Ageing and Injury

Okay, I'm on my hobby horse again - Work Cover claims for age-related degenerative conditions.

The industry I work in, transport and logistics, is one which, rightly or wrongly, places great emphasis on the Lost Time Injury Frequency Rate. A company can lose a tender if their LTIFR is high and they are seen to be "unsafe" operators. But the LTIFR doesn't always tell the true story – and is often affected by the jurisdiction in which the operator is based. For instance, journey claims are counted in Queensland, but not in some other jurisdictions. Return to work is treated in different degrees in different states - SA, for example, has a very pro-active policy of returning injured workers to suitable duties as soon as possible, to ensure the psychological wellbeing of the claimant which will have a positive effect on his physical rehabilitation.

I am frustrated at the growing prevalence of Work Cover claims accepted for age-related degenerative conditions which are a fact of everyday life, and not specifically or necessarily due to or caused by an incident at work. I am not ageist – far from it, since I am fast approaching 60 myself. But there is no distinction between an injury that happened when you were at work and one that happened as a result of the work you were doing. To my mind, that should be the fundamental distinction in any injury claim. Just because you were at work doesn't mean work caused it.

There are quite a few age-related degenerative conditions, most which we've heard about from time to time – including osteoarthritis (OA), degenerative disc disease, osteoporosis, fibrosis, sarcopenia, scoliosis – but which we don't really give any thought to until we reach the age when these things start happening to us. A bit of background on each of these conditions is merited.

Osteoarthritis is a normal age-related condition caused by wear and tear on a joint. In 2007 it was estimated that nearly 1 in 5 Australians have some form of arthritis. 62% of those with arthritis are still of working age. As the population ages, that number is expected to rise proportionately. (http://www.arthritis.org.au/page/Arthritis/Arthritis_Statistics).

Degenerative disc disease (which is not actually a disease) may result from the normal changes in your spinal discs as you age, or may be due to a previous back injury. It commonly affects either cervical (neck) or lumbar (lower back) regions. (http://www.medtronic.com.au/your-health/degenerative-disc-disease/index.htm).

Osteoporosis is a condition where the bones become fragile and brittle due to loss of minerals such as calcium. In Australia 1 in 2 women and 1 in 3 men over 60 years will have an osteoporotic fracture (http://www.osteoporosis.org.au/about/about-osteoporosis/what-is-osteoporosis/). Many of those people will still be in the workforce.

Fibrosis is the thickening and scarring of connective tissue, usually as a result of injury. It can affect the kidneys (renal fibrosis), the heart (cardiac fibrosis), the lungs (pulmonary fibrosis) and other organs in the body. The Lung Institute says of lung fibrosis that it can be caused by inhalation of small particles (such as asbestos), or "inflammation can be generated without obvious cause". (http://www.liwa.uwa.edu.au/index.php?option=com_content&view=article&id=129&Itemid=129).

Sarcopenia is the natural and progressive loss of muscle mass and strength due to aging (0.5-1% loss per year after the age of 25). It is believed to be accelerated due to lack of physical activity. The economic cost is reported to be similar to that of osteoporosis. (http://www.racgp.org.au/afp/200603/200603taaffe.pdf).

Spinal degeneration in adults can cause Degenerative De-Novo Scoliosis (DDS). In adults between the ages of 50 and 80 who suffer from chronic lower back pain, research shows that up 40% will have an adult scoliosis. (http://www.scolicare.com.au/about-scoliosis/adult-scoliosis). The main complaint with DDS is lower back pain.

According to the Royal Australasian College of General Practitioners, however, "[a]pproximately 95% of cases of acute low back pain are nonspecific. Serious spinal conditions are rare and can be identified by triaging for 'red flags'. ... It is essential to reassure patients to stay active and to resume normal activities quickly – including return to work." (http://www.racgp.org.au/afp/200612/14023 AFP Vol 35, (12) 929 – 1024).

Comment and research on age-related conditions affecting workers and compensation is by no means new. In 2008 the Australian Institute for Social Research at the University of Adelaide undertook research for the SA WorkCover Corporation on the impact of an ageing workforce on the scheme (http://www.workcover.com/custom/files/ageingworkforcereportchapter1introduction.pdf). In 2009 the University of Newcastle conducted research on age-related safety of professional drivers, and found that "the risk increases after approximately 60 years of age". They suggested that "[t]he natural process of ageing bring with it physical and cognitive differences which perhaps do not equate to the desirability of encouraging older workers to continue their employment as professional heavy vehicle drivers." (http://www.workcover.nsw.gov.au/formspublications/publications/Documents/workcover_assist_age_related_safety_2973.pdf).

In Queensland, WorkCover seems content to allow GPs to continue issuing medical certificates to mature aged workers for age-related conditions masquerading as work injuries which entail days or weeks off work, when other jurisdictions recognise the value of returning the worker to the work environment even in a light duties capacity as soon as possible. Occasionally WorkCover or Q-Comp grows some balls and will challenge a worker’s claim – see Worker v Q-COMP, 10 August 2010, http://www.workcoverqld.com.au/forms-and-resources/case-studies/claims-and-premium-outcome-case-studies/worker-v-q-comp - but these instances seem few and far between.

In 1990 the median age in Australia was 32.1 years. By 2010 that had increased to 36.8 years. As the population gets proportionately older, the incidence of mature aged workers aggravating their pre-existing and/or age-related degenerative conditions will increase. The ones carrying this cost are the employers. They need to sit up and take notice before this worsening situation bankrupts them and results in fewer jobs for us all.

And WorkCover needs to stop accepting claims for age-related degenerative conditions that are a fact of everyday life.