Here’s an important excerpt from a recent GAO report on OSHA audits that addresses concerns about disincentives for reporting injuries (Italics added):
“Occupational safety and health stakeholders we interviewed and occupational health practitioners we surveyed told us that primary factors affecting the accuracy of injury and illness data include disincentives that affect workers’ decisions to report work-related injuries and illnesses and employers’ decisions to record them. Stakeholders most often cited workers’ fear of job loss and other disciplinary actions as disincentives that can affect workers’ decisions to report injuries and illnesses. Occupational health practitioners concurred: 67% reported observing worker fear of disciplinary action for reporting an injury or illness, and 46% said that this fear of disciplinary action has at least a minor impact on the accuracy of employers’ injury and illness records. Workers’ fear of disciplinary actions might be compounded by policies at some worksites that require workers to undergo mandatory drug testing following incidents resulting in reported injuries or illnesses, regardless of any evidence of drug use. Several labor representatives described mandatory drug testing policies as a disincentive that affects workers’ decisions to report injuries and illnesses, and 67% of health practitioners reported they were aware of this practice at the worksites where they treated workers in 2008.
“Stakeholders also said employers’ safety incentive programs can serve as disincentives for workers reporting injuries and illnesses. These programs reward workers when their worksites have few recordable injuries or illnesses. One-half of the health practitioners who responded to our survey reported they were aware of incentive programs at the worksites where they treated workers in 2008. Safety incentive programs are designed to promote safe behavior by workers; and 72% of health practitioners reported that these programs motivate workers to work in a safe manner. However, some stakeholders said these programs could discourage workers from reporting injuries and illnesses; more than three-quarters of health practitioners said they believed workers sometimes avoid reporting work-related injuries and illnesses as a result. Stakeholders also said that in addition to missing the chance to win prizes for themselves, workers who report injuries and illnesses might risk ruining their coworkers’ chances of winning such prizes.
“Disincentives that discourage workers from reporting and employers from recording injuries and illnesses might also result in pressure on occupational health practitioners to treat workers in a manner that avoids the OSHA requirement to record injuries and illnesses. From our survey, we found that more than one-third of health practitioners were asked by company officials or workers to provide treatment that resulted in an injury or illness not being recorded, but also was not sufficient to treat the injury or illness properly. For example, in some cases, practitioners stated that employers might seek out alternative diagnoses if the initial diagnosis would result in a recordable injury or illness. One practitioner said that an injured worker’s manager took the worker to multiple providers until the manager found one who would certify that treatment of the injury required only first aid, which is not a recordable injury. More than half (53%) of the health practitioners reported that they experienced pressure from company officials to downplay injuries or illnesses, and 47% reported that they experienced this pressure from workers. Further, 44% of health practitioners stated that this pressure had at least a minor impact on whether injuries and illnesses were accurately recorded, and 15% reported it had a major impact. In some cases, this pressure might be related to the employers’ use of incentive programs. Of those experiencing pressure from workers, 61% reported they were aware of incentive programs at the worksites where they treated workers. In comparison, among the practitioners who reported not experiencing pressure from workers in 2008, 41% reported being aware of incentive programs at the worksites where they treated workers.
“Various disincentives might also discourage employers from recording workers’ injuries and illnesses. Stakeholders told us employers are concerned about the impact of higher injury and illness rates on their Workers Compensation costs. Several researchers and labor representatives said that because employers’ Workers Compensation premiums increase with higher injury and illness rates, employers might be reluctant to record injuries and illnesses. They also said businesses sometimes hire independent contractors to avoid the requirement to record workers’ injuries and illnesses because they are not required to record them for self-employed individuals. Stakeholders also told us employers might not record injuries and illnesses because having high injury and illness rates can affect their ability to compete for contracts for new work. The injury and illness rate for worksites in certain industries, such as construction, affects some employers’ competitiveness in bidding on the same work.
“An OSHA official told us that OSHA does not have an official policy on incentive programs or practices that might affect workers’ decisions to report injuries and illnesses, but it has authority under the OSH Act to discourage inaccurate reporting by employers. The official stated that, under a planned National Emphasis Program, OSHA will explore the possible impact that incentive programs have on workers’ decisions to report injuries and illnesses. To address disincentives that might affect employers’ decisions to accurately record injuries and illnesses, the official stated that OSHA can issue citations or fine employers when recordkeeping violations are found.”
Lessons to be learned:
- There are inherent pressures not to report injuries or to minimize their scope.
- Employees are afraid of losing jobs, receiving discipline, or being drug tested (even where drug use plays no part in causation).
- Safety programs designed to reduce injuries, lost time on the job, and insurance costs can create a disincentive for reporting injuries.
- These factors also affect managers and health care providers.
- OSHA will be more vigilant in exploring how employees might be reluctant to report injuries at the workplace.
- Keep these lessons in mind when designing and implementing injury-reporting systems.
Read the entire report here.