Project Results

To see the Demonstration Project results for the UNITE Occupational Health/Workers' Compensation Program, click here.

Public Policy Goal:

To improve access and quality of medical care by providing medical care to workers whose occupational disease claims have been denied or delayed.

Project Objective:

To explore the experiences of UNITE members filing for WC in New York who are participating in the UHC program and to evaluate their perceptions of the programs impact on symptoms, medical outcomes, work and financial status, and the process and quality of care; then compare the UNITE garment workers outcomes to those of a different labor group with a similar diagnosis.

Project Description:

UNITE, in collaboration with the Union Sanatorium Association, a comprehensive primary care center located in New York City, and the Mount Sinai Center for Occupational and Environmental Medicine devised new methods for providing UNITE members with access to basic medical care for cumulative trauma disorders without regard to claims status or claim controversion. This addressed an important problem-the inability of workers with occupational illnesses, whose claims for workers' compensation benefits are frequently contested, to receive prompt diagnostic and medical treatment. A model system was developed that provides a basic level of diagnostic testing and treatment regardless of claim status, in hopes of minimizing functional disability and promoting a more speedy return to work. This evaluation project was to study the effectiveness of this model. (See UNITE Occupational Health/Workers' Compensation Program - Demonstration Project )

Key Findings and Accomplishments:

• The project collected the first valid and reliable information about a group of immigrant workers on the outcomes of work-related illness, using standardized instruments.
• Both the garment workers and the comparison group (computer users at Mt. Sinai COEM) experienced negative impacts on their work status due to their work related musculoskeletal disorders. However, the garment workers experienced much more adverse events and they also reported more disability. Over 80% of the garment workers were not working at baseline and did not return to work during the study period. Many were either temporarily disabled (36%) or permanently disabled (33%) at follow up. The computer users were more likely to be working at baseline (78%) but they also experienced negative outcomes in work status with only 70% actively working at follow up and 14% temporarily or permanently disabled.
• Few workers (10%) who were disabled and out of work at the time of filing for workers' compensation returned to work during the three year project, suggesting that prompt access to medical care, while important in its own right, may not be sufficient to facilitate return to work among an aging, primarily non-English speaking and female population with chronic musculoskeletal disorders and limited ability to find alternative work settings.
• Garment workers waited an average of 7 to 10 months before seeking medical treatment for their symptoms; the computer users waiting 7 months to seek treatment. Primary reasons for delay in treatment by garment workers was "thought I'd get better", "couldn't get off work', "worried about losing job", and thought wrist pain was part of the job. Pain was the top reason for stopping work among the garment workers and fear of re-injury was the top reason among the computer users.
• Only 4% of the garment workers in the retrospective group received a work site change (20% requested a change) compared with 45% of the computer users who received a work-site change.

Reports and Publications:

Fahs, MC, Herbert R, Kontos, N. "Detection, Disease Management and Compensation: Health and Economic Outcomes of Upper Extremity Work-Related Musculoskeletal Disorders among Garment Workers in New York City."

Final Grant Report- Evaluation Project- Evaluating the Benefits of Enhanced Access to Medical Care for Patients at UNITE's Union Health Center

Herbert, R, Janeway, K, Schechter, C. "Carpal Tunnel Syndrome and Workers' Compensation among an Occupational Clinic Population in New York State." American Journal of Industrial Medicine 35 (1999): 335-42.

Presentations:

Marianne Fahs, PhD, MPH, Robin Hebert, MD, Nina Kontos, PhD, "The UNITE Union Health Center Workers' Compensation Health Initiative" Poster Presentation. The Robert Wood Johnson Foundation, Workers' Compensation Health Initiative Annual Meeting, September 14, 1999, Berkeley, CA.