By Peter Rousmaniere
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| Image © Bill Bedard |
How do we reduce the number of work injuries and ensure timely return to work for a huge and extremely diversified, foreign-born workforce? A workforce within which many do not speak English well, and are baffled by a health system that confuses even many native born workers?
In my prior article I described the evolution of foreign-born workers in the United States. I documented how these workers have on average taken on a higher level of work injury risk than native-born workers.
I follow up now to highlight what American employers and their agents, such as occupational medical providers, loss control consultants, and workers’ compensation claims payers, can do to reduce injury risks of these workers.
First a question: where can you find people with know-how?
That’s a question that led me on a search throughout the country, extending to conversations with several hundred individuals, ranging from medical professionals to claims adjusters, safety experts, lawyers, immigrant labor activists, translators, and others. Expertise is both extremely valuable and extremely scattered.
So, colleagues and I decided to write a guide to bring the expert advice together. We will distribute the guide at that National Workers Compensation and Disability Conference in Las Vegas in late November. This free employers guide to safety and health of a diversified workforce will then made available throughout the country.
The guide, the first of its kind, will include, for example, special safety training techniques, emerging regulation, medical treatment pitfalls. Advice will be as specific as, for instance, how to check if your bi-lingual employee is correctly describing work hazards in, say, Vietnamese.
We’ll also lead a conference session on immigrant workers on November 21 at 2 PM. We will talk about work safety, claims management and medical care of injured immigrant workers. We will be using case studies. We’ll include practical advice about translation.
For now, workers’ comp professionals might focus on a few key steps.
First, carefully inventory your and your organization’s experience with safety and health issues involving foreign-born workers. This requires patience, persistence and tact. More likely than not, a very few people know a very great deal, but have never had an opportunity to articulate and convey what they know.
You may bump into a stumbling block of doubt and fear that to probe deeply into the experience of immigrant workers will uncover something illegal, such as undocumented workers, or something unhealthy such as pervasive under-reporting of injuries.
A claims adjuster told me that some accounts hire “many illegal and legal immigrant workers that speak little to no English. This can delay handling of claims for many reasons. Many are afraid to report claims for fear of being fired; others are not sure how to report claims and this delays reporting of a claim. There are also many claimants that are very familiar with system and file highly questionable claims and seek attorneys immediately to extend claims and disabilities. On acceptable claims I find that medical care can be delayed as workers are not sure where or who to go to and language barrier exists.”
Second, review your written communications to make sure that they are truly accessible to people who are not brought up in the United States. Some one can be pretty competent in English in a workday sense, and yet have a hard time really comprehending a document larded with legal and technical terms.
A doctor told me about a teaching hospital, proud of its patient centered care, which discharged an injured worker with hardly any English, giving him pages upon pages of medical instruction in English and no money to pay bus fare.
Third, develop as complete a mental picture as you can of the whole life of an immigrant worker. Is she working a second job? (It could be that a fifth of your workers do.) Can you really expect the worker, with limited career-savvy, to really “lean in” to the job to learn safety and other rules when prospects of advancement are perceived as very limited?
Fourth, discuss these issues openly in business association and professional gatherings, online groups, and publications. More discussion will lead to good ideas and practices.
As of today (late August) comprehensive immigration reform’s prospects are up in the air. If Washington enacts reform, all immigrant workers will enjoy legal protections and thus meld more into the regular workforce. That will be a boon to employee safety and health. It will also raise expectations for better safety and health. In any event, we can, and will, figure out ways to make our foreign born workers safer.
About Peter Rousmaniere
Peter Rousmaniere is a journalist and consultant in the field of risk, with a special focus on work injuries. Peter is an award-winning author of some 200 articles on many aspects of workers compensation. He is the workers’ compensation columnist for Risk & Insurance Magazine. Holding an MBA from Harvard Business School, Peter has been in the workers’ compensation field for 25 years. He resides in Woodstock, VT, a picturesque New England village.
Email: pfr@rousmaniere.com.