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Worker Compensation in Commercial Drivers Injury Prevention and Case Management Brian Harrison, M.D. April 2014. Worker Comp (WC) in Commercial Drivers (CD)- Concepts. DOT Regulations reduce major WC Cases BUT: DOT Regulations may increase Lost Workdays in both major and minor cases
Injury Prevention and Case Management
Brian Harrison, M.D.
Active Interstate Truck and Bus Companies (2004)
Between 2000 and 2010:
truck and bus miles increased 20%; more carriers.
Total Number of CDLs Issued
FMCSA certification examinations for commercial motor vehicle drivers: 3-4 million exams annually
Source: Motor Carrier Safety Progress Report (September, 2004)
13 standards directly related to medical requirements
4 standards are specific
Medical examiner cannot interpret or alter
Vision, Hearing, Epilepsy, Insulin use
9 standards are general (“likely to, which interferes,” or satisfied by Skill Performance Evaluation or OK’ed by MD)
Medical examiner decides if medical condition affects driver’s ability to safely operate a CMV
Two or more of the following:
1. Body mass index >35 kg/m2
2. Neck circumference in men >17” and in women 16”
3. Hypertension (new, uncontrolled, or unable to control with fewer than two medications)
And kept it off
For 1 year!!!
Remained at BMI < 35
When given option
to lose weight:
Seen for re-cert (10.6 mo average f/u)
No unaddressed OSA risk
At BMI < 35 in 3-9 months
To weight loss option
At risk for OSA, BMI ≥ 35
Available for f/u at 3-9 mo.
BMI still ≥ 35 at 3-9 months
To bariatric surgery
Proceeded to PSG and treatment (if indicated)
Lost to f/u
Out of service PSG (all positive)
The Omnibus Transportation Employee Testing Act became law on Oct. 28, 1991
Seems like a long time ago: Packers went
4-12 in 1991 with Coach Infante and QB
Illegal drug use among transportation workers has since dropped 50%
Fatal accidents from alcohol use by truck and bus drivers has since dropped 23%
Making illegal maneuver
Traveling too fast for conditions
Following too close
Misjudgment of gap or other’s speed
Stop required before crash
most important by
8. Over-the-counter drug use
9. Inadequate surveillance
258, up from
251 in 2011
Ill health and health-risking behavior underlie this conundrum, not a lack of driving safety
Individuals with multiple health risks are more likely to submit claims
Workers Comp medical care and wage indemnity costs are higher in high risk claimants
Organizations with higher prevalence of health risks have higher Workers Comp costs
And – Drivers must WORK more safely, not just DRIVE more safely!
LowRisk(any 2 or fewer)
Medium Risk(any 3 or 4)
HighRisk(any 5 or more)
77% higher average medical costs (obese vs. ideal)
Treatment of obesity-related diseases accounted for 27% of the rise in inflation-adjusted per capita medical spending between 1987-2001
Thorp et al, “The impact of obesity on rising medical spending” Health Affairs 2004 supplement
Age-related degenerative lumbar disk disease develops simply as a part of life. It makes some less able to tolerate the whole body vibration they absorb from work vehicles.
Get Vibration-Canceling Equipment.
But studies specific to Disc Degeneration (LSP and CSP DDD) do not show this correlation