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By DAVID KITTROSS, a writer with cyberFEDS® in the publication's Washington bureau

Over the past five years, the U.S. Army has implemented a coordinated workers' compensation system that produced significant reductions in workers' comp case rates and days lost to injury, while improving employee safety.

The Army will be recognized Nov. 9-11 at the 6th Annual Workers' Compensation in the Federal Workplace Conference in Las Vegas.

Daisy Crowley, the Army's national workers' compensation program manager, said that several years ago the Army faced two major problems in handling workers' comp. Civilians are often asked to serve in risky areas, which increases the chances of a workplace injury.

The system at that time suffered from fragmentation. Workers' comp was handled by officials at different locations. In one case, workers' comp was even handled by a cafeteria manager. "There was no national program manager, no oversight, no training required, and no accountability," Crowley said. And claimants often determined when -- and if -- they came back to work.

So the Army vowed to make improvements. "The improvements have been a gradual process over several years," said Ronna Rowe Garrett, interim deputy assistant G-1 for civilian personnel.

In 2005, the program manager was hired and a year later began annual reviews with each Army installation. In 2007, the workers' comp handbook was published and the next year the program manager held regional training workshops around the country, Rowe Garrett said.

In 2009, an operations manager was hired and larger training workshops were established. Over the past three years, the Army has trained 42 injury compensation administrators, Rowe Garrett said.

In the wake of Crowley's hiring, the next step was to bring everyone who handled workers' comp under the same chain of command, the Army personnel system, and all responsibility was turned over to the base Injury Compensation Program Administrator (ICPA).

One of the challenges at military installations, Crowley said, is ensuring that commanders understand -- and appreciate -- the requirements of the complex and detailed civilian workers' comp system.

"Workers comp is surprisingly complex," Rowe Garrett said. "To become an 'expert' really requires several years of experience, but the Army is fully committed to training individuals ensuring a robust workers' comp program."

Crowley developed a training module on workers' comp for garrison commanders in 2008 in the form of one-hour classes with handouts to be studied over a two-week course. Budget cutbacks have forced the cancellation of the courses, but the Army is considering online options instead, Rowe Garrett said.

Crowley also began conducting annual telephone interviews with every installation, reviewing their case files, costs, and problem cases. The calls included the national program manager, the operations manager, the local workers' compensation administrator, and the head of the personnel office.

The Army has 102 locations around the world where at least one injury compensation administrator is assigned, Rowe Garrett said. The Army also has about 15,000 workers' comp cases on the books, she said. Some cases are closed within a day or less, while other cases drag on for decades.

The training provided to the installation administrators has contributed to a decrease in the number of cases and costs in the last three years, as the Army seeks to return injured employees to productivity, Rowe Garrett said.

Crowley said the Army was making "great strides in getting newly-injured claimants back, challenging suspicious cases, and even chiseling away at the long-term cases who are still young enough to reasonably be employed."

The strength of the new workers' comp system is that local workers' comp administrators are located close to the population they serve. Local and regional workers' comp administrators to help employees is a great advantage to both the employee and supervisor, Crowley said, because the injury compensation program administrator is familiar with the conditions and missions of the population.

Other improvements

The Army's efforts also included developing a stronger return-to-work program and implementing a voluntary protection program, which is designed to promote worker safety.

The key to the return-to-work program is making sure that base workers' comp personnel have the right medical information to make a decision about light duty and getting injured workers back to their jobs.

The injury compensation program administrator sends a letter to the injured worker's treating physician, stating that Army will modify the employee's position in any way possible for light duty and including a copy of the position description. If needed, there is follow-up with further requests for information within a specific timeframe.

If information is not provided quickly, in about 20 days, the injury compensation program administrator will review medical information with the military treatment facility physician and ask what restrictions and time off work are advised.

The base civilian personnel office is responsible for securing a position for the injured employee as soon as medically possible, and a position description can be custom-made to fit the abilities of the employee.

The return-to-work program also ensures accountability. Every installation must establish a working group that meets at least quarterly to discuss new claims and injury trends. Installation commanders are required to chair the meeting, which brings top-level accountability.

The local attorney, medical officer, and safety officer are also required to participate, in addition to the workers' comp administrator and head of the personnel office. The group's responsibility also includes deciding on job offers for at least three long-term claimants.

The best way to reduce workers' comp costs is preventing injuries from occurring in the first place. The Army has developed a voluntary protection program designed to give installation commanders both the encouragement and tools necessary to improve overall health and safety.

The program focuses on meeting the requirements established by the Occupational Safety and Health Administration under its Star recognition program, which promotes the comparison of existing site safety and health management systems against "best in class" criteria to identify and close gaps, thereby improving performance.

To prevent fraud, Army's Criminal Investigative Division (CID) and the Corps of Engineers' FECA Fraud Unit have established an informal working relationship to investigate suspicious cases.

Since 2005, the Army's total case rate -- the number of claims divided by the number of employees -- fell from a frequency of 3.84 to 3.08 in 2010. Lost production days also fell substantially, from 64,537 in 2006 to 45,713 in 2009.

There was an increase in 2010, but Crowley said this reflected the substantial jump in the number of people serving in the Army, "increasing the possibility of a higher number of injuries." The lost-time case rate also fell over the five-year period from 2006 to 2010, from 1.86 to 1.59.

Total incurred costs per claim rose, but this was the result of a big reduction of 5,000 cases on which Army was paying as the remaining cases were severe, more expensive long-term cases, Crowley said.

The voluntary protection program has also been successful. The program has been implemented at 49 sites. Three-year annual lost workday rates have decreased by as much as 70 percent, with associated savings that ranges from $200,000 to as much as $900,000 over a three-year period, depending upon the installation. Three-year incident rates at Army sites in the protection program have decreased an average of 29 percent, with associated savings of $1.65 million.

After conducting several Lean Six Sigma studies, the Army decided it needed to increase the use of technology to manage the system. The Army is now developing a Web-based "dashboard" that will allow the injury compensation program administrator to better manage their case files and keep track of their workers' compensation bills across multiple installations in one consolidated report.

Crowley is also working with the Army public health command to create a handbook for Army physicians on workers' compensation and is also creating guidance to ensure uniformity on how workers' comp is handled across all Army commands.

Rowe Garrett said the Army is sharing the workers' comp information contained in the handbook and the training techniques with the Navy. The Army, she said, has met with the Air Force program manager on many occasions and discussed best practices in the program. The Air Force program is more centralized than the Army's decentralized structure at the installation level.

November 1, 2011

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