Each year, more than 600,000 workers lose time from their jobs because of repetitive strain injuries (RSIs) and back injuries. The cost of these injuries, sometimes referred to as cumulative trauma or musculoskeletal disorders, and even strain and sprain injuries, is staggering. According to one insurance industry report, the average cost for a worker with RSI is $27,500--meaning that the total cost to our economy for these conditions is approximately $20 billion! These conditions, including everything from carpal tunnel syndrome to back injuries, not only are costly: They often are permanently disabling for the workers affected.

Workers who suffer from RSIs should be treated fairly.

Workers' compensation should be relatively straight-forward proposition: If you get injured or become sick as a result of your job, your employer or your employer's insurer should pay for medical treatment and income benefits. Unfortunately for growing numbers of injured workers, especially those suffering from RSIs, this is not the case.

At the same time business associations are trying to block ergonomic protections that can prevent RSIs, employers and the insurance industry are trying to avoid their workers' compensation responsibilities for the cost of these debilitating conditions.

This is part of a calculated strategy. If not compensated, the number of reported RSIs will decrease, making the problem "disappear." If employers are not held liable for medical treatment and wage replacement for workers suffering from these conditions, the cost pressures to do something to correct the problem will lessen. This strategy includes:

• Denying claims of injured workers. A recent study at the Mount Sinai Center for Occupational and Environmental Medicine found that 81 percent of workers diagnosed with occupational carpal tunnel syndrome had their claims contested or received no response from the insurance carrier.
• Arguing that these injuries are the result of non-work-related conditions.
• Characterizing workers with these injuries as malingerers, frauds or cheats
• Controlling the selection of doctors who treat injured workers and
• Pushing state lawmakers to cut benefits or eliminate coverage for RSI conditions.

Here are just a few examples of efforts by employers and the insurance industry to limit compensation for RSIs in individual states:

Virginia

In 1996, the Virginia Supreme Court ruled that job-related impairments resulting from cumulative trauma or repetitive motion were not covered by the state's workers' comp law. Fearing exposure to tort suits for these injuries, the business community supported an amendment that says "hearing loss and the condition of carpal tunnel syndrome are not occupational diseases but are ordinary diseases of life." Benefits for either condition, but not for other repetitive motion or cumulative trauma injuries, are only available if the claimant can prove "by clear and convincing evidence" that the disease arose out of and in the course of employment. This standard is a more stringent burden than required for other conditions and was signed into law in February 1997. Virginia remains the most restrictive state for compensation for RSIs.

Arkansas

Under changes adopted in 1993, compensable injuries are required to be caused by a specific incident identifiable by time and place. Exceptions were made for injuries caused by "rapid" repetitive motion. The sad fact is that, in a state where RSIs are rampant in the poultry processing industry, virtually no one is found to have a compensable condition that meets the test of being caused by "rapid" repetitive motion.

Kentucky

A special session of the legislature, called by the governor in December 1996, excluded from workers' comp coverage conditions that are a result of the "natural aging process." This will likely result in the elimination of coverage for repetitive strain injuries unless the worker can prove that the condition is due to a series of "traumatic" events.

Ohio

Governor Voinovich signed into law, in April 1997, radical changes in the definition of occupational disease and drastic restrictions in compensation for repetitive strain injuries. The new law would have limited coverage for so-called "pre-existing conditions" and required proof "by a preponderance of evidence" that the cumulative or repetitive trauma was characteristic of and peculiar to a particular industrial process, trade or occupation. It would have potentially excluded all diseases that occur without occupational exposure. A coalition, led by labor, collected twice as many signatures as required to put the new law to a vote of the people as a referendum issue. Despite massive spending by big business, labor's get-out-the-vote effort turned back this horrible law by a 14-point margin (57 percent to 43 percent).

Illinois

RSIs are currently compensable if the injured worker can demonstrate that the injury is work-related and causally connected to the employment. The business community and insurance associations are urging the legislature to tighten the circumstances that a worker must meet to retain coverage for repetitive strain or cumulative trauma conditions. If they are successful, workers will have to satisfy a much higher burden of proof and demonstrate that their condition was caused by "unusual work stresses."

What You Can Do

• Establish workers' compensation committees or elect or appoint workers' compensation representatives to assist your members with workers' compensation claims should they suffer a job injury or illness.
• Work with your local union, central labor council and state labor federation to protect and improve workers' rights to compensation for job injuries and illnesses.
• Keep in touch with members of your union who are hurt on the job and are not back at work. Make sure they understand that their co-workers are concerned about their injury, their treatment and their recovery.
• Coordinate your activities with allies and assist other groups that are involved in this struggle. This could include organizations of injured workers, RSI support groups and local or state Committees on Occupational Safety and Health (COSH groups).
• Work to convince employers and others that the way to cut the terrible costs and pain associated with repetitive strain injuries is to eliminate the hazards that create them.

For further information, contact:

AFL-CIO Department of Occupational Safety and Health
815 16th St. N.W.
Washington, D.C. 20006
Phone 202-637-5366, Fax 202-508-6978