Practices in the Construction Sector
Supported by a grant from the Community Initiatives and Research Program of
the Workers Compensation Board of Manitoba
Table of Contents
Executive Summary"
3
Project Objectives!
5
Scope of Review!
5
Qualitative Assessment!
6
Results"
7
Respondent profile!
7
Survey themes!
7
Disability Management Practices!
7
Barriers to return to work!
7
Injury data tracking!
7
Awareness of WCB rate setting!
8
Snapshot of other Canadian jurisdictions!
8
Challenges and Opportunities !
9
Communication/Dissemination!
10
Appendix A - Survey"
11
Appendix B - Tools and Resources"
18
Executive Summary
The report Illnesses and Injury in the Manitoba Construction Sector 2000-2005 indicates that the incidence of
musculoskeletal injuries is growing and they now make up more than half of all time loss injuries in the construction sector. The building construction sector which this project targeted, is responsible for about 85% of all MSI’s in the sector overall. The construction sector is facing the same challenges as other industry sectors, an aging workforce, labour shortages and the recruitment and retention challenges that this brings. Given the significant growth that is predicted in the sector, the high incidence and severity of injuries in the group and the need for effective and innovative approaches to employee recruitment and retention, this project attempted to provide some insight and solutions to these challenging issues. The intent of this project which was supported by a grant from the Community Initiatives and Research Program of the Workers Compensation Board was to examine the utilization of disability management programming in the Manitoba Building Construction sector and to provide practical solutions to improve programming. The objectives of the project include: • Identifying what disability management practices and return to work strategies are currently in place in the target group; • Identifying leading and innovative practices in this sector;
• Identifying gaps in programming;
• Implementing leading practices in several workplaces on a pilot basis;
• Make recommendations to the broader construction sector to address gaps in programming.
The qualitative assessment included conducting a review of the challenges, gaps and opportunities related to disability management and return to work in the building construction sector. Data collection methods included:
• Survey of construction companies. The distribution was to members of the Construction Safety Association of Manitoba.
• Secondary research relating to leading practices in this sector. This information was obtained through literature search, program representatives, employer groups and government sources.
• Targeted data collection. From the pool of companies who responded to the initial survey a small number of
workplaces were selected for more targeted data collection to further examine the practices in place in their workplaces. Based on the information gathered during the review a further filtering was done to identify companies to participate in phase three which provided assistance with implementing disability management initiatives within each organization. The initial survey indicated that The most common practices relating to return to work and injury management reported by respondents include reporting and documenting work injuries, offering alternate work to a worker who is temporarily unable to do their job, communicating with the WCB regarding the workers abilities following and injury, and modifying the job, tasks, equipment to assist an injured worker in returning to work. Although the vast majority of respondents indicated that limited or no alternate or light duty jobs is a barrier to return to work, we found that this is not actually the case when we worked with companies in subsequent phases of the project to look at tasks rather than whole jobs when developing modified duty assignments for injured workers. Respondents also indicated that difficulty communicating with the healthcare community and assessing an employee’s fitness to return to work were challenges when attempting to return their employees to work. Accordingly, much of the focus of phase three was on providing the tools necessary for
One of the challenges that participating companies have with respect to providing modified employment is related to the fact that construction work is varied and changes from project to project. Therefore the duties that are available on one day may not be on the next depending on the nature of the project. We were able to see this as an opportunity as well as a challenge. The perception of the majority of workplaces involved in this project was that the lack of availability of modified duties was a significant barrier to return to work in this industry sector. On further examination it appears that this perception is largely based on an assessment of the job as a whole rather than the individual tasks or steps within a job. Given the vast number of different tasks associated with work on a construction site on any given day our project team assisted participating companies to break down each job into tasks and did a physical demands analysis on the task rather than the job. This opened up a discussion relating to which combination of tasks would be appropriate for different modified duties. We assisted four companies to start an inventory of tasks that would be appropriate for modified duties to use in discussing accommodation with each injured worker. This was considered a very useful and practical tool for use in the accommodation of injured workers. It should be noted that all companies who participated in phase three of the project were COR certified. As such they have already gone through a process of breaking down their jobs and developing safe work procedures. We found that having these safe work procedures assisted in the process of breaking each job into steps and completing an inventory of tasks to be used to accommodate injured workers. This is a motivated group of companies who have already developed a safety management program in their workplace and for the most part have some level of return to work process in place. When participating companies were asked about adding a return to work
component to the COR process, the majority were receptive since they already have some level of process in place. Many of the the companies who participated in this project are experiencing the challenges associated with an aging workforce such as the time loss associated with chronic non- occupational disability. There is a high motivation to retain workers with significant experience and skills so finding ways to manage disability and keep employees at work was a priority for many workplaces. The tools provided in the course of the project are applicable to managing any disability (occupational or non occupational). As a result we predict that companies will find them very useful.
In closing, this was a challenging but enjoyable project for our consulting team. The group of participating workplaces were very motivated, open and giving of their time throughout the project. We believe the resources developed and implemented in the phase three workplaces will assist in the future implementation of their disability management process. These resources along with the full report will also be made available to the broader construction sector.
For further information on this project please contact: Yvette Milner
On-Site Safety and Health Management Solutions (204) 489-6574
Project Approach and Methodology
Introduction
It is well known that activity in the Manitoba construction sector is the strongest in years. One of the consequences of this increased activity has been an increase in injuries. A report by the Workers Compensation Board of Manitoba (WCB) and the Manitoba Workplace Safety and Health Division (WSHD) entitled Injuries and Illnesses in the Manitoba Construction Sector provides a comprehensive review of injuries and illnesses in Manitoba’s construction sector for the period 2000 through 2005. Though the time loss injury rate for the province decreased by 21 percent from 2000 to 2005, the time loss injury rate for the construction sector decreased by only four percent for that same period of time. In 2005, the time loss injury rate for building construction was 9.8 time loss injuries per 100 FTE workers compared to the provincial average of 4.6 for the same year. In 2007, the construction industry saw about 2,100 time loss injuries in the workplace.
Over the period 2006-2010 it is predicted that competition for workers will intensify as the needed growth in the labour force (at least 15%) far exceeds growth in the provincial workforce of 3.5%. Over the longer term (2011-2015) the overall construction labour force needs will continue to be at least double the increase in the provincial labour force growth and all construction sectors will share in many recruitment challenges. In addition to recruitment challenges a relatively large number of older workers will consider retirement which makes it essential for government, industry and contractor HR strategies to focus on retaining these older workers. Disability Management policies and practices are an effective
retention strategy for workers who experience an illness or injury and these practices lend themselves to helping employers address the challenges associated with an aging workforce and the increasing prevalence of disability that this
demographic brings.
The report Illnesses and Injuries in the Manitoba Construction Sector 2000 - 2005 indicates that the incidence of
musculoskeletal injuries is growing and they now make up more than half of all time loss injuries in the construction sector. The building construction sector which this project targeted, is responsible for about 85% of all MSI’s in the sector overall. The construction sector is facing the same challenges as other industry sectors, an aging workforce, labour shortages and the recruitment and retention challenges that this brings. Given the significant growth that is predicted in the sector, the high incidence and severity of injuries in the group and the need for effective and innovative approaches to employee recruitment and retention, this project attempted to provide some insight and solutions to these challenging issues.
Project Objectives
• Identifying what disability management practices and return to work strategies are currently in place in the target group; • Identifying leading and innovative practices in this sector;
• Identifying gaps in programming;
• Implementing leading practices in several workplaces on a pilot basis;
• Make recommendations to the broader construction sector to address gaps in programming.
Scope of Review
Qualitative Assessment
The qualitative assessment included conducting a review of the challenges, gaps and opportunities related to disability management and return to work in the building construction sector. Data collection methods included:
Survey of construction companies. The first phase of the project involved distributing a survey to approximately 7200
companies in the Construction sector. The survey was distributed to Construction Safety Association members through a combination of direct email, survey link posted on CSAM’s website and newsletter. A direct email distribution to
approximately 175 COR certified companies was deployed. In addition the survey information and link was sent to all of CSAM’s 7200 members in a monthly newsletter and was also communicated and could be accessed on their website. The survey gave us good initial baseline information which we were able to build on through our subsequent data collection methods. Through the survey process we identified twenty organizations to participate in subsequent phases of the project.
Secondary research relating to leading practices in this sector. This information was obtained through literature
search, program representatives, employer groups and government sources.
Targeted data collection. Approximately forty four companies responded to the initial survey. Although this was a
relatively low response rate we felt the information was useful and the survey provided a pool of motivated employers to select for subsequent phases of the project. From this group, twenty workplaces were selected for more targeted data collection to further examine the practices in place in their workplaces. A number of filters were used to identify which companies to include in this targeted data collection phase. When contacted, some companies chose not to participate or simply did not respond to multiple contacts. Of the twenty companies contacted, thirteen were interviewed. A modified version of the WCB’s Return to Work Assessment tool was used to guide our discussions and review the companies return to work program. Based on the information gathered during the review a further filtering was done to identify companies to participate in phase three. The criteria included:
• In the building construction sector; • Mix of rural/city;
• Mix of type of construction; • Mix of size;
• High WCB rate or incidence of claim;
• Expressed need of assistance and interest in participating in the next phase.
Pilot Initiatives. Five companies were selected to participate in a pilot phase where disability management practices were
implemented. Of the five companies, four participated to project completion. Intervention in this stage was customized based on the company’s expressed needs and gaps identified in the targeted data collection phase. Activities in the final stage of the project included:
• Reviewing accident data and identifying opportunities for modified duties;
• Providing each company with templates for a number of tools for the development of a return to work program including return to work policy, return to work fitness form, letter to physician, employee information sheet, manager check list and return to work procedure. Generic templates of these tools are included in Appendix B;
• Meetings with key stake-holders in organization to review process and discuss implementation strategy;
• Development of physical demands analysis for common tasks, inventory of tasks, and templates for return to work plan; • Training on use of the Physical demands tools so that companies could complete this process on additional jobs as
A project Advisory Committee consisting of representatives from the WCB Safe Work department was consulted prior to and following the survey phase of the project. Progress reports were also provided to the WCB between phases two and three. A follow up with all five companies will take place in three and six months to determine progress in implementation of initiatives and success utilizing tools.
Results
The following is a high level summary of the survey findings. A complete copy of the survey is included in appendix A. We received a total of 44 completed surveys.
Respondent profile
Of the 44 respondents 84% are in the building construction sector. 23% of respondents were from organizations under 20 employees. 43% of respondents were from organizations between 21-50 employees. 34% of respondents were from organizations over 50 employees. 73% of respondents were from organizations who were COR certified.
Survey themes
Disability Management Practices
The most common practices relating to return to work and injury management reported by respondents include reporting and documenting work injuries, offering alternate work to a worker who is temporarily unable to do their job,
communicating with the WCB regarding the workers abilities following and injury, and modifying the job, tasks, equipment to assist an injured worker in returning to work. 95% of respondents indicate that they utilize WCB staff to assist in managing their return to work program. 28% indicate they utilize an Employer Advocate/consultant. Very few reported using other external resources.
Barriers to return to work
81% of respondents indicate that limited or no alternate or light duty jobs is a barrier to return to work. Other common barriers include employee motivation (64%) and difficulty in getting medical information (57%). Of note is that only 12% or 5 respondents identified cost as a barrier to return to work.
When asked about the types of resources/assistance that are needed to make the return to work process more successful 90% of respondents indicate that they need assistance in assessing an employee’s fitness to return to work. 64% identified information on best practices, 45% identified assistance in developing a return to work program and 42% identified assistance in matching an injured employee to a job.
Injury data tracking
The majority of respondents were in organizations where time loss injuries had occurred in the past year. 67% reported being able to accommodate some injured workers, only 22% reported being able to accommodate all injured workers and 11% could not accommodate any injured workers.
Awareness of WCB rate setting
• 91% of respondents were aware that the WCB rewards good performance through rate reductions.
• 80% believe that provision of an injury management/return to work COR program would be a good idea for Manitoba.
Snapshot of other Canadian jurisdictions
Part of our initial research was to survey other Canadian jurisdictions to see what if any initiatives they have in place to encourage implement return to work/disability management practices in the Construction sector. Some initiatives to note are:
WorkSafe BC has a COR initiative that recognizes and rewards employers who go beyond the legal requirements of the Workers Compensation Act and Occupational Health and Safety Regulation by taking a best practices approach to implementing health, safety, and return-to-work programs. Employers who implement a Health and Safety Management system receive a 10% reduction on their WCB premiums. Those employers who implement an injury management/return to work system receive a further 5% rebate. The employer’s health and safety management system and injury
management/return to work system are evaluated through a standardized audit.
The Construction Association of British Columbia (CSABC) and CBI Health Group are partnering in a voluntary
program designed to assist employee recovery from soft tissue injuries and aid in the prevention of further injury. The Employer Injury Services Program is designed to provide an injured employee with immediate and convenient access to medical assessment and comprehensive rehabilitative care by a team of physicians and therapists familiar with
occupational injury.
The Construction Safety Network in BC has proposed a Claims Assistance Service Pilot Project. Where traditional disability management models tend to defer medical management, with the hopes that a claim will resolve with minimal or even no intervention, the point of injury disability management model employs medical management from the onset of the claims process. According to literature on this model this model is “proven to reduce an injured worker’s recovery time by up to 2.5 times.
WSIB in Ontario have recently created a new regulation relating to return to work and re-employment for the Construction Industry. The regulation came into effect on September 1, 2008 and provides:
• Return to work cooperation rules for construction employers and workers that do not currently exist. • More clearly articulated re-employment obligations for construction employers.
• Improved return to work outcomes for the construction sector.
Challenges and Opportunities
• Although companies in the review had high WCB rates relative to the average rate in their industry, based on their small size the actual volume of time loss claims is very low. Therefore, there was very limited use of the tools during the project. The three and six month follow up will be important to determine what is working well within each workplace. Given the low volume of claims and limited opportunity to use the tools during the project we tried to provide very practical assistance to address issues that were occurring at the time of the project. For example, we utilized the Ergonomist time with one company to directly assist with the accommodation of one worker who was off work. In that case, a Physical Demands Analysis of the employee’s job was completed and discussions re: appropriate alternate duties took place.
• Construction work is varied and diverse and there are hundreds of tasks involved in a construction project. For this reason it was not realistic to conduct physical demands analysis on all of the tasks for each company within the scope of the project. Instead, our project team focused on those tasks that were high priority and went through the process of conducting a physical demands analysis with the safety officer/administrator. Four out of the five companies who participated in phase three received training on how to complete a Physical Demands Analysis and will complete the process as needed and as time permits.
• Construction projects are varied and change on a constant basis. Therefore, appropriate modified duties may only be available on a short-term basis depending on the length of an actual project. The fact that construction projects are constantly changing is an opportunity as well as a challenge. The perception of the majority of workplaces involved in this project was that the unavailability of modified duties was a significant barrier to return to work in this industry sector. On further examination it appears that this perception is largely based on an assessment of the job as a whole rather than the individual tasks or steps within a job. Given the vast number of different tasks associated with work on a construction site on any given day our project team assisted companies to break down each job into tasks and did a physical demands analysis on the task rather than the job. This opened up a discussion relating to which combination of tasks would be appropriate for different modified duties. We assisted four companies to start an inventory of tasks that would be appropriate for modified duties to use in discussing accommodation with each injured worker. This was considered a very useful and practical tool for use in the accommodation of injured workers. It should be noted that all companies who participated in phase three of the project were COR certified. As such they have already gone through a process of breaking down their jobs and developing safe work procedures. We found that having these safe work procedures assisted in the process of breaking each job into steps and completing an inventory of tasks to be used to accommodate injured workers.
• Many of the the companies who participated in this project are experiencing the challenges associated with an aging workforce such as the time loss associated with chronic non- occupational disability. There is a high motivation to retain workers with significant experience and skills so finding ways to manage disability and keep employees at work was a priority for many workplaces. The tools provided in the course of the project are applicable to managing any disability (occupational or non occupational). As a result we predict that companies will find them very useful.
make the assumption that it is not appropriate light duty work. All companies who participated to the end of the project were provided the assistance of an Ergonomist who conducted physical demands analysis of priority tasks and were provided with tools to communicate with physicians in their community more effectively. Follow up will be done to determine how the utilization of these tools is working. This will assist in addressing this barrier relating to
communication with physicians. The Physical Demands Analysis can also be used in communicating with the WCB. • The majority of the companies participating in this project are COR certified. As part of this process they have already
developed a formal safety management program. The majority of the companies we visited also have some level of return to work program in place albeit sometimes informal. The process that we went through with the companies who participated in phase three was largely formalizing practices that were already in place informally and adding some tools relating to physical demands analysis of jobs to assist in the accommodation process. When participating companies were asked about adding a return to work component to the COR process the majority were receptive since they already had some level of process in place.
Communication/Dissemination
Appendix B - Tools and Resources
Sample Policy Statements
Injury Management Procedure
Injury Management Checklist
Employee Incident Reporting Information Sheet
Employee Fitness Form
Return to Work Agreement
Job Task Descriptions
Task Analysis Guide
Job Task Inventory
Sample Policy Statements
Example #1- Policy Statement
In fulfilling NAME OF ORGANIZATION to providing a safe and healthy working environment, a
Return to Work Program has been established for workers who sustain workplace injuries.
NAME OF ORGANIZATION undertakes to accommodate injured workers through early
rehabili-tation and placement, where possible, to the benefit of the entire workplace. This program
pro-vides gradual and consistent rehabilitation to all injured workers. ORGANIZATION will work
to-ward facilitating injured workers to an appropriate and timely return to work in pre-injury
posi-tions. If this is not possible, the ORGANIZATION will make every effort to place workers in
suit-able, alternate positions within another position in the organization.
SIGNED: _______________ DATE________________
Example #2- Policy Statement
NAME OF ORGANIZATION shall make every reasonable effort to provide suitable transitional or
alternate employment to workers who are temporarily or permanently unable to return to their
regular employment duties as a result of an occupational or non-occupational injury or illness.
This will include training and/or the modification of work stations or equipment to accommodate
workers with disabilities, provided that such modifications do not create undue hardship to
OR-GANIZATION.
It is believed that the injured worker must be responsible for participating in the program to the
best of his/her abilities and capacities. Early assistance is considered the cornerstone of disability
management.
SIGNED: ________________ DATE:______________________
Example # 3 – Policy Statement
NAME OF ORGANIZATION will make every reasonable effort to provide suitable (temporary)
employment to any employee unable to perform their duties. This may include a modification to
the employee’s original position or providing an alternate position, depending on the employee’s
medical restrictions. All employees regardless of injury or illness will be considered for
place-ment through the Return to Work Program.
SIGNED:_______________DATE:______________________
INJURY MANAGEMENT PROCEDURES
Name of Organization is committed to a safe work environment. An initial investigation and claims
man-agement procedure is necessary to ensure that causes of injury are promptly identified and that follow-up takes place to avoid reoccurrence, where possible, and encourage an early return to work for employees following an injury.
When an accident or incident at the workplace occurs to an employee, the employee will obtain a copy of the Employee Accident Reporting Information Sheet and complete an Accident/Incident Report. The completed form is then forwarded to the _____________________.
When a personal injury is involved, First Aid care should be provided by a Certified First Aider immediately. In situations where medical treatment is warranted, ie. A serious injury is involved, the injured employee must be transported immediately, with an escort, to the nearest public medical treatment center (hospital, clinic or doctor’s office).
If an employee is absent for more than one day they should be provided with an Employee Fitness Form
(EFF), which is to be completed by the treating physician and returned to the Supervisor.
If the accident involves a “serious injury” as defined by Workplace Safety and Health legislation*,
___________calls Workplace Safety and Health at 945-0581. The Safety and Health Officer will then de-cide whether he or she will do an investigation on-site. If so, _________________ should be present. The accident site should also be secured to prevent further injury. NO EQUIPMENT OR MATERIALS
IN-VOLVED IN A SERIOUS ACCIDENT SHOULD BE MOVED, UNLESS IT IS NECESSARY TO RELEASE AN INJURED PERSON OR TO AVOIDE CREATING ADDITIONAL HAZARDS.
In any situation where the injury involves medical treatment beyond first aid and /or time loss, the Supervi-sor and __________will investigate the accident or incident and interview the employee and any witnesses, if available, within 24 hours. An Incident Investigation Report will be completed, signed and forwarded to _________________within 48 hours. The completed Incident Investigation Report should also be for-warded to the division’s safety committee for review and follow up.
If the accident involves medical treatment and /or time loss from work, Payroll will complete and submit a
WCB Employer’s Report of Injury (Form 2) to the WCB within 5 business days from the date of
notifica-tion of the injury. The employee will be required by the WCB to complete and submit a WCB Workers
Re-port of Injury, (Form 3) or call the WCB direct at 954-4100.
If absent beyond a day the employee is advised that they should be providing a completed EFF to their Su-pervisor at regular intervals until their return to work.
Once physical restrictions are identified in an EFF, the Supervisor in consultation with _____________ out-lines modified duties consistent with the physical restrictions. A meeting with the employee is then held to discuss the available modified duties and a Return-to-Work Agreement is completed and signed off by the employee and the Supervisor.
Once the employee returns to work, his/her progress should be monitored until they recover to full work capacity.
*Workplace Safety and Health legislation defines a serious incident as one: In which a worker is killed;
Injury Management Checklist
When an Accident Occurs:
Employee Name:_________________ Date of Accident:________________
(Check when completed)
In the case of a “serious injury” the Supervisor calls Workplace Safety & Health at 945-0581.
Review Accident/Incident Report and provide an Employee Accident Reporting Information Sheet to employee.
Conduct a thorough investigation of the claim within 24 hours after the accident (or immediately if a serious injury).
Complete the Incident Investigation Report in all situations after notification of an injury or incident that involves medical treatment beyond first aid and/or time loss, and forward the report to ________ within 48 hours after the accident.
If medical attention and/or time loss involved, ____________ completes the Workers Compensation Board’s Employer’s Report of Injury and forwards it to the WCB within 5 business days of notification of injury to avoid penalty. Employees are not to fill out this form.
If employee is absent for more than one day they will be given an Employee Fitness Form – EFF to have it completed by the treating physician.
While an Employee is off work:
For the initial week, the Supervisor reviews the EFF and reinforces with the employee the requirement that they keep them informed of any developments in their condition or until their return to regular work. Beyond a week the Supervisor requests additional EFF(s) at appropriate intervals until physical restrictions identified or employee fit to return to work.
When an Employee is able to return to work:
Supervisor reviews EFF(s) and determine appropriate modified duties.
Complete a Return to Work Agreement and meet with the employee to discuss available modified duties. Have employee review and sign the Return to Work Agreement. Date returned to modified
duti-es______________.
Monitor employee’s progress and intervene if necessary.
Date returned to full duties and hours________________________.
