Claims and claims rates
In part because of the growth in the number of claims, Oregon's workers' compensation system was overhauled between 1987 and 1990. During the 1987 legislative session, HB 2900 expanded OR-OSHA's consultative program, required insurers and self-insured employers to provide safety and health loss prevention programs, and increased penalties against employers who violated the state safety and health act. In 1990, continued high workers' compensation costs and the cancellation of the policies of many small employers provided the impetus for further reform. This effort culminated in the passage of SB 1197 during a special session of the Oregon legislature. SB 1197 extended HB 2900 by requiring that all employers with more than ten employees establish safety and health committees and that employers with ten or fewer employees establish safety committees if they had a lost workday cases incidence rate in the top ten percent of rates for employers in the same industry or were subject to a premium classification in the highest 25 percent of premium rates.
In SB 1197, the legislature also changed the definitions of compensability for both injuries and diseases. The reforms required that a compensable injury be established by medical evidence supported by objective findings. In addition, the compensable injury had to be the major contributing cause of a consequential condition for that condition to be compensable. If the compensable injury was combined with a preexisting condition, the resultant condition was compensable only to the extent that the compensable injury remained the major contributing cause of the disability or need for treatment. Injuries from recreational and social activities were excluded. Injuries that arose from the use of alcohol or drugs were excluded when it was proved by clear and convincing evidence that the alcohol or drug was the major contributing cause of the injury. (In 1995, the legislature reduced the standard of proof to the “preponderance of evidence.”) Likewise, the definition of a compensable occupational disease was changed. To be compensable, the disease had to be caused by substances or activities to which an employee was not ordinarily subjected, the employment had to be the major contributing factor, and the existence of the disease had to be established by objective medical evidence.
Legislative reforms and the increased number of safety committees have not been the only changes. Oregon employers obtain workers’ compensation insurance from private insurers or the SAIF Corporation, or they choose to be self-insured. Between 1989 and 1991, SAIF dropped the coverage of a large number of small employers and instituted claims handling procedures that resulted in a higher claims denial rate. More recently, changes in claims management by insurers and employers, such as return-to-work programs that help employees get back to work quickly, may be reducing the number of accidents that are classified as accepted and disabling.
Also, Oregon’s economy has changed over the past 20 years. There are fewer workers in the hazardous wood products industry, and more workers in comparatively safer services industries. Although this employment shift has had some effect, claims rates have declined in all industries, and the available information indicates that this economic shift has had a fairly small role in the recent reductions in the number of claims.
These factors have helped to recreate Oregon's workers' compensation environment. In most recent years, Oregon has had a slowly decreasing number of accepted disabling claims coming from an expanding pool of workers. Between 1988 and 1996, the number of workers covered by Oregon's workers' compensation law increased 28 percent, and the number of accepted disabling claims declined 35 percent. Because of this pattern, the claims rate fell from 3.8 claims per 100 workers in 1988 to 1.9 in 1996.
Industries and occupations
In 1976, 42 percent of the accepted disabling claims came from the manufacturing division; in 1996, 21 percent came from manufacturing. The largest drops in claims have come from the wood products and food products industries. In 1976, the wood products industry produced 20 percent of the claims and 38 percent of the fatalities; in 1996, it had seven percent of the claims and 22 percent of the fatalities.
A quarter of Oregonians work in the services sector, and this division now provides the second largest number of claims. Health and social services and business services (such as personnel supply companies and building maintenance services) produce the largest number of claims. The retail sector employs nearly 20 percent of Oregonians, and it produced 18 percent of the claims in 1996. Almost a third of the retail sector claims came from employees of eating and drinking establishments.
The three divisions with more claims in 1996 than in 1991 were construction, transportation and public utilities, and mining. The 11 percent increase in construction claims resulted from a 52 percent increase in employment that more than offset a drop in the claims rate from 5.5 to 4.0 claims per 100 workers. Historically, the construction industry has had the highest claims rate; in 1996, however, its rate was lower than the rates in either the mining or the transportation and public utilities industries.
The shift in the industries of injured workers is seen to a lesser extent in the shift in claimants' occupations (see Table 3). There has been a decline in the percentage of workers whose occupations are chiefly manufacturing jobs: precision production occupations and non-transport machinery operators. Also, in 1981, 41 percent of the injured non-farm laborers were in the manufacturing division; in 1996, 22 percent of the non-farm laborers worked in manufacturing.
One of the important trends in Oregon's worker' compensation system has been the steady decline in the wages of injured workers compared to the wages of all Oregon workers. In 1981, the average weekly wage (AWW) of an injured worker was $18.70 higher than the statewide AWW (see Table 5). In 1996, the AWW of injured workers was $78.03 less than the statewide average.
A 1993 department study, Differences in Average Weekly Wages, Workers Disabled on the Job and All Oregon Workers, 1982-1990, looked for explanations of this trend. The study showed that changes in the industrial mix during the 1980s had little impact. The AWW of injured workers declined in comparison to the AWW of all workers in all industries except the agriculture, forestry, and fishing division. The study found several possible explanations for the increasing difference. First, the increasing difference in wages was strongly correlated with the decline in the unemployment rate between 1982 and 1990. This result would have been expected if the economic expansion brought new, low-wage workers into the work force. These inexperienced workers would have had an above-average likelihood of being injured. In the early 1990s, however, the unemployment rate increased, but the wage differential of injured workers continued to increase.
The second explanation for the increasing wage differential was the increasing percentage of injured workers who were women. On average, women have earned less than men. Therefore, as the percentage of injured workers who were women grew closer to the percentage of all Oregon workers who were women, the wage differential should have grown. Again, however, this explanation doesn't hold true during the 1990s. The percentage of women in Oregon's work force has increased, while the percentage of the injured population who are women has declined.
The third explanation is the difference in educational levels. In 1990, while about 40 percent of employed Oregonians aged 25 and over had no more than a high school education, 72 percent of the injured workers had no more than a high school education. In 1996, 67 percent of the injured workers had no more than a high school education. It is often reported that the wage gap between those with and those without a college education is increasing. Because the majority of injured workers do not have a college education, the increasing wage differential may be the result of this education gap. The department will be exploring this possibility further.
Injury and disease descriptions
The top portion of the table shows the events that caused the claims in 1981 and 1995. In both years, 36 percent of the claims resulted from overexertion. An increasing percentage of the claims are from bodily reaction (where a single incident of bodily motion causes a strain upon the worker's body) and repetitive motion (where multiple incidents of bodily motion cause strain). A smaller portion of the claims now result from workers being struck by objects or against objects. These claims are more often likely to occur in the manufacturing industry, especially in the logging industry, so this decline reflects the change in the industrial mix.
The second portion of the table shows the nature of the injuries and illnesses that resulted from the injury events. There has been an increase in the number of claims resulting from carpal tunnel syndrome and from musculoskeletal and tissue diseases, which are caused by repetitive trauma that usually affect workers' shoulders and upper extremities. The declining percentage of claims resulting from contusions come from the fewer incidents in which workers were struck by objects; it may also reflect return-to-work programs that return employees to work quickly enough that their claims are not defined as disabling.
The third portion of Table 6 shows the part of the body affected by the injury event. The increases in carpal tunnel syndrome and musculoskeletal diseases are reflected in the increased percentages of claims involving the trunk (other than the back), arms, and wrists. The back remains the most frequent body part injured.
The final portion of the table shows the object that directly caused the injuries or diseases. The "self injured" category is used when the injury was not caused by some external object; it is usually used for bodily reaction and repetitive motion events. Floors, walks, and the ground are usually the sources of injury in falls, although workers also fall onto other items. Containers are most often the sources of injury in overexertion claims. In four percent of the cases, another person is the direct cause of the injury. In the majority of these cases, the injury resulted from overexertion while moving a person; other cases include inadvertent striking of the worker, as when a patient falls against a nursing aide; other cases involve intentional assaults, often during the commission of a crime.
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