SUPPORTING EMPLOYERS IN MANAGING AN AGING WORKFORCE

Patty Reinecke RN, BSN, CCM, MSCC
Senior Medical Management Consultant, Midwest Employers Casualty
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Employees have dramatically changed in comparison to the workforce of 25 years ago. Starting in 2012, 10,000 Americans a day turn 65. Many of these Americans will continue to actively participate in the workforce.

With the changing demographics, further attention is required to ensure our employees remain safe and potential injuries are prevented. Within the next decade, 40 percent of the labor force will be eligible for retirement and as many as 75 percent of older adults expect to work after age 70.

Many older workers defined as 55 or older do not have adequate savings to support full retirement and cannot live at the standard of living for which they have become accustomed; therefore, they must work to support their lifestyle choices. In addition, depending on your date of birth, electing to take Social Security earlier at the age of 62 will create a reduction in benefits from 20 percent to 30 percent. Retirement age will soon reach 70 years old, if you chose to receive the maximum benefit.

Let’s start with understanding the effects of aging. The normal aging process affects every area of the body. Generally, as an individual ages they will experience decreased strength and range of motion, vision and hearing loss, reduced cardiac and lung function and balance changes that can increase the risk of falls. There is also an increased incidence of chronic conditions, which require medication management and side effects that go along with them.

This can impact the top five types of injuries of an aging workforce, which include rotator cuff sprains, lumbar disc disease, knee cartilage injuries, brain injuries (due to high risk of falls/MVA), and nerve compression conditions such as carpal tunnel syndrome. Decreased blood flow from reduced cardiovascular capacity, pre-existing osteoarthritis, and diabetes can impact the healing of these common injuries.

Now that we understand the increased risk, prevention is the key. To prevent the most common injuries for aging, or any, employees we can start with the basics. Any work area should be well lit, clear of clutter, clean, dry and with cushioned walking or standing areas if possible.

The costliest injury of employees age 50 to70 is an injury to the rotator cuff. To protect the shoulder, overhead work needs to be limited, if unable to be eliminated, and closely monitored. Lumbar conditions make up the next highest cost of this demographic. Minimizing heavy lifting, offering proper lifting training and reinforcement, and avoiding static positions including standing, are all valuable to maintaining proper low back protection. Avoiding or minimizing work on ladders will also help protect the third cost driver, the knee. Providing even working surfaces to prevent a slip, trip, or fall is also essential.

It’s important to identify the differences in diagnostic results in a population over the age of 55. By age 67 at least 30 percent of the population will have degenerative rotator cuff tears in both shoulders. These tears are not due to an acute injury and, in general, it is advisable to undergo a surgical repair. For the lumbar spine, degenerative disc disease (DDD) is not actually a disease but rather a normal aging process in the body. People with DDD are asymptomatic in 46 to 93 percent of cases. It is an incidental radiographic finding unrelated to the symptoms. Spinal stenosis is a narrowing of the spinal cord space with possible spinal cord compression. Spinal stenosis is common in people older than 60 and the vast majority of patients have no symptoms.

Osteoarthritis is a normal finding in the knees of aging workers. If an employee is above the recommended BMI this could have an additional impact on the wear and tear of their knees, which contributes to the amount of osteoarthritis and internal derangement found in testing. Overall, an aging worker may take longer to heal.

The process is similar to any claim regardless of the age of the injured employee. During the initial evaluation gather as much medical and supplemental information about the accident or injury as possible. During conversations, introduce and encourage the plan for return to work. Early intervention remains crucial. It always better to anticipate obstacles and prevent them from materializing, rather than trying to chase and manage problems after they have developed. Staying in touch with the injured employee remains imperative. In asking about the individuals general health, a lot of information can be obtained about how they are healing from their injury. Emphasizing the focus of increasing function and managing their symptoms can also be beneficial. Allowing transitional duty to ensure a successful return to the workforce can also be valuable.

The aging workforce is a factor most employers deal with today. Knowing the risks and how to manage them will provide an advantage in handling the complicated claims that can occur.

By: Patty Reinecke RN, BSN, CCM, MSCC
Senior Medical Management Consultant, Midwest Employers Casualty

Summary of Qualifications

Patty is a certified case manager with 23 years of experience directly handling workers’ compensation claims.

Responsibilities

Patty is responsible for working in concert with internal and external team members to employ the most effective cost containment measures to medically stabilize claims. She reviews and interprets medical data to ensure all treatment is reasonable and necessary. She also projects future medical costs based on current diagnosis and treatment and develops partnerships with external third party administrators, attorneys, employers, internal analysts and attorneys to develop a plan of action to bring cases to successful resolution. Patty evaluates Medical Set Asides (MSAs) to ensure the allocations are accurate to prepare for settlement of workers’ compensation claims.

Business Experience

Midwest Employers Casualty

Senior Medical Management Consultant, August, 2008 – present

Missouri Baptist Medical Center

Manager, Workers’ Compensation Department, December 2003 – August 2008

Broadspire (formerly Kemper National Services)

Senior Regional Supervisor, February 1997 – November 2003

CorVel Corporation

Onsite Case Management, June 1994 – January 1997

Professional Affiliations

Certified Case Manager (CCM) #021861

Medicare Set Aside Certified Consultant (MSCC) #1043

Education

Maryville University, Bachelor of Science in Nursing, May 1993

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