ALFA International is the premier network of independent law firms. Founded in 1980, ALFA International was the first and continues to be one of the largest and strongest legal networks.

The Bureau of Labor Statistics confirms what anyone connected to the construction industry already knows. A construction site is a dangerous place to work.

While the employment sector known as “natural resources, construction, and maintenance occupations” (NRCM) is the smallest high-level civilian occupational group — with slightly more than 11 million wage and salary workers — its incidence of injuries and illnesses involving days away from work is second only to workers involved in production, transportation and material moving. And, NRCM’s incidence rates of illnesses or injuries to the trunk, hand, and head are nearly twice that of all of the other five high-level civilian occupational groups.

Construction-related injuries and illnesses add up to big costs for employers, as well as big claims and exposure for insurance companies and litigants in our court system. According to the BLS, in March 2015, “employers spent an average of $1.02 per-hour-worked for workers’ compensation in the natural resources, construction, and maintenance occupations (NRCM) group, compared with $0.45 for all occupations. Workers’ compensation costs made up 3.0 percent of total compensation costs in the NRCM group, compared with 1.4 percent in all occupations.”

No wonder this has the attention of lawyers, insurance executives and healthcare professionals, who will have construction law front and center in late July when ALFA International convenes a construction seminar in Banff, Alberta. MKC Medical Management and members will be participating in ALFA International Construction Group’s symposium, Construire une meilleure piège à souris international—Building a Better International Mousetrap, a “…conversation on the strides, business concerns, and risks facing the industry around the world.”

Of the offerings most relevant to workers illnesses and injuries, three sessions and sets of issues have my attention:

●      Pre-existing conditions

I’m eager to see and hear my peers focus on the role of pre-existing conditions and how they impact claims. From my independent, professional perspective, I see injured employees and plaintiffs in personal injury cases who may have pre-existing conditions which can affect their claims. Some pre-existing conditions — such as repetitive motion

— may make a worker more susceptible to injury from a traumatic incident. It’s important to look for and recognize the difference and to develop defense and case management strategies accordingly.

●      Job site hazard analysis and risk

Failure modes and effects analysis (FMEA) is a promising process that can work with a wide variety of settings and platforms — from operations to services to construction and beyond. The July 2018 ALFA International session in Banff will focus on job site safety, exploring the utility of FMEA and how it might be applied to claims handling, review, and the like.

While FMEA is a critical part of any construction project, it’s often overlooked, underused, underappreciated and not updated. However, there are software programs that offer help, saving workers and employers from avoidable illness, injuries and costs.

●       Environmental hazards on site

It’s important that claims handlers, lawyers and other professional services providers learn more about the environmental challenges associated with construction…and how to plan for these, especially best practices for addressing toxic and hazard materials from a medical standpoint.

Construction injuries and illnesses could be mitigated by pre-construction investigations and planning for potential exposure to toxic contaminants and hazardous substances on a construction site. Yet, our best efforts to plan, educated and prepare, contaminated substances can unexpectedly be released into the environment during construction. It’s important to explore how to avoid these issues, by minimizing any risks through contractual and insurance considerations and by understanding the potential liability in the event a release occurs.

A fourth area of interest in controlling claims and losses is the use specialty centers of excellence. Data suggest that facilities such as Craig Hospital in Englewood, Colorado, achieve better outcomes. In a recent article, the author made the case that, among other benefits, “…[s]pecialty centers understand the psychosocial factors that account for 40 percent or more of outcomes, and have strong staff-patient ratios and numerous psychosocial programs with decades of expertise. Centers that treat more than 200 patients with spinal cord injuries and 200 patients with traumatic brain injuries per year should be strongly considered.” In Atlanta, The Shepherd Center is an outstanding center of excellence which has cared for and rehabbed many of the workers comp cases on which MKC Medical Management’s catastrophic case management team have consulted.

For another take on this difficult and costly issue, here’s a post on workers comp from a legal nurse consultant’s perspective from the MKC blog.