Tuesday, January 12, 2016

Constant or Persistent "Non-Trauma?"

In workers' compensation, we have seen an evolution. I recently heard Frank Neuhauser speak about the future of workers' compensation. He appeared at the Southern Association of Workers' Compensation Administrators' (SAWCA) Annual Convention in Williamsburg last summer.  He is with the Center for the Study of Social Insurance at Berkley in California. He says that workers' compensation was originally designed early in 20th century to deal with traumatic injuries. 

He says that these traumatic injuries are reasonably easy to observe and verify. His example is a blunt-force trauma (something hits someone) and there is a resulting fracture of a bone visible on an x-ray. 

He compared these to work injuries in the 21st century. These injuries (the result of accident or disease) are more frequently, in his perspective, more difficult to perceive and verify. These are the occupational diseases, internal soft-tissue injuries like torn rotator cuffs or menisci, spinal disc injuries, and similar. He does not suggest that these are less valid injuries, just that they are harder to observe (visually identify and verify) than a fracture or a visible abrasion. 

He laments that the workers' compensation systems struggle with these modern injuries. He contends that these struggles are not because they are harder to discern, but because the systems were adapted to them, not originally designed for them. These maladies came into a system designed for blunt-force trauma and obvious injury, and adjustments and amendments have been made to adapt. But, in the end, the workers' compensation system, in his perspective, was not designed for these and so struggles with them. 

As I listened to his perspectives on the future of workers' compensation in America, it made me think about the "trivial trauma" injuries. Florida workers' compensation lawyers are familiar with Festa v. Teleflex and Tokyo House v. Hsin Chu and Pearson v. Paradise Ford and a litany of cases that discuss the issues of "repetitive trivial trauma." As I thought of those cases and Mr. Neuhauser's comments, I remembered an article I read earlier in 2015. It struck a chord with me because it effects me personally. 

CBS News reported in January 2015 that "too much sitting raises risk of death, even if you exercise." They caution that "too much sitting can take a serious toll on your health." Citing the Institution of Occupational Safety and Health, they take issues with sitting for too long. This is certainly a potential concern for those of us who are primarily desk-bound staring at computer monitors ten hours per day. 

The authors of the study do not suggest that exercise is anything but positive for us. Exercise is good, and most any physician will endorse that. But, they contend that "even if you do a half and hour or an hour of exercise every day doesn't give us reassurance that sitting for the other 23 hours is o.k. In fact, it's not."

In short, the study found that "the health hazards seem to be greatest for people who sit 8 or 9 hours a day." Clarifying the benefits of exercise generally, they also concluded "the impact (of constant sitting) was even more pronounced in people who did not exercise regularly." Sitting all day is not good. Sitting all day and never exercising is worse. 

The possible "sitting" maladies are not to be taken lightly. They include increased "risk of cardiovascular disease by 14 percent, cancer by 13 percent, and diabetes by a whopping 91 percent." The combination of prolonged sitting combined with the absence of exercise equates to a significant risk of "early death." That phrase should get the attention of desk-sitters.

The article questions whether "sitting (is) the new smoking?" With all that has been published regarding the health risks associated with smoking, that question likely resonates with many. Everyone has heard a great deal now about how dangerous smoking is. As an aside, those risks curiously have been ignored by doctors who recommend smoking marijuana as medical treatment. But in the end, for many of us, sitting is simply what we do. It is the "normal" in our lives. And, we hear more and more about how sedentary our lives have become both on and off-the-job. 

With so many risks in the work place, there have been responses in the form of safety devices, safety rules, and ergonomics. But how can one be protected from the risk of sitting? Is the risk of sitting a repetitive trivial trauma or occupational disease analysis? Or is this yet another new concept, a repetitive "non-trauma," to which systems may have to adapt? Is the fact that our posterior is placed on the chair a "trauma" each morning? Is there a workplace reaction to guard against the effects of this threat, whether it is a "trauma," a "trivial trauma" or a "non-trauma?"

The current suggestion is "standing up and taking a quick, 1 to 3 minute break every half hour or so throughout the day." There is also support for the idea of standing desks. Some companies cited by CBS News have transitioned large portions of their workforce to stand-up desks. Last year, workers' compensation blogger Bob Wilson noted some dissatisfaction with that remedy, noting that constant standing also resulted in complaints. Perhaps the solution is not "constant" anything, but periodic change?

So, we will see if repetitive sitting claims become a part of the workers' compensation landscape. With this study's conclusion that "too much sitting can be hazardous for your health," what will employers do to alleviate risk? Would we all be wise to remind ourselves to take a walk down the hall every half hour? 

For some of us, the only time we arise is to retrieve more coffee, or visit the restroom. These have come to be known as "personal comforts" in the lexicon of workers' compensation. Injuries can happen in the course of such comforts. An injured worker returning from a bathroom break might be injured. Courts have ruled that such injuries are compensable. In the same thought process, might employers likewise be liable if an employee was injured while taking that periodic walk down the hall to alleviate persistent non-trauma sitting?

Is that walk down the hall for a periodic stretch, a simple interruption of the persistent sitting, a good idea? The experts seem to say it is. Could that walking result in accidents or injuries? That is also possible. So, there appears to be risk either way, from prolonged sitting or from a brief stretching of the legs. The risks of sitting, "early death" seem to be a bit more serious. It seems logical to attempt to alleviate that big risk with the risks of taking a short break for a walk to the break room, restroom, or end of the hall.  

As a caveat, taking that walk to smoke (anything) seems to cancel any benefit with just another harm. This sitting risk now gives you a better reason to stretch your legs than going outside for a smoke!

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