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By MELISSA TURLEY, a writer in the Washington bureau of cyberFEDS®, which is produced by LRP Publications, the parent company of Risk & Insurance®

The Transportation Security Administration (TSA), created in the wake of the Sept. 11, 2001, attacks, has one of the most important jobs in U.S. government: Its workers screen passengers and baggage before they can board airplanes.

There is also the responsibility of getting passengers of all ages and of all sizes through the metal detectors, while inspecting carry-on luggage as quickly and thoroughly as possible.

It's no surprise that in the agency's infancy, as many as one-third of its workforce filed workers' comp claims. Limited work duty was scarce. TSA officers were subject to the quotidian rigors of bending, lifting and twisting--requirements when dealing with harried passengers and restrictive packing requirements. So partly as a result, workers' comp costs skyrocketed as the periodic rolls swelled.

In fiscal year 2004, for example, just two years after the TSA began operations and took over the civilian security duties formerly handled by the Federal Aviation Administration, the TSA reported as many as 17,763 injuries to its own employees and 7,276 lost-time cases.

If ever there was a Cinderella story, the TSA's workers' comp program is it. In just five years, from fiscal year 2004 to fiscal year 2008, the number of injuries plummeted from 17,700 to fewer than 4,800, according to TSA statistics.

Over the same period, the TSA's workers' comp program also saw lost production days decline by more than half, to an average of 148 days. Limited duty is now mandatory for all workers injured on the job, according to TSA workers' comp and disability managers.

For its reform efforts, the TSA was awarded the Federal Theodore Roosevelt Workers' Compensation Award, which is given to U.S. government agencies with the most success in managing their injury and safety programs. TSA administrators will be recognized at the 18th Annual National Workers' Compensation and Disability Conference® & Expo in Chicago on Nov. 18.

So, what's the secret to TSA's turnaround?

NURSES AS MANAGERS

The agency deployed a team of experts with an understanding of the claims process and of the medical care process. TSA's nationwide nurse case management program relies on the medical expertise of 18 nurses who from the start of the claims process work with claimants on their rights and responsibilities.

"We realized we needed help," said Elizabeth Buchanan, TSA's deputy associate administrator of human capital. "We needed someone to medically manage claims. We ran a pilot for about eight months. It went so well, that we agreed to (expand it)."

Supervisors have access to a 24-hour injury hotline to report injuries. Within one day of their call, nurses are on the case, making sure employees are seeking and receiving prompt medical care that can speed their recovery and get them back to work as quickly as possible.

TSA contracts with MCA Innovations Joint Venture for its nurses. Nurses help employees set up appointments at diagnostic testing centers. Information from MRIs, for example, is then ready for the treating physician. Nurse case management includes communication with injured workers, the U.S. Department of Labor and airport managers to facilitate return to work.

"Our primary purpose is to take care of employees," Buchanan said, adding that having nurses as managers also costs less.

TSA field workers' comp coordinators are also on the case. More than 300 airports each have at least one coordinator responsible for claims administration and program management, usually as a collateral duty. They help employees complete forms, find limited duty assignments and coordinate with the DOL's Office of Workers' Compensation Programs.

As a result, 99 percent of employees who come back to work are accommodated. But if 90 percent of TSA jobs are classified as physically demanding, where do these workers go when they come back?

Buchanan said it's about being creative with job restructuring. Nurse case managers, who are familiar with medical restrictions, find compatible job tasks that can help with limited duty. Rather than lifting suitcases, limited-duty employees check tickets, work the X-ray machines or focus on administrative tasks at the airport.

"As long as there are medical restrictions, we can marry them with job tasks," said Darryl Thornton, TSA's workers' comp director. "We look at what the person is physically able to do. We have that person agree to a job offer. (Limited duty) continues while they go through the medical recovery period."

This approach also helped reduce TSA's periodic, or long-term, rolls.medical recover period.

This approach also helped reduce TSA's periodic, or long-term, rolls. Of the 965 periodic-roll cases in 2007, the agency resolved 67 percent of them. "We found a few cases where the injury had been resolved but the employee was still receiving compensation and had not been asked to return to work," Buchanan said. "We gave employees in this category an opportunity to return."

CONTROLLING COSTS

Tackling the long-term workers' comp rolls also works wonders on continuation-of-pay costs. Under federal workers' comp law, the Department of Labor covers the wages of an employee after the first 45 days of injury. The costs are then charged back to the agency.

Buchanan noted that in this respect TSA's relatively young age worked in its favor. Unlike agencies that have been around for decades, the periodic rolls aren't quite as hefty.

"When going through the periodic rolls, you have to understand each person's circumstances and accommodate individuals as necessary," Buchanan said. "As a result, you get people off (the rolls). We have more people going off than coming on."

Buchanan and Thornton said that case management contributed to success in this area. "We got costs to go down because we started early," Buchanan said. "It sets the stage for prompt medical care."

An integral part of workers' comp is to improve work methods to prevent recurring injuries. One of TSA's biggest safety modifications had to do with in-line baggage systems. Previously, TSA workers loaded baggage into airplanes manually, which resulted in a lot of back injuries. Now, the baggage systems take care of that task. As for lifting baggage onto belts, the agency also introduced power-lift carts that "go up and down to help employees avoid lifting bags and twisting awkwardly," Buchanan said.

Airports share the cost of in-line baggage systems with TSA.

Furthermore, rubber mats help prevent musculoskeletal injuries that result from standing for long periods on a hard surface, a tarmac for example. And TSA does a safety investigation for every injury and illness that occurs.

"It's a constant effort to understand why we have injuries and what to do to prevent them," Buchanan said. "The best thing we can do for the program is get to the point where there are almost no injuries among folks."

TSA also uses its performance on the Bush administration's Safety, Health and Return to Employment (SHARE) initiative that compares federal agencies' performance in regard to injuries, lost production days, lost-time case rates and timely filing of workers' comp claims.

TSA keeps senior leaders informed of where the agency ranks in regard to other agencies and ensures that accident and injury notices are investigated and captured in the Safety Information System within one week of notice. TSA headquarters provides safety training workshops and conducts inspections. Local Safety and Health Councils and Hazard Mitigation Teams convene to discuss best practices too.

When DOL launched SHARE in 2004, TSA stuck out like a sore thumb. The agency revealed an exorbitant number of injuries and a lost-production day rate averaging more than 462 days a year. In fiscal year 2008, however, that rate had plummeted to an average of 148 days a year. In addition, the total number of injuries went from 17,763 in fiscal year 2004 to fewer than 4,800 in fiscal year 2008.

While these numbers represent growth, Buchanan said TSA can to improve on its efforts by sustaining a culture of safety. "Preventing injuries in the first place, that's the best possible result for anybody," she said.

November 1, 2009

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