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At 1:20 p.m. on March 23, a massive explosion ripped through the isomerization unit of a BP refinery in Texas City, Texas, killing 15 workers, injuring more than 100 people and sending shock waves powerful enough to rattle windows in buildings five miles away.

BP, one of the largest petroleum companies in the world, employs about 1,100 employees and 2,200 contract workers at the plant.

Here's a glimpse at some of the procedures BP executives and safety managers might have taken immediately following the explosion in a city that has seen more than its fair share of chemical explosions and industry-related victims.

The disability manager, already at the plant, rushed into action and began working hand in hand with safety personnel to tend to other workers. At the same time, within hours of the explosion, the disability manager would have been in contact with the insurance carrier about the explosion. The disability manager would have been providing details to the carrier about the accident, the extent of worker injuries and just who the workers were.

Senior executives would then have assigned a nurse case manager who would have been dispatched to the hospital to assess the extent of the injuries to workers who had been hospitalized.

The nurse case manager would have also been responsible for communicating with the family of the victims, providing information, answering questions and determining what other resources the injured workers would have needed.

COALESCING INTO A TEAM

Throughout the reminder of March, and then into spring and summer, the medical case manager, disability manager, occupational health nurse and safety manager will hope to be functioning as a team, to respond as efficiently as possible to the "wounded" company.

Fast-forward five months. By late summer the medical case manager, disability manager, occupational health nurse and safety manager should begin to think about the recovery of the workers and their eventual return to work.

The managers will need to make sure that adequate financial reserves and services are established to cover disability costs and property losses.

In the event of catastrophic injury, such as the one that befell BP refinery workers in March, the refiner is faced with crisis intervention requiring immediate action by key people. This can only happen with thorough planning.

Companies like BP spend millions of dollars to prevent workplace accidents through safety and injury prevention programs. Some companies may even employ teams bridging diverse departments such as safety, industrial hygiene, disability management, risk management, human resources and security to work on these initiatives.

Despite all, workplace accidents happen. Employees suffer head injuries, spinal cord injuries, burns, amputations or other trauma. Not only do the injured suffer, colleagues and managers are left emotionally scarred.

To handle catastrophic workers' comp cases, companies need to be diligent in their preplanning, identifying who will be contacted and what actions will be taken as soon as an accident occurs.

Plans at a BP refinery or at a DuPont Co. chemical manufacturing plant, for example, are different from plans at a retailer like Wal-Mart Stores Inc. Some company plans may include Occupational Safety and Health Administration requirements. Other companies may address workplace violence.

Whatever the industry, planning for catastrophic workplace accidents should extend beyond emergency response.

BEYOND EMERGENCY MODE

An injured worker's acute medical needs are the primary concern, to be sure. But planning should also encompass steps that companies can take to return injured employees to the workplace. Ongoing contact between the company and the injured worker will help maintain the employee's connection with the employer. That's where disability managers play key roles.

Also essential is a predefined early return to work program that allows injured and ill employees to come back to work when they are cleared by their doctors. Such return to work programs include modified duties and temporary assignments.

"A company's preplanning should include return to work activities, in particular transitional return to work plans and the development of 'task banks' for transitional assignments," says Robert Hall, principal of AtWork Resources Inc., which develops software products for disability management and return to work programs.

Task banks are listings of previously identified jobs at various departments in the company. Drawing upon the task bank, the disability manager can match an employee's abilities with tasks at the company that need to be accomplished. In that way, an employee who cannot return to his regular job can still return to his employer.

"Employers that take the steps to establish a task bank and to train their managers in the return to work process are going to be more successful in returning severely injured and ill individuals to the workplace," says Hall, an adjunct professor in the graduate Rehabilitation Counseling Program at San Diego State University.

"To the degree that the program can be built around a focus on functional capability, the employer has the opportunity to match the person's abilities with the job responsibilities," he says. "If someone has a spinal cord injury but has use of their hands for even two or three hours a day, then the focus can be on what this person can do as opposed to what they cannot do."

The planning process begins with identifying the hazards of the workplace and the safety managers who will play a key part in the event of an emergency.

This varies from company to company, depending on size, the industry in which it operates, whether the company is self-insured and the scope of the benefits programs it offers.

For example, a medical case manager may be on staff or may work for the insurance company or third-party service provider.

Similarly, a company may have a disability manager, whether an occupational health nurse or coordinator, or may contract for those services. The medical case manager or the disability manager might even be the same person.

Regardless of who the individual players are, their roles and responsibilities need to be spelled out in a catastrophic response plan. These individuals, with specific yet complementary jobs to perform, comprise the "first response team" that is mobilized in the event of a catastrophic injury, accident or other incident.

Members of the team include the medical case manager, the disability manager, the occupational health manager, the safety manager and the security manager.

PAMELA M. CAGGIANELLI, is a manager of corporate health for Bausch & Lomb Inc. in Rochester, N.Y.

RENEE MATTALIANO, is an absence management consultant at Hewitt Associates in Lincolnshire, Ill.

May 1, 2005

Copyright 2005© LRP Publications