What are the benefits in deploying pre-employment medicals?
If organisations want to look at the benefits of pre-employment medicals from purely a cost perspective in worker’s transitioning from normal employment into either poor health or compensation claims, the evidence stacks up and is supported statistically in academic (peer reviewed) journals. Examples of this are as follows:
- Non-screened (pre-employment medical) employees have a 33% higher injury rate of compensation claims than screened employee (Roshenblum & Shankar, 2006).* refer to footnote
- Non-screened employees incur 4.3 times higher claims costs. (Roshenblum & Shankar, 2006).
- The average cost of return to work cases for non-screened employees was 18:1 higher than screened employees. (Roshenblum & Shankar, 2006).
As any rehabilitation provider will tell you, it is quite often the hidden component of a workers compensation claim that is much more difficult to manage. Often there is an underlying health or degenerative condition that gives rise to the compensation claim in the first place and makes both the claim and injury management very difficult.
From a claims management perspective, trying to disentangle the claim component from the health component in say a degenerative condition, is extremely difficult and will quite often lead to a breakdown in the working relationship with the individual. For example, telling a worker who was injured during the normal course of their employment, that their claim for compensation has now ceased as the residual loss of functioning and pain is as a result of their degenerative condition and not the work condition, is extremely difficult.
After all, the worker associates the pain, discomfort and, in some cases, the complete loss of being able to return to their job, as having everything to do with the work injury. In many instances, protecting the worker from themselves and not placing them in a position of exposure should have been seriously considered.
What are the potential downsides?
Pre-employment medicals can backfire on an organisation if all they are going to do is the screening and nothing else. This is because the results for that medical essentially become the benchmark for the worker and if there is any deterioration over time, which one would almost inevitably expect, there is an instant exposure to a claim for compensation if that deterioration has anything to do with the duties performed. Using standardised or nonspecific assessments paints too broad a picture and this type of approach has significant shortcomings in that it won’t necessarily address all of the occupational risks or indeed the inherent requirement placed upon the individual.
It is also worth considering the cost to pre-employment and indeed what components within the assessments are actually going to be used by an organisation. I have seen a number of organisations that get all manner of radiology, including X-Ray’s, CT Scans and even MRI’s of applicants and the cost for all of this does need to be considered in terms of what an organisation is going to achieve by screening.
The purpose of a pre-employment medical can be broken down into two main statements:
- Identify risks to the individual that will place them in a position whereby a loss will be experienced (be that a workers compensation claim, illness or absenteeism or indeed force the worker to resign and seek employment elsewhere). It is worth remembering the initial cost of employing the individual, including their training and the loss of institutional knowledge
- Job matching the individual so that they are afforded the maximum ability and protection to stay at work, gainfully employed, for as long as possible. If we consider some of the key issues in the media at present: skills shortage, ageing workforce, productivity and workers compensation claims the aim must be to get the right person in the right role for as long as possible
Should pre-employments medicals follow a ‘one size fits all’ approach?
The simple answer to this is no. Organisations need a more mature appreciation around targeting what risks are present and how they impact on each and every occupation within their organisation. Carrying out detailed respiratory and radiography for, what is essentially an administration position is largely overkill, both from an intrusive, personal perspective and from a cost perspective. Organisations would be much better placed to target their pre-employment medicals and their inherent requirements, against the physical attributes for each role within their organisation. For example, a highly physically demanding role would certainly require a higher level of physical ability than an administrative role and the medical testing carried out should be aimed directly at the aspects of the role that will impact on the individual(s).
By way of example, a few years ago, I had the opportunity to work with an organisation that had a particular trend in workers compensation claims. Claims were coming in for one occupation and one type of injury, which was an anomaly with respect to the rest of the organisation. In order to address this, identifying the source of the claims, which were incorrectly tuned pre-employment medicals, was critical. This showed that the medicals used were not appropriate for the role and, the inherent risks for the role were not identified until well after the fact. As a result, there was an accumulation of workers compensation claims. By addressing this, the organisation reduced their risk exposure and respective workers compensation claims. What this clearly demonstrated was that targeted pre-employment medicals afford protection for both the incoming worker and the organisation.
In conclusion, having a discussion with an organisation that is considering the deployment of pre-employment medicals and explaining the benefits to both parties, is simple. Then, if employers are truly committed to the need and understand the benefit of pre-employment medicals then this same process can be extended to cover employees as they move between different roles in the same organisation.
It is my belief that that in adopting this approach the benefits to the organisation and the individual can continue throughout the lifetime of employment.
*Roshenblum & Shankar, (2006).A study of the effects of isokinetic pre-employment physical capacity screening in the reduction of musculoskeletal disorders in a labour intensive work environment
About the author
Nick Binns is managing director of 2CRisk. For further information phone +61 1300 736 361, email firstname.lastname@example.org or visit www.2CRisk.com.au