The Growing Importance of Vehicle Accidents to Workers ...

The Growing Importance of Vehicle Accidents to Workers’ Compensation Claims and Cost
Gregory Krohm
International Association of Industrial Accident Boards and Commissions
January 22, 2008

I. Introduction.

Most business managers think of onsite accidents when they consider injury threats for their employees. However,
outside of the construction, agriculture and a few natural resource industries, vehicles cause more serious injury to
workers than anything else. Moreover, traffic accidents result in a disproportionate share of serious disability and
fatalities. Highway accidents have been the leading cause of occupational fatalities in the U.S., accounting for about 13
thousand civilian worker deaths (22% of all injury-related deaths). Following is a high level review of the risks of vehicle
injury and basic measures to control injury. It is a survey of recent literature, with a guide to technical resources for a
more in-depth study.

II. Overall vehicle injury trends and risk factors by type of organization and job classification.

Ironically, the death rate for occupational injuries is far lower than the comparable risk of traffic deaths in the general
driving population. Because vehicle accidents occur sporadically and often with no human injury, it is easy to see why
most small employers would largely ignore this risk factor. Yet, for most businesses, highway vehicles present the biggest
risk of very serious injury to employees, and are associated with workers compensation claims of relatively great dollar
severity. Thus, it behooves all employers, even in industries with low claims frequencies, to consider at least the basics
in accident prevention and loss control. This section relies heavily on the National Council on Compensation Insurance
studies that contain the only source of published data on vehicle related workers' compensation claims (see Restrepo et
al., 2006).

1. Trends in injury over time

Happily, the injury rate from vehicle accidents is declining, but less slowly than other WC injuries. Hence, vehicle
accidents are becoming a large source of WC claims and losses.

2. Injury by industry/occupation

Truck drivers face a disproportionately high risk of death, but relatively fewer non-serious injuries. Private passenger cars
have lower fatalities but nearly double the rate of non-fatal injury. Intuitively, this is because size and mass of trucks
protects occupants well in low speed collisions with other vehicles. Yet, trucks are susceptible to jackknifing and overturn,
which are likely to result in fatal injury.

Frequency of Accidents 2002
(rate per 100 million miles)

Fatalities
Non-Fatality
Heavy trucks
2.4
62
Passenger vehicles
1.6
118



Source: Fatalities in Crashes Involving Large Trucks and Passenger Vehicles per 100 Million Vehicle Miles Traveled,
Calendar Years 1990–2002, Federal Motor Carrier Safety Administration.

The above federal data is consistent with workers’ compensation claims data collected by the National Council on
Compensation Insurance (NCCI). The NCCI data shows that truck drivers have disproportionately high rates of serious
injury. In addition to high fatalities, trucking occupations tend to generate longer duration claims and higher average costs
of workers’ compensation.

As shown in the table below, the workers’ compensation class codes covering “Salespersons, messengers, collectors”
and Office Clerical NOC” generate the top ranked shares of claims, and similarly costs, for WC vehicle accidents.
Trucking codes fill three of the top ten spots. It should be noted that these are not rates of injury per worker; the clerical
code is the largest single employment code so, all things being equal, it would have a large share of accidents. The point
of this exhibit is to show that occupations not intuitively associated with traffic accidents can indeed generate large
volumes of WC claims.

Class code
% share of claims
rank
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International Association of Industrial Accident Boards and Commissions

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Clerical Office NOC
6.2
1
Sales, collectors, or
6.1
2
messengers
Drivers, chauffeurs NOC
5.5
3
commercial
Trucking—long distance
3.5
4
Auto service/repair
2.9
5
Trucking NOC
2.7
6
Police
2.6
7
Trucking local
2.3
8
Bus company
2.2
9
Nursing/home health and
1.6
10
public health
Source: Restrepo et al., NCCI, 2006

Traffic accidents are a high risk to the general driving population. Hence, anyone whose job requires that they spend long
hours behind the wheel faces a high risk of injury from an accident. This includes management and technical employees
that travel frequently in the course of their work.



3. Characteristics of WC Claims

The authoritative resource on workers compensation claims from vehicle accidents is a 2006 study by the National
Council on Compensation Insurance (Restrepo et al., 2006). The following analysis is based on that NCCI study. It
covers claims reported by its member insurers over the period 1997-2003.

Traffic vehicle claims make up almost 2% of claims but represent more than 5.5% of total losses. The share of costs and
claims due to vehicle accidents grew over the period 1997-2003.



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International Association of Industrial Accident Boards and Commissions

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Vehicle injuries produce far fewer medical only claims (about 61%) compared to all WC claims (about 77%). As the
figure above shows, vehicle injuries had a far higher rate of Permanent Total and Fatality WC claims than claim overall.
And, even though only about 2% of all claims, vehicle accidents account for over a fifth of the fatalities.

In general, vehicle accidents tend to have a worse claim severity than non vehicle causes of injury. There are relatively
few “medical only.” Moreover, the severity of medical only claims is greater for vehicle claims. Likewise, the average
severity of ever Temporary Total, Permanent Injury, and Fatality is worse for vehicle versus non vehicle claims. For
example, total severity for motor vehicle accidents in trucking (1997–2003) averaged close to $29,000, but for all other
occupations it was just over $16,000 (NCCI).

Neck injuries are by far the leading part of body injured. Based on the injury codes in WC claim reports, neck sprain and
cervicalgia (pain in neck) were the first and second ranked codes, accounted for 15% of all vehicle claims. But the same
codes amounted to less than 2% of all WC claims. The code for “face and neck injuries” ranked fourth with 1.4% of all WC
claims reported (Restrepo et al., 2006). This is consistent with the relatively high medical and indemnity costs of vehicle
related claims.


4. Other Costs Than WC

Workers’ Compensation constitutes only a small fraction of the costs of vehicle accidents. According to a study done by
the Network of Employers for Traffic Safety, the combined cost of motor vehicle crashes to employers averaged $60
billion per year between 1998 and 2000. According to that study, employer medical expenses from motor vehicle
crashes was $7.7 billion in 2000; another $8.6 billion was spent on sick leave and life and disability insurance for crash
victims. Workers compensation costs, by comparison, averaged $2 billion per year over the same period.1 Thus,
employer actions to reduce vehicle accidents can have a powerful effect on human resource, property and casualty costs
for their organizations.



III. Specific causes of injury.

1. State of driver (sleep deprivation, distractions, multi-tasking).

Unsafe operation by the driver is the leading cause of injury, and, in a sense the easiest to control. According to the
National Highway Traffic Safety Administration (NHTSA), behavior related cause hold 5 of the top 6 causes of vehicle
accidents.

1. Driver distractions
2. Driver fatigue
3. Drunk driving
4. Speeding
5. Aggressive driving
6. Weather

Two specific behaviors to focus on are seat belts and driving under the influence of alcohol. Both are very expensive to
employers. According to one study, employers paid $2.1 billion per year work related highway crashes for the 1998–2000
period. Alcohol-related motor vehicle highway crashes while on work time cost employers an estimated $3.1 billion
annually over the same period.2

Driver distraction and fatigue, discussed below, are leading contributors to traffic accidents.


2. State of vehicle (improper tire pressure, mechanical failure, failing brake systems, mirror/blind spot)

1 “The Economic Burden of Traffic Accidents on Employers: Costs by State and Industry and by Alcohol and Restraint Use,” Network
of Employers for Traffic Safety, December 2003, Table 2, page 5, found at:
http://www.nhtsa.dot.gov/people/injury/airbags/EconomicBurden/index.html

2 Id.
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International Association of Industrial Accident Boards and Commissions

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Fleet operators take pains to comply with specific safety requirements on their vehicles. Other businesses may not be so
careful about vehicle maintenance, or the maintenance of private vehicle used by employees in the line of work. Yet, the
evidence seems to show that mechanical problems with vehicles are a minor cause of injuries.


3. Outside factors (weather, other drivers, highway construction and signage). The nature of the highway route makes a
difference in serious accidents. Interstate highways have a small fraction of the injury rate on state and county routes.
The difference is due to the careful engineering of interstates to avoid crashes and to minimize the serious injury from
those that do occur. Unfortunately, there is not much that can be done about these outside factors, other than to train
employees to adjust speed and breaking distance to adverse conditions.



IV. Steps to improve safety.

There is an age old debate on whether accidents are primarily caused by behavior or by poor equipment/process design.
I personally side with the behavioral school of thought. Driver error – doing something they knew was hazardous – is the
single biggest cause of accidents. Changing behavior is not easy. Thus, a collection of approaches are commonly used
to avoid and control behavioral shortcomings.

1. Training

Training can be directed at practical information about safety, practicing driving techniques or motivational information.
Standard topics include avoiding distractions, seat belt use, trip planning, speed reduction, and obedience to traffic laws.
Specialized training is needed for specialized work requirements, such as hazardous materials, loading and unloading
injuries, and cargo securement. Training is often targeted at high risk groups, e.g., new hires or employees with poor
driving records. The reference cited at the end of this paper offer assistance in designing a training program.

2. Health & Wellness

Certain health issues can impede driver judgment, alertness, and other behavior to the extent that accidents are more
likely. The most important of these are:

•
vision
•
obesity
•
hypertension
•
stress

The Federal government has prohibitions on truck drivers operating long distance freight trucks with hypertension,
diabetes, epilepsy and certain heart conditions.

These factors may be directly related to the ability to operated a vehicle safely, especially vision. They may also
contribute indirectly to losses, e.g., obesity and low back pain by professional drivers.

3. Technology

There is a growing arsenal of technologies to prevent crashes in trucks and cars. Examples include:

Better performance brakes for trucks and buses
Camera technology for blind spots
Collision prediction technology
Cargo securement devices

4. Other Business Practices

Besides training and health and wellness programs, employer safety practices should include accident investigations for
purposes of reviewing causes and remedies. Such investigations should be integrated into a loss/accident management
information system. Business practice should reinforce messages delivered in training. For example, zero tolerance for
substance abuse and failure to use protective equipment should be both preached and practiced by management.

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International Association of Industrial Accident Boards and Commissions

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Other things that should be done in planning for safe operations include: shift scheduling and realistic expectations for
driving time and routes. Speed and risk taking can be associated with unrealistic work schedules. Also, drivers drowsy
from long hours without rest can be as impaired as those impaired by drugs or alcohol.

Maintenance of vehicles including safety inspections should also be built into operational procedures.

Finally, high rates of staff turnover are associated with WC injury in general and with traffic accidents in particular. Thus,
focusing safety training on new hires may be a good targeting strategy.


5. Specific Safety Issues

Below are highlighted some additional information about some issues of interest.

Driver distractions
According to a recent study by the University of North Carolina Highway Safety Research Center each year an estimated
284,000 distracted drivers are involved in serious crashes.3 Distractions of all sorts are a growing cause of vehicle
crashes. Today, there are more distractions than ever: cell phones, laptops, GPS systems and other multi-tasking.
Despite heavy use of cell phones in vehicles and the strong suspicion that cell phone use is dangerous, the evidence is
mixed on how large a contribution cell phone use makes to vehicle accidents. A recent statement of the National Highway
Traffic Safety Administration on the evidence for cell phone related accidents:
Research shows that driving while using a cell phone can pose a serious cognitive distraction and degrade driver
performance. The data are insufficient to quantify crashes caused by cell phone use specifically, but NHTSA
estimates that driver distraction from all sources contributes to 25 percent of all police-reported traffic crashes.

A recent study continuously monitored a sample of drivers with onboard cameras to determine what they were doing
immediately before an accident. The research assigned the following risk factors to common activities.

Behavior Increased Risk Factor
Reaching for a moving object 9
Drowsiness 4
Looking at external object 4
Reading while driving 3
Applying makeup 3
Use of cell phones/handheld devices
Dialing 3
Talking/listening 1

Source: “Driver Distractions and Increased Risk Factors,” National Highway Traffic Safety Administration
and The Virginia Tech Transportation Institute, April 20, 2006

Research has pinpointed slow reaction time to the cause of cell phone related accidents. Some experts assert that cell
phone users have the reaction time of an elderly driver, or one intoxicated. Yet, on balance it seems that cell phone use
is not the worst culprit for driver distraction, particularly for short, simple conversations.


Substance Abuse
According to the Federal Motor Carrier Safety Administration, in 2003, “about 2% of drivers with a commercial driver's
license (CDL) used controlled substances, and 0.2% used alcohol (0.04 or higher blood alcohol content) while performing
their duties.” Of course, workers in every job class can drive while under the influence of alcohol or other substances.
According to the National Highway Traffic Safety Administration, driving under the influence alcohol is responsible for 41%
of all highway deaths.

The payoff to employers from controlling impaired driving and failure to use seat belts has been estimated to by $15 billion
in 2000.4 Screenings at time of employment and random testing for employees can be very effective. Comprehensive
information on drug and alcohol rules and testing procedures can be found at: http://www.fmcsa.dot.gov/safety-
security/safety-initiatives/drugs/drugs-alcohol.htm

3 AAA Foundation for Traffic Safety website at: http://www.aaafoundation.org/multimedia/index.cfm?button=disdrv

4 Network of Employers for Traffic Safety, “Conclusion” section
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International Association of Industrial Accident Boards and Commissions

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Age and Accidents
The aging workforce is creating many new human resource and workers' compensation challenges, including the
propensity of older workers to sustain serious injuries from vehicle accidents. According to National Highway Traffic
Safety Administration data, both accident rates and fatality rates are highest for drivers in the 16-24 age range, and
decline thereafter. Older drivers get in fewer accidents. However, they meet or exceed the rate of fatal injuries from work
related traffic accidents for middle age drivers. The fatality rate spikes for drivers 74 year of age or older.

The above accident patterns for the general population are confirmed in the workers' compensation loss data collected by
the National Council on Compensation Insurance (Restrepo, 2006). They show that WC injuries in vehicles are inversely
related to age, but that the severity of injury measured by total medical and indemnity payments is positively correlated
with age. The higher costs for older workers is due in part to their higher earnings, and in part to a variety of other
differences between older and younger workers.

Cell phone use seems to be particular dangerous for older drivers because it deteriorates their already slow reaction time
to traffic.



V. Conclusion

Vehicle accidents are an increasing share of WC claims and costs. No employer type or industry is immune, especially
for fatalities and serious injuries.

Behavioral causes are the root of most accidents, with distractions and fatigue leading the list. Relatively simple
measures can be taken to teach and reinforce good driving behaviors. Of course, not all employees will respond to safety
messages equally, hence monitoring and reinforcement of desired behaviors is essential. Strong policies on substance
abuse by drivers and the failure to use protective equipment by all vehicle occupants should be in place and vigorously
promoted and enforced.

Employers should be protecting employees for humanitarian and human resources reasons. In addition, the toll crash
related property and liability costs far exceed the direct savings in WC costs.

Hence employers have manifold reasons to take at least the basic steps to learn more about risk factors and accident
prevention techniques.


VI. Recommended resources on safety and loss control.

•
Federal Motor Carrier Safety Administration website has a comprehensive set of links to truck, bus, and fleet
safety related information, found at: http://www.fmcsa.dot.gov/safety-security/safety-security.htm

•
Federal Motor Carrier Safety Administration website has a good link for information on drug and alcohol abuse
program: Federal Motor Carrier Safety Administration website has a comprehensive set of links to truck, bus, and
fleet safety related information, found at: http://www.fmcsa.dot.gov/safety-security/safety-initiatives/drugs/drugs-
alcohol.htm

•
National Safety Council, “Guide to Determine Motor Vehicle Accident Preventability,” can be previewed and
purchased at: http://www.nsc.org/onlinecart/product.cfm?id=263

•
Network of Employers for Traffic Safety, “Traffic Safety Primer: A guide book for employers,” can be previewed
and purchased at: http://www.trafficsafety.org/primer.asp

•
National Highway Traffic Safety Administration, contains a wealth of data and analysis of injuries and their causes
at: http://www.nhtsa.dot.gov/portal/site/nhtsa/menuitem.9fa154a4d39f02e770f6df1020008a0c/

•
National Institute for Occupational Safety and Health, “Work-Related Roadway Crashes—Challenges and
Opportunities for Prevention,” NIOSH Publication Document 2003-119, September 2003, found at:
http://www.cdc.gov/niosh/docs/2003-119/
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International Association of Industrial Accident Boards and Commissions

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•
Tanya Restrepo, Harry Shuford and Auntara De., National Council on Compensation Insurance Research Brief,
“Traffic Accidents—A Growing Contributor to Workers Compensation Losses,” December 2006, found at:
https://vds.info/ncci/media/pdf/research-traffic-accidents.pdf

•
Tanya Restrepo, Harry Shuford and Auntara De., National Council on Compensation Insurance Research Brief,
“Age as a Driver of Frequency and Severity,” December 2006, found at:
http://www.ncci.com/ncci/media/pdf/research-age-frequency.pdf










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International Association of Industrial Accident Boards and Commissions

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