Health Care Workforce Needs in Wyoming: Update 2017

Chapter 7: Wyoming Workers’ Compensation Incidence Rates
by Industry and Licensed Occupations

by: Patrick Manning, Principal Economist

In this chapter, R&P analyzes the incidence rates of injury at the major industrial sector, and also for licensed health care occupations within these industries.

Reducing workplace injuries provides benefits to both employers and employees. For employers, the reduction in workplace injuries prevents a loss of productivity and leads to lower workers’ compensation insurance rates. Employees can avoid serious injuries and loss of income. In extreme instances, an injury may prevent workers from returning to work. Additionally, reducing workplace injuries provides stability to the overall labor market.

Four states rely entirely on state-run programs for workers’ compensation: Ohio, North Dakota, Washington, and Wyoming; this is referred to as a monopolistic state fund (Bonner, 2016). Many other states maintain state-run funds but also allow private insurance companies to insure employers and their employees.

Because Wyoming has a monopolistic workers’ compensation state fund, research can be conducted on the entirety of the workers’ compensation claims.

It is important to understand the differences between occupations and industries. An industry refers to the type of firm for which a person works, as defined by the North American Industry Classification System (NAICS). In contrast, an occupation refers to a specific task or set of tasks performed by an individual, as defined by the Standard Occupational Classification (SOC) System. One occupation may be found in several different industries. For example, as shown in Table 7.1, registered nurses (SOC 29-1141) can work in retail trade (NAICS 44-45), educational services (NAICS 61), health care & social assistance (NAICS 62), and public administration (NAICS 92).

The objective of the research presented in this chapter is to determine workplace injury incidence rates by industry and licensed health care occupations.

Three sources of information were necessary to conduct this research: a complete workers’ compensation database, a database of licensed health care occupations, and a complete database of wage records. The wage records database also contains the industry in which a person worked in any given quarter, which is utilized in this report.

The Research & Planning (R&P) section of the Wyoming Department of Workforce Services is the only state agency that has access to all three of these databases. This research has never been conducted and therefore, no methodological precedent has been established. One goal of this research is to aid in establishing a methodology to further examine these topics.

Methodology

Data from 2010 to 2015 from the workers’ compensation, licensed health care occupations, and wage records databases were used in this analysis. The workers’ compensation dataset contained some observations with missing or erroneous industry data (based on the North American Industry Classification System) and/or unemployment insurance taxation information. Of all workers’ compensation claims, 91.0% could be accurately assigned to an industry; the remaining 9.0% could not be assigned to an industry.

As shown in Box 7.1, the incidence rate was calculated by dividing the number of workers’ compensation claims from the workers’ compensation database (the numerator) by the possible quarters of exposure risk obtained from the Wage Records database (the denominator). For example, as shown in Box 7.1, there were 11,350 workers’ compensation claims in Wyoming’s health care & social assistance sector (NAICS 62) from 2010 to 2015. During that time, there were 829,988 quarters of exposure risk for all individuals working in health care & social assistance. Dividing the numerator (11,350 workers’ compensation claims) by the denominator (829,988 quarters of exposure risk) produces an incidence rate of 1.4%.

Results

Comparing Data

The average injury incidence rate across all industries in Wyoming was 0.9% from 2010 to 2015 (71,310 workers’ compensation claims divided by 7,793,553 quarters of exposure risk). By comparison, Wyoming’s nonfatal occupational injury and illness incidence rate for 2015 was 3.3%, according to the U.S. Bureau of Labor Statistics (BLS, 2016). There are differences in how R&P calculated the injury incidence rate for this research (see the methodology section) and how the BLS calculates its nonfatal occupational injury and illness incidence rate. For example, the BLS’ methodology uses a sample survey of employers (instead of all incidences of injuries), the use of only private industry, the use of only 2015 data, and the incidence rate per 100 full-time workers. When converted to an incidence rate per quarter, the BLS’ nonfatal occupational injury and illness incidence rate of 3.3% becomes 0.8%, similar to R&P’s average injury incidence rate of 0.9%.

Industry

As shown in Table 7.1 and Figure 7.1, manufacturing (NAICS 31-33) experienced the highest incidence rate of injuries (1.6%) in Wyoming, followed by health care & social assistance (NAICS 62; 1.4%); agriculture, forestry, fishing, & hunting (NAICS 11; 1.3%); and public administration (NAICS 92; 1.3%).

Public administration (NAICS 92) experienced a higher injury incidence rate than industries such as construction (NAICS 23) and mining (NAICS 11). This is because a large component of public administration is publically owned hospitals and services such as law enforcement and emergency services, and therefore contains occupations with relatively high risks of injury.

Licensed Health Care Occupations

Across all industries in Wyoming, the overall injury incidence rate of licensed health care occupations was 1.2%. Certified nursing assistants (CNAs; SOC 31-1014) demonstrated the highest incidence rate of 2.1%. The three major classifications of nursing occupations – certified nursing assistants, licensed practical & licensed vocational nurses (LPNs), and registered nurses (RNs) – were all included in the top five occupations that experienced the highest incidence rates from 2010 to 2015 (see Table 7.1 and Figure 7.2). Previous research from R&P also demonstrated relatively high incidence rates for nurses in Wyoming (Leonard, 2012).

Occupations within Selected Industries

For this research, R&P identified the four industries in which the greatest number of licensed health care occupations were found: retail trade (NAICS 44-45), educational services (NAICS 61), health care & social assistance (NAICS 62), and public administration (NAICS 92). As shown in Table 7.1, incidence rates for an occupation may vary by industry. For example, for 2010 to 2015, the average incidence rate for CNAs working in retail trade was 0.6%, compared to 2.8% for CNAs working in health care & social assistance.

It is important to understand that incidence rates can be misleading when the denominator is very small. For example, if the denominator consisted of 10 quarters and one workplace injury occurred, then the incidence rate was 10%. This rate can be far from the rate of a larger sample, such as the statewide rate. Therefore, the occupations with very few observations were not the focus of this analysis.

Table 7.1 shows that nurses tended to have relatively high injury incidence rates in the four selected industries, particularly in health care & social assistance, where the incidence rate of 2.8% for CNAs was more than three times greater than the overall rate of 0.9% across all industries and occupations.

Conclusions

The manufacturing (NAICS 31-33) and health care & social assistance (NAICS 62) industries demonstrated the highest injury incidence rates from 2010-2015. As has been discussed previously, health care related occupations tend to demonstrate higher rates of workplace injuries relative to the overall employed population. As noted by Knapp (see Chapter 2), the need for workers in the health care sector in Wyoming and the U.S. is projected to increase. To ensure that the demand for health care workers (and other high risk occupations) is met, injury prevention efforts could lead to a decrease in workplace injuries.

While the efficacy of workplace injury prevention programs is not addressed in this analysis, the importance of these programs should be noted. Programs to prevent workplace injuries are available to Wyoming employers. For example, the Wyoming Department of Workforce Services has a drug-free workplace discount and a safety discount, and to qualify, an employer must have a documented health and safety program (DWS, n.d.).

The combination of injury prevention efforts and workplace injury prevention programs may help alleviate labor shortages within health care specifically, and across all other occupations generally.

Future Research

Research & Planning has the ability to conduct research on a variety of topics related to rates of injury and workplace safety. Future research efforts may include:

Incidence rates of injury calculated by other factors, such as industry size or workers’ age, gender, or other demographic information;
Incident rates calculated by industry and overall work experience; and
Differentiating incidence rates by medical only claims and indemnity claims.

References

Bonner, M. (2016, May 9). Workers’ compensation insurance in monopolistic states. In The Balance. Retrieved from https://www.thebalance.com/workers-compensation-insurance-in-monopolistic-states-462813

Leonard, D. (2012). Nursing employment in Wyoming dashboards. Retrieved April 5, 2017, from http://doe.state.wy.us/LMI/nursing/2012/DASHBOARDS_COMPLETE_FEB2012.pdf

Wyoming Department of Workforce Services. (n.d.). Workers’ compensation discount programs. Retrieved March 28, 2017, from http://www.wyomingworkforce.org/_docs/wc/info-on-all-discount-programs.pdf

U.S. Bureau of Labor Statistics. (2016, October). Industry injury and illness data – 2015. Summary news release. Retrieved on March 28, 2017, from https://www.bls.gov/news.release/archives/osh_10272016.pdf