by Frank Pennachio, WorkCompEdge Contributor

Much has been written about the decline of the frequency of workplace injuries over the past 15 plus years. Improved workplace safety, modular construction, cordless tools, and reductions in heavy manufacturing are some of the most popular reasons attributed to the decline.

On the surface, this sounds like a positive thing. But upon further examination, this much-celebrated decline in the number of workplace injuries may not be completely legitimate.

Does it make sense that delays in getting prompt medical care are often increasing the treatment requirements – and therefore the cost – of injuries? Increased rates of surgery and physical therapy are contributing to increased loss severity.

The June 2008 report to Congress by the U. S. House of Representatives Committee on Education and Labor, “Hidden Tragedy: Underreporting of Workplace Injuries and Illnesses,” states that work-related injuries and illnesses in the United States are chronically and even grossly underreported.

According to the report, “as much as 69 percent of injuries and illnesses may never make it into the Survey of Occupational Injuries and Illnesses (SOII), the nation’s annual workplace safety and health “report card” generated by the Bureau of Labor Statistics (BLS). If these estimates are accurate, the nation’s workers may be suffering three times as many injuries and illnesses as official reports indicate.”

What are the causes of underreporting? According to experts:

• OSHA’s reliance on self reporting by employers. Employers have strong incentives to underreport injuries and illnesses that occur on the job.
• Twenty percent of workers— including public employees in high-risk jobs such as law enforcement, fire protection, and public works; workers on small farms employing less than 11 employees; and those who are self-employed—are not even counted by BLS.
• Work-related illnesses are difficult to identify, especially when there are long periods between exposure and illness, or when work-related illnesses are similar to other non-work-related illnesses.
• Recent changes in OSHA’s recordkeeping procedures have affected the accuracy of the count of musculoskeletal disorders (MSDs).
• Some employers are confused about reporting criteria and OSHA staff are often not well-trained to provide accurate advice.
• Workers report widespread intimidation and harassment when reporting injuries and illnesses. Immigrants are also less likely to report, as explored in last week’s blog entry by Bill Wilson.
• While they may be well-intentioned, widespread and popular safety incentive programs which provide awards for a period of time without a recordable injury, can have the effect of putting pressure on workers not to report their injuries.

Here’s what I’d like your ideas about: Do you think it’s possible that underreporting of injuries may be one of the causes of the increased severity of the injuries that are reported? In other words, are employees resistant to report an injury, and only do so when they can’t stand the pain any longer? If so, does it make sense that delays in getting prompt medical care are often increasing the treatment requirements – and therefore the cost – of injuries?

A report published just a few days ago by NCCI presents an interesting analysis of claim severity as related to the “growth in treatments per claim” over recent years. This report shows that significant contributors to increased claim costs are increased rates of surgery and physical therapy. Catastrophic injuries aside, of course, doesn’t it make sense that the longer you defer medical attention for a problem, the more likely you may need surgery and/or extensive physical therapy?

Ultimately, it’s in the best interest of the employer and the injured employee to report all injuries promptly and get immediate medical treatment. It’s essential for the employer to create a culture that fosters the reporting of injuries. Education and communication is the key. Get the message out loud and clear: if you get hurt, report it. The company, the injured employee, and the employee’s family will all benefit from reporting all injuries. It’s the right thing to do – and it may cost us all less in the long run.