious accident, but the potential is worrisome to say the least.

How do you control the DOT health certs for your drivers? Dr. Tony was on the DOT's registry. Do you know who's signing those forms? Do you want to find out after an accident?



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