Physical disorders brought on by repetitive tasks and poor workplace conditions constitute a significant body of compensation claims. Insurers can work with employers to assist sufferers and identify contributory causes. Nicola Smith reports
The term repetitive strain injury, or RSI, is now widely misused, as the word `injury' was not necessarily true and implied fault. Work Related Upper Limb Disorder or WRULD is the generic term in general use. It describes a range of symptoms characterised by pain and discomfort in the hands, wrists, arms or shoulders, that often have an occupational cause or component. It is accepted that, to date, there are no clear diagnostic criteria based on clinical findings or tests.
WRULD comes under the umbrella of musculo-skeletal claims and, as such, is part of a growing area of claims experience. These conditions are the second highest cause of claims for most income protection insurers (around 25%). Depending on the profile of policyholders, that is whether employees work in high-risk industries, WRULD can account for up to 28% of all musculo-skeletal claims.
The signs and symptoms may vary between individuals and may include one or more of the following:
1.A sensation of mild discomfort or aching in the hands, wrist, arm or shoulder, affecting the muscles, tendons or joints.
2.Tingling and numbness or `pins and needles' in the fingers and hands.
3.A swelling of the soft tissues of an affected limb, or the sensation of swelling.
4.Progressive, persistent pain.
5.Restricted joint movement and loss of function.
Upper limb disorders are relatively common in the general population. They can be brought on by knitting, sewing, DIY, weight training and playing musical instruments.
It is also recognised that a number of other factors may play an important role in their development and prognosis. These include psycho-social factors and compensation awareness. The Australian RSI epidemic in the 1980s, for example, coincided with the introduction of a work compensation system that allowed lump sum payments for work related disease. Reports of the condition faded away once the qualifying criteria for compensation were changed.
Alternative duties
The symptoms can be eased with medication and physiotherapy. But care should be taken to assess the individual's psycho-social circumstances and identify any predisposing factors .
Ideally, the individual should be managed in the workplace and this may require the provision of temporary alternative duties so as not to aggravate the symptoms.
Insurers need early notification of a forthcoming claim, usually after six to eight weeks of sickness absence. Once insurers are notified, they can work with advisers and employers to assess the nature of the work and workplace conditions. They can also consider, where the claim is after the full deferred period has elapsed - for example 26 weeks - how to encourage the individual back to work.
Meanwhile, it is essential for the employer to ensure that all reasonably practicable precautions have been taken to prevent future recurrence.
Under the Health and Safety at Work Act 1974, the employer has a general duty to protect the health of employees.
This duty is now detailed in a series of regulations requiring an employer to identify tasks that expose an employee to risks and complete a formal risk assessment. Employers must also ensure tasks are designed to reduce the risk of injury as far as is reasonably practicable by providing a suitable working environment with the correct apparatus and equipment. Procedures for safe working practices should be implemented and for particular tasks a safe method of carrying it out should be designed.
It is also essential to have a programme of distributing information to staff and ensuring that they are adequately instructed in all aspects of safe working.
Nicola Smith is communications manager, employee benefits at Swiss Life (UK)
