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					         Workers’ Compensation Resource for Hawai‘i Employers / Volume 3 Number 1


         An OccMed                  A Short                    Return to
           Primer                  History of                    Work
                                  Occupational
                                   Medicine




Occupational
 Medicine
    The Way to Treat Injured Workers
                                                                                                    H E M I C
                                                                                         Hawai‘i Employers’ Mutual
                                                                                          Insurance Company, Inc.
                                                                                                -
                                                                                                  BOB DOVE
President’s Message                                                                                CEO/President
                                                                                                 bdove@hemic.com

                                                                                               JAS O N YO S H I M I
                                                                                         Vice President/Accounting & Budget
                                                                                                jyoshimi@hemic.com

                                                                                                    JOE HEE
                                                                                       Vice President/Finance and Compliance
Dear Members.                                                                                     jhee@hemic.com

                                                                                               S TA C Y M I L L E R
In our work with our insureds, we at HEMIC spend a lot of time helping                   Vice President/Claim/Legal Services
employers to improve workplace safety by helping them to create a safety                         smiller@hemic.com
program and by offering free safety seminars throughout the year. Fewer                       C A R LT O N C H U N
injuries mean fewer claims. That’s good for member-owned HEMIC, good for the                   General Counsel/AVP
employers who benefit from better safety records which may translate to lower                   cchun@hemic.com

premiums, and good for the employees who avoid needless pain and suffering.                     C O N N I E FA R I A
                                                                                          Director of Underwriting Services
But even with the best of safety programs in place, and with the best intentions                 cfaria@hemic.com
of managers and employees, accidents do happen. Part of what we do at HEMIC                      FAY E B U E N O
is to help our members prepare for the process of dealing with an accident                   Director of Administration
                                                                                                fbueno@hemic.com
before a crisis occurs. After all, Loss Prevention is more than making a safe
workplace: it involves having a plan for getting the injured employee the best               S H AY N E D O B B I N S
                                                                                           Director of Information Services
and fastest care possible. It also involves a good return-to-work program to get
                                                                                               sdobbins@hemic.com
the injured employee back on the job as soon as possible.
                                                                                                   BOB LONG
In this edition of HEMIC Connections, we take a look at Occupation Medicine:                 Director of Network Services
                                                                                                 blong@hemic.com
what it is, how it differs than other forms of treatment, and how a good
Occupational Medicine program may be right for your workplace. We’ll take a                   JOE BENEVIDES
look at how timely communication with your employees can help them get the                    Premium Audit Manager
                                                                                              jbenevides@hemic.com
care they need in the event of an accident. Because the worst time to be talking
about an employee’s treatment options is in the heat of a crisis when time is of                RON TOGUCHI
                                                                                              Agency Relations Manager
the essence.                                                                                    rtoguchi@hemic.com

I encourage our insureds to learn all they can about this exciting trend in                 MICHAEL REDMAN
                                                                                            AVP Loss Prevention Services
treatment for work-related injuries, and to learn how best to communicate these
                                                                                              mredman@hemic.com
options to your employees. As always, if you have questions about these issues,
don’t hesitate to contact us. At HEMIC, our policy is taking care of Hawaii.       HEMIC Connection is published quarterly and
                                                                                   is a free service exclusively for policyholders
                                  Sincerely,                                       of Hawai‘i Employers’ Mutual Insurance
                                                                                   Company, Inc.


                                                                                   Q U EST I O N S & CO M M ENTS
                                  Robert L. Dove                                   Are there questions and ideas you’d like to
                                  President and CEO                                share? Please write us at HEMIC Connection
                                                                                   P.O. Box 3376, Honolulu, Hawai‘i 96801 or
                                                                                   email us at info@hemic.com.
                                                                                                                        H E M I C   C O N N E C T I O N   3




An OccMed Primer
When you have a toothache, you see a dentist.          versed in the physical requirements of particu-
Irregular heart beat? Get yourself to a cardi-
ologist. But who do you call if you are injured
                                                       lar jobs. Because of his or her experience, the
                                                       OccMed physician can apply the right kinds of        OccMed
at work?
    In recent years, the answer is becoming
                                                       treatment at the right time for specific injuries,
                                                       helping to ensure a rapid recovery and return        in Hawaii
increasing clear: an Occupational Medicine             to work. The OccMed physician can also help
practitioner. Like Sports Medicine doctors             employers to minimize occupational and envi-         Several health care providers in

and clinics that focus on injuries sustained by        ronmental risks in order to promote the health       Hawaii now offer Occupational

athletes, OccMed practitioners specialize in the       and safety of the individual and the workplace.      Medicine programs. Each provid-

kinds of injuries that are suffered on the job.            In recent years, a number of healthcare          er offers a good all around pro-

    Occupational and Environmental Medicine            providers have put together programs that            gram to help prevent injuries and

is the medical specialty devoted to the preven-        combine the experience and knowledge of              promote safety, to provide appro-

tion and management of occupational and                OccMed practitioners, safety and prevention          priate and expeditious treatment,

environmental injury, illness, and disability;         techniques, and streamlined administration           and to make sure all the proper

and promotion of health and productivity of            and benefits to get the fastest and most appro-      paperwork and administration is

workers, their families, and communities.              priate treatment possible to injured workers.        taken care of. Here’s how to con-

    In practice, OccMed is concerned with the          In most cases, an OccMed program is available        tact these providers:

prevention, diagnosis, and treatment of injuries       to all employees, regardless of their personal
and illnesses that occur at the workplace or as        health care provider.                                KAISER PERMANENTE

a result of toxic exposures, stress, or accidents          HEMIC encourages its members to find             808-597-5452

at the workplace. It encompasses issues such as        out about the many new options for treating          www.kaiserpermanente.org/

industrial hygiene, safety, pollution control, ergo-   injured workers.                                     hawaii

nomics, industrial and agricultural toxicology,
disability evaluation, and physical rehabilitation.                                                         CONCENTRA MEDICAL CENTERS

    Because of the interconnectedness of health                                                             808-831-3000

care and workplace safety, the occupational                                                                 www.concentra.com

and environmental medicine team encompass-
es a great many members. In the workplace,                                                                  STRAUB OCCUPATIONAL

it may include the company’s safety                                                                         HEALTH SERVICES

officer, industrial hygienist, worker                                                                          808-522-3815

representative, management team, or                                                                            www.straubhealth.com/

ergonomist. The medical part of the                                                                            meddept/occupationalhealth

team includes nurses, physicians, physi-
cal therapists, epidemiologists, clinics                                                                       In addition, HEMIC maintains

and hospitals.                                                                                                  a list of independant OccMed

    Of course, the OccMed physician                                                                             practitioners. For a current

is a major player. Working with man-                                                                            list of Ocupational Medicine

agement and other occupational and                                                                             providers on all islands, visit

environmental health professionals,                                                                           www.hemic.com/occmed.

the OccMed physician supplies expertise
in occupational risks and injuries, and is well-
4   H A W A I I   E M P L O Y E R S ’   M U T U A L




                                                                                      Dr. Alice Hamilton 1869-1970



                       A Short History of
                              Occupational Medicine
The protection of                                     The history of Occupational and Environmental Medicine (OEM) can be traced back into

workers from disease or                               antiquity. Some of the earliest references to the modern discipline were made in classical

an accident is a recent                               times when increased rates of illness and mortality among miners were noted by Greek

development in the                                    and Roman observers.

history of labor.                                        In 1556, the German scientist Georg Bauer, interested in the pharmacological uses of
                                                      minerals, published De re Metallicus, a discussion of the dangers and diseases of miners.
                                                      His study was one of the first empirical links between job and disease.
                                                         In 1713, Italian physician Bernardini Ramazzini published De Morbis Artificium. Ramazzini
                                                      had devoted his practice to aiding workers and tradesmen. As a published author, he spent
                                                      much time in the print shop correcting proofs where he observed, “...the pressmen, have to
                                                      stand incessantly at work that is very fatiguing, for almost the whole body must be exerted in
                                                      such a task; hence these workmen inevitably suffer from lassitude and intense fatigue, and
                                                      then stricken in years are compelled to say farewell to that sort of work.”
                                                                                                                       H E M I C   C O N N E C T I O N   5




                              In 1910, a new concept emerged: workers are
                             entitled to compensation for health impairment
                                     and injuries sustained on the job.

    But the practitioner who more than any         compensation laws were passed in Illinois.         pass both industrial and medical practitio-
other laid the foundation for the modern           They introduced a new notion that work-            ners. A number of organizations s have arisen
practice of occupational and environmental         ers were entitled to compensation for health       to help promote optimal health and safety
medicine and for the protection of worker          impairment and injuries sustained on the job.      of workers, workplaces, and environments
health was the American physician Alice                Dr. Hamilton’s findings were so scientifi-     though research, education and policy.
Hamilton.                                          cally persuasive that they caused sweeping
    Born into a prominent family in Indiana,       reforms, both voluntary and regulatory, to           F O R M O R E I N F O R M AT I O N
Alice graduated from medical school at the         improve the health of workers. Investigations        www.acoem.org
University of Michigan in 1893. After accept-      for which she is best known include carbon           American College of Occupational and
ing a teaching position at Northwestern            monoxide poisoning in steelworkers, mercury          Envrionmental Medicine represents
University in 1897, she opened a well-baby         poisoning in hatters, and “dead fingers” syn-        more than 6,000 physicians and other
clinic for poor families in a Chicago neighbor-    drome among laborers using jackhammers.              health care professionals.
hood. As she acquainted herself with the fami-         In 1919, Dr. Hamilton was appointed
                                                                                                        www.aaohn.org
lies in the neighborhood, she learned of their     Assistant Professor of Industrial Medicine
                                                                                                        The American Association of
pains, strange deaths, lead palsy, and “wrist      at Harvard Medical School, the first woman
                                                                                                        Occupational Health Nurses Inc.
drop,” and of the high numbers of widows.          on the faculty of Harvard University, decades
                                                                                                        (AAOHN) ensures occupational and
    In the typhoid fever epidemic in Chicago       before Harvard would admit female students.
                                                                                                        environmental nurses (OHNs) are the
in 1902, Dr. Hamilton made a connection            She served two terms on the Health Committee
                                                                                                        authority on health, safety, productivity
between improper sewage disposal and the           of the League of Nations where she investigated
                                                                                                        and disability management for worker
role of flies in transmitting disease, leading     industrial health conditions in other countries.
                                                                                                        populations.
to the reorganization of the Chicago Health        She published Industrial Poisons in the United
Department. She also noted that the health         States, Industrial Toxicology, and Exploring the     www.oehf.org
problems of many of the immigrant poor were        Dangerous Trades.                                    Occupational and Environmental
due to unsafe conditions and noxious chemi-            Today, at the laboratory that bears her          Health Foundation (OEHF) advances
cals, especially lead dust, to which they were     name in Cincinnati, Ohio, and at other facili-       the knowledge of occupational and
being exposed at work. At the time, employ-        ties, researchers of CDC’s National Institute        environmental health and medicine and
ers routinely fired sick workers and replaced      for Occupational Safety and Health still             to promote and protect the health of
them with new ones looking for jobs.               explore the “dangerous trades.”                      workers through preventive services,
    With little understood about occupational          In 1970, the year that Alice Hamilton            clinical care, research, and educational
illnesses in the United States, Dr. Hamilton       died at age 100, the United States Congress          programs.
published her first article about occupational     passed the Occupational Safety and Health            www.medem.com
diseases in 1908. She was soon a recognized        Act, creating the Occupational Safety and            Medem has created the nation’s premier
expert on the topic.                               Health Administration (OSHA), the National           physician-patient communications net-
    Dr. Hamilton became director of the            Institute for Occupational Safety and Health         work, designed to facilitate online access
Occupational Disease Commission when it            (NIOSH), and the Occupational Safety and             to information and care for more than
was created by the governor of Illinois in 1910.   Health Review Commission (OSHRC).                    90,000 physicians, their practices and
It was the first such commission in the world.         Since then, the field of occupational and        their patients.
As a result of its findings, several worker’s      environmental medicine has grown to encom-
6   H A W A I I   E M P L O Y E R S ’   M U T U A L




                                                                                                        6 Benefits
                                                                                                        of OccMed Programs
                                                                                                        For both the employer and the inured
                                                                                                        employee, a sound Occupational Medicine
                                                                                                        program offers a great range of benefits in
                                                                                                        terms of rapid and complete recovery and
                                                                                                        timely return to work.

                                                                                                        APPROPRIATE TREATMENT – OccMed
                                                                                                        providers are specialists in all kinds of
                                                                                                        workplace injuries and can often diagnose
                                                                                                        and treat these kinds of injuries sooner
                                                                                                        and with more successful results than
                                                                                                        regular doctors.




Return to Work
                                                                                                        COST BENEFIT – Because OccMed providers
                                                                                                        move rapidly to injury-specific treatment,
                                                                                                        often avoiding unnecessary and costly
                          Modified duty can be a part of an injured employee’s                          diagnostic proceedures, the cost of treatment

                          treatment on their way back to full recovery.                                 can be greatly reduced.

                                                                                                        EMPLOYER CONCERN – By communicating
Employers want to get employees back to               employee and with the medical team, a tem-        treatment options before an accident
work as soon as possible after an injury. After       porary assignment or reduced workload may         happens, and by combining them with
all, the longer an injured employee is off the        be able to get the employee back on the job       a comprehensive safety and accident
job, the more his absence is felt. On the other       without causing undue stress or risking re-       prevention plan, employees know that their

side of the coin, most injured employees are          injury. Most OccMed programs have specific        safety and well-being is their employer’s
                                                                                                        highest priority.
anxious to get back to work as soon they              guidelines for creating such programs, and for
can. They may need to regain their full level         monitoring the employee’s progress to ensure      PAPERWORK – Workers’ comp claims are
of employment for a variety of reasons. But           a rapid return to full duty.                      associated with specific paperwork that
even when employer and employee agree,                    When communicating with your employee         is required both by insurer and service
the time may not be right for the recovering          about their return to work, it is important to    providers. OccMed specialists know the
employee to come back to work, or to work at          emphasize your concern for their complete         requirements for forms and record keeping,
full capacity.                                        recovery. Employees should know that pro-         often saving time and confusion during the

    Making the decision of when the employee          grams like Modified Duty help them to mini-       recovery process.

should return to work is best made in con-            mize their loss of income, to get back to their   RETURN TO WORK – OccMed providers
junction with the injured employee’s medical          regular job more quickly, and to maintain         can often provide better guidance for the
team. If the team is headed by an OccMed              contact with co-workers and their employers.      scheduling of an injured employee’s return
physician, it will be more likely to take into        They should know that Modified Duty is in         to work. OccMed specialists may also be in a
account all the physical and mental require-          fact part of their treatment on the way back to   better position to recommend Modified Duty
ments that the return to work may put on the          full recovery. Above all, they should know that   programs to get employees back on the job
employee because it has full knowledge of the         if they have any trouble handling Modified        in a limited capacity.

specific requirements of a given job.                 Duty—or their full return to work—that their      FULL ACCESS – Most OccMed providers
    Even if the employee is not ready for full        employer will quickly rectify the situation in    provide services to all employees that choose
duty, employers can offer their employees a           the employee’s best interest.                     to participate in the program, regardless of
Modified Duty program. By working with the                                                              their carrier of health insurance.
                                                                                                                  H E M I C   C O N N E C T I O N   7




When an Injury Occurs
In the event of an accident, the employer’s fast           In addition, the employer’s attitude can do much to
and proper response is critical. If the situation          indicate concern for the injured employee, and help
is an emergency:                                           to ensure a speedy recovery and return to work.
• Call 911 immediately, or get the injured employee to     • Respond positively to an injured employee’s report of
  the nearest emergency facility.                            an injury.
• Provide first aid if applicable.                         • Always allow appropriate medical treatment for seri-
                                                             ous injuries.
If the injury does not require                             • Remain in contact with the injured worker until he
emergency services:                                          or she returns to work. Assure the employee that
• Recommend that the employee seek appropriate               he or she is needed back to
  medical attention. Offer to make an appointment            work and that you are look-
  with a physician on our medical provider list. If the      ing forward to a complete
  employee has opted to be a part of an Occupational         recovery from the injury.
  Medicine program, help the employee contact that         • Encourage the employees
  provider’s clinic.                                         return to work with modi-
• Transport the injured worker to the doctor or              fied duty, if appropriate (See
  hospital.                                                  “Return to Work”, this issue)

In all cases:                                              There are a number of
• Provide the injured employee with the workers’ com-      actions are specifically
  pensation booklet that contains a description of ben-    prohibited. Employers who
  efits under the law.                                     fail to comply with State
• Have the employee’s supervisor and/or the injured        guidelines may be subject to
  employee complete the Employer’s Report of Industrial    fines and/or legal or punitive
  Injury (From WC-1). Refer to the instruction sheet       damages. Avoid
  included in the claim kit. Also, complete the WC-14      the following:
  report, if necessary, for wage verification. Contact     • Delaying submission of the
  HEMIC Claim Services if you need assistance.                accident report (WC-1) for any reason.
• Provide the injured worker with the medical certifi-     • Terminating or suspending the injured employee
  cate form in your claims kit that will be completed by      because of his injury.
  the physician.                                           • Prohibiting or delaying medical treatment.
• Notify the injured worker’s family.                      • Requiring the injured worker to seek care from a physi-
• Preserve evidence that may be significant in deter-         cian on the medical provider list. Which doctor, clinic
  mining the cause of the injury (defective equipment,        or hospital to use is always the employee’s choice.
  chemicals, etc.).                                        • Discarding evidence that may be used to determine
• Notify HEMIC’s Claim Services of the incident,              the cause of the injury.
  including when the injured worker is disabled, and
                                                           Doing your best to help your employee is a win-win
  when the worker returns to work. Claims should be
                                                           strategy. Your employee will appreciate your sincere
  reported promptly, within 24 hours if possible.
                                                           concern on his or her return to work.
                                            HEMIC
                                            F R AU D HOTLI N E
                                            If you suspect an employee or co-worker is
                                            re ce iv i n g wo rke rs ’ co m pe n s at i o n b e n ef i t s
                                            due to a fraudulent claim, call the hotline
                                            t o d a y. A l l c a l l s a r e s t r i c t l y c o n f i d e n t i a l .

                                               On Oahu Call                     Neighbor Islands Toll Free
                                             522-5279                          1-888-522-5295




Protect your business and your employees.
Report all injuries within 24-hours.



                                                                                                           PRESORTED
                                                                                                            S TA N D A R D
                                                                                                       U . S . P O S TA G E PA I D
                                                                                                         HONOLULU, HI
                                                                                                        PERMIT NO. 564
   1001 Bishop Street,
   Pauahi Tower, Suite 1000
   Honolulu, Hawai‘i 96813

   Mailing Address:
     H E M IC
     P.O. Box 3376
     Honolulu, Hawai‘i 96801

   Island of O‘ahu:
     Tel: (808) 524-3642
     Fax: (808) 522-5510

   Neighbor Islands:
     Toll Free: 888 292-3642
     Toll Free Fax: 888 686-5510

				
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