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Occupational Injuries in the Mining sector:Key observations
6 September 2014
Dr Deodat KritzingerRand Mutual Assurance
Outline
• Background and introduction• Methods• Results
• Most prevalent Injuries• Demographic Profile• Injuries ( Time/Day/Month of the event) • PD Awards• TTDs• Injuries- Benefits paid to MSPs• Most common reasons for outstanding claims
• Discussion/Conclusion
Background and Introduction
• Mining industry under pressure• Wealth of data• Data mining
• Impact of injuries• Sustainability• Identify trends• Highlight obvious abnormalities• Benchmark
• Assist industry with feedback• Injury patterns• Preventative measures
• Importance of correct and timeous reporting
Methods
• Exploratory descriptive analysis of the claims data• Data included mainly reported injuries by industry. • Demographic data are reported on workers injured, the nature of the
disabling condition.• For multiple injuries, a primary ICD-10 code was used. • The current analysis excluded the AUG policy• Due to data quality, the study included 2011-2013 data • Cross section was further conducted on the 2012 data
Results: Claims reported 2014DRG Description Number of Claims % of Total Claims
DRG00 Fatal Pensions 53 0,62%
DRG01 Spinal Cord Injuries 4 0,05%
DRG02 Low er Limb Amputees 8 0,09%
DRG03 Upper Limb Amputees 3 0,03%
DRG04 Partial or Total Blindness 75 0,87%
DRG05 Noise Induced Hearing Loss (NIHL) and Acoustic Trauma 822 9,55%
DRG06 Injuries to the Head 903 10,49%
DRG07 Injuries to the Neck 62 0,72%
DRG08 Injuries to the Thorax 201 2,34%
DRG09 Back Injuries 357 4,15%
DRG10 Injuries to the Abdomen and Pelvis 26 0,30%
DRG11 Injuries to the Shoulder and Upper Arm 365 4,24%
DRG12 Injuries to the Elbow and Forearm 357 4,15%
DRG13 Injuries to the Wrist and Hand 1473 17,12%
DRG14 Injuries to the Hip and Thigh 149 1,73%
DRG15 Injuries to the Knee and Low er Leg 741 8,61%
DRG16 Injuries to the Ankle and Foot 780 9,06%
DRG17 Injuries involving Multiple Body Regions 94 1,09%
DRG18 Foreign Body in Eye, Ear and Lung 308 3,58%
DRG19 Burns and Corrosion 123 1,43%
DRG20 Toxic effects - solvents, metals, chemicals, gases 233 2,71%
DRG21 Effects of radiation, heat, pressure, electricity, vibration 79 0,92%
DRG22 Mental and Behavioural Disorders 79 0,92%
DRG23 Diseases of the Respiratory System 224 2,60%
DRG24 Skin Disease (Dermatitis / Eczema) 14 0,16%
DRG25 Other Conditions - miscellaneous 58 0,67%
DRG27 Sequelae 9 0,10%
(blank) (blank) 1006 11,69%
Grand Total 8606 100,00%
Results: Claims Cost 2104
Medical PD Fatal Days Off Not Classified Sundry -
20,000,000.00
40,000,000.00
60,000,000.00
80,000,000.00
100,000,000.00
120,000,000.00
140,000,000.00
160,000,000.00
180,000,000.00
Claims Cost 2014
Breakdown medical cost 2104
Results: Most prevalent injuries
Trend-Top 14 Injuries
Year Of Event All Injuries Top14 Categories Percent2009 21245 9836 46.30
2010 19649 8988 45.74
2011 19542 9342 47.80
2012 16216 7194 44.36
2013 15070 6799 45.12
Top 14 Injuries (2009-2013)
Fracture of finger
Sprain and strain of ankle
Contusion of ankle
Contusion of lower back and pelvis
Contusion other parts of foot
Contusion of shoulder/upper arm
Nitrogen oxides
Foreign body in respiratory tract
Foreign body cornea
Contusion of finger(s)/thumb
Contusion of knee
Other respiratory conditions
Open wound of finger(s)/thumb
Noise Induced Hearing Loss
0 50 100 150 200 250 300 350 400
22.9
18.7
16.3
22.7
35.3
28.8
11.1
7.1
41.8
40.5
38.7
36.3
73
69.7
23.1
18.6
19
21.4
30.5
25.9
14.9
8.3
35.6
37.9
35.2
35
78
74.2
21.7
20.7
17
20.6
30.1
23.4
9.4
3
38.9
33.9
33.5
84.9
67.1
73.8
24.7
19.2
19.5
20.1
27.2
25.5
20.9
5.1
29.1
36.1
35.8
45.6
64.9
69.8
18.4
19.2
19.7
20.3
24
24.3
27.7
28.9
30.7
35.5
36.2
37.1
53.6
75.6
2009 2010 2011 2012 2013
Per 1000 claims
Inju
ry C
ateg
ory
Results: Demographics ( Top Ten Categories)
Age distribution (2011-2013)
15 - 19
20 - 24
25 - 29
30 - 34
35 - 39
40 - 44
45 - 49
50 - 54
55 - 59
60 - 64
65 - 69
70 - 74
75-79
85+ -
200
400
600
800
1,000
1,200
1,400
1,600
1,800
ClaimYear2011 ClaimYear2012 ClaimYear2013
Average Age (2012)
ICD10 description No Of Beneficiaries Weighted average age ( yrs.)
Noise Induced Hearing Loss 1132 52.11
Open wound of finger(s)/thumb 1073 38.65
Other respiratory conditions 742 38.13
Contusion of knee 624 38.39
Contusion of finger(s)/thumb 595 37
Foreign body cornea 475 38.84
Fracture of finger 451 39.56
Contusion other parts of foot 441 37.92
Contusion of shoulder/upper arm 436 38.47
Contusion of ankle 343 38.25
Nitrogen oxides 339 41.48
Contusion of lower back and pelvis 331 39.46
Sprain and strain of ankle 318 36.48
Foreign body in respiratory tract 83 39.71
Demographic distribution: NHIL (52.1 yrs.)
Demographic distribution:Open wound of finger(s)/thumb (38.7yrs.)
Results: Demographics (NHIL/Open wound of fingers/thumb)
Results: Time/Day and Week of Injury, 2012
Time of the injury Day on the Week of the injuryICD10Description N Mean STDERR Lclm Uclm
Contusion of ankle 1828 9.66 0.13 9.41 9.91
Contusion of finger(s)/thumb 3458 9.78 0.09 9.61 9.95
Contusion of knee 3567 9.64 0.09 9.46 9.82
Contusion of lower back and pelvis 1960 9.47 0.12 9.24 9.7
Contusion of shoulder/upper arm 2504 9.47 0.11 9.25 9.68
Contusion other parts of foot 2758 9.46 0.1 9.27 9.65
Foreign body cornea 3302 9.43 0.09 9.25 9.62
Foreign body in respiratory tract 904 9 0.23 8.55 9.44
Fracture of finger 2261 9.67 0.11 9.45 9.89
Nitrogen oxides 1456 10.1 0.17 9.76 10.43
Open wound of finger(s)/thumb 6375 9.79 0.06 9.67 9.92
Other respiratory conditions 4459 8.78 0.08 8.62 8.93
Mean STDERR Lclm Uclm
4.03 0.04 3.95 4.11
4.04 0.03 3.99 4.1
4.07 0.03 4.02 4.13
4.14 0.04 4.06 4.21
4.07 0.03 4 4.13
4.17 0.03 4.11 4.24
4.14 0.03 4.08 4.19
4.58 0.05 4.49 4.68
4.16 0.04 4.09 4.23
4.1 0.04 4.02 4.18
4.1 0.02 4.06 4.14
3.83 0.02 3.78 3.88
Results: Injury by Day Of the Week (%), 2012
Contusion of ankle
Contusion of finger(s)/thumb
Contusion of knee
Contusion of lower back and pelvis
Contusion of shoulder/upper arm
Contusion other parts of foot
Foreign body cornea
Foreign body in respiratory tract
Fracture of finger
Nitrogen oxides
Open wound of finger(s)/thumb
Other respiratory conditions
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
7%
4%
6%
3%
5%
4%
3%
2%
4%
2%
4%
2%
15%
18%
17%
18%
18%
16%
17%
8%
18%
18%
18%
26%
18%
18%
18%
17%
16%
17%
19%
21%
18%
15%
18%
22%
19%
19%
17%
17%
19%
18%
19%
10%
16%
25%
18%
14%
17%
17%
17%
19%
19%
18%
18%
22%
18%
22%
17%
15%
14%
14%
16%
15%
14%
17%
15%
35%
16%
11%
15%
14%
9%
9%
9%
10%
9%
10%
9%
3%
10%
7%
10%
6%
Monday Tuesday Wednsday Thursday Friday Saturday Sunday
Results: Injuries by sectorper 100 000 employees per sector (2012)
Injury CategoryDeep Underground
(Gold)Deep Underground
(Other) Offices & Admin. OpenCastShallow
UndergroundSurface
Employees
Contusion of ankle 119.34 81.25 12.52 40.99 55.12 50.54
Contusion of finger(s)/thumb 188.57 143.7 50.08 115.51 75.16 214.06
Contusion of knee 222.28 124.9 118.94 55.89 117.75 148.65
Contusion of lower back and p 133.91 78.22 50.08 29.81 55.12 35.68
Contusion of shoulder/upper a 155.78 110.35 12.52 40.99 75.16 53.52
Contusion other parts of foot 204.97 108.53 31.3 7.45 45.1 35.68
Foreign body cornea 321.58 43.66 31.3 14.9 40.09 65.41
Foreign body in respiratory t 33.71 27.28 5.01 2.97
Fracture of finger 140.29 108.53 6.26 22.36 105.23 53.52Nitrogen oxides 204.06 46.08 43.82 7.45 2.51 104.06
Noise Induced Hearing Loss 456.4 273.46 31.3 93.15 230.5 172.44
Open wound of finger(s)/thumb 354.37 254.66 75.12 167.68 175.38 344.88
Other respiratory conditions 43.73 389.87 11.18 65.14 83.25
Sprain and strain of ankle 98.39 66.7 62.6 93.15 67.65 95.14
Results: PD awards
Distributions of PD Awards (Event Year)
1 3 5 7 9 11 13 15 17 19 21 23 25 27 290
20
40
60
80
100
120
140
160
180
NoOfPD Award By Event year
2012 2013
PD Awards Percentage
Num
ber
of
PD
aw
ard
s
Results : PD awards (cont.), 2012
PD Award percentage PD award amount
Description N Mean Median Lower Quartile Upper QuartileContusion of ankle 10 6.2 7.0 2.0 10.0
Contusion of finger(s)/thumb 14 5.3 3.5 2.0 6.0
Contusion of knee 30 8.1 6.5 5.0 12.0
Contusion of lower back and pe 11 8.8 7.0 5.0 10.0
Contusion of shoulder/upper ar 30 7.2 5.5 3.0 10.0
Contusion other parts of foot 6 2.3 1.0 1.0 2.0
Foreign body cornea 5 16.8 8.0 8.0 30.0
Fracture of finger 297 3.4 3.0 1.0 4.0
Noise Induced Hearing Loss 742 9.6 8.0 7.0 11.0
Open wound of finger(s)/thumb 158 4.5 3.0 1.0 6.0
Sprain and strain of ankle 8 4.4 4.0 1.5 6.5
Mean Median Lower Quartile Upper Quartile25224.9 23149.2 7502.8 38779.3
23748.5 15822.6 6800.1 25727.5
33561.9 28519.7 16135.8 50776.8
37897.1 25404.5 18500.5 64845.0
30208.0 25262.5 9982.4 44409.2
8708.8 4209.5 3578.2 7502.8
89279.0 43856.6 40443.3 145202.9
14641.4 10391.3 5325.6 18751.7
44516.1 38907.0 28596.2 54419.4
19598.8 12186.4 5797.2 23238.1
20469.2 19458.0 9726.8 29206.2
Results: TTD Benefits, 2012
Average TTDs (Only reported Days Off) Average TTDs (Incl. non reported Days Off)Description ICD-10 Code
Authorised Amount ( R)
Authorised Days Off (Days) N
Contusion of ankle S90.0 4,381.0 15.7 719
Contusion of finger(s)/thumb S60.0 5,013.9 15.6 595
Contusion of knee S80.0 6,348.2 17.4 1241
Contusion of lower back and pelvis
S30.0 5,051.0 17.0 690
Contusion of shoulder/upper arm S40.0 5,956.6 17.1 833
Contusion other parts of foot S90.3 3,761.7 14.9 817
Foreign body cornea T15.0 2,267.2 9.1 486
Foreign body in respiratory tract T17.8 1,798.3 8.2 19
Fracture of finger S62.6 4,736.1 18.9 2650
Nitrogen oxides T59.0 2,254.7 8.1 41
Noise Induced Hearing Loss H83.3 210.5 1.1 852
Open wound of finger(s)/thumb S61.0 4,165.8 16.0 2306
Other respiratory conditions J68.8 3,458.1 10.3 29Sprain and strain of ankle S93.4 4,619.3 15.3 493
Authorised Amount ( R) Authorised Days Off (Days) N4,139.3 14.8 761
4,639.6 14.4 643
5,879.2 16.1 1340
4,567.8 15.4 763
5,581.4 16.0 889
3,590.4 14.3 856
2,029.2 8.1 543
1,708.4 7.8 20
4,587.2 18.3 2736
2,149.8 7.7 43
177.7 0.9 1009
3,972.8 15.3 2418
3,235.0 9.7 31
4,337.7 14.4 525
Results: TTD benefits (cont.)On reported days Off: 2012
Days Off ( TTD)11Authorised Days Off Authorised Amount
description Median Lower Quartile Upper Quartile Median Lower Quartile Upper Quartile
Contusion of ankle 13 7 23 2577.41 1208.63 5329.65
Contusion of finger(s)/thumb 13 7 23 2583.35 1136.22 5070.75
Contusion of knee 15 7 29 3325.2 1258.06 6880.75
Contusion of lower back and pelvis 14 7 27 2885.46 1165.2 5574.84
Contusion of shoulder/upper arm 14 7 28 3267.53 1354.59 6102.07
Contusion other parts of foot 12 6 22 2564.69 1179.51 5076.89
Foreign body cornea 6 4 11 1104.44 174.73 2323.23
Foreign body in respiratory tract 6 4 10 1224.66 549.47 1818.76
Fracture of finger 17 9 29 3564.38 1700.95 6127.99
Nitrogen oxides 7 4 9 1339.1 668.8 2234.13
Noise Induced Hearing Loss 1 1 1 136.93 116.17 173.89
Open wound of finger(s)/thumb 13 7 24 2840.3 1301.21 5373.95
Other respiratory conditions 5 4 13 1152.65 169.37 3250.02
Sprain and strain of ankle 13 6 23 2593.2 1171.41 5058.49
Results-Injury Category by MSPNIHL (Authorised amount), 2012
ICD10Description PracticeTypeDescription N Mean Median Lower Quartile Upper Quartile
Noise Induced Hearing Loss
Audiology 17 8541.2 7700 7700 7700
Hearing Aid Acoustician 46 9361.6 9649.1 6754.4 13508.8
Otorhinolaryngology 24 525.3 527.4 491.2 559.1
Speech therapy / Audiology 30 6378.2 5231.7 886 10263.2
Results-Injury Category by MSP Open wound of finger (s)/thumb (Authorised amount): 2012
ICD10Description PracticeTypeDescription N Mean Median Lower Quartile Upper Quartile
Open wound of finger(s)/thumb
Advanced Life Support 25 1466.6 1325.2 1200.2 1656.8
Aneasthetics 26 1691.4 1725.9 1165.6 1968.4
General Practitioner 256 808.5 532.5 266.3 953.9
Group Practices 14 1035.2 1172.9 493.6 1417
ORTHOTIST/PROSTHETIST 4 350.4 350.4 337.1 363.6
Occupational Therapy 67 986.8 707 437 1027.2
Orthopaedics 71 2508.2 1872.8 527.3 3506.9PHARMACY 2 6.7 6.7 6.7 6.7Physiotherapists 140 848.2 466.9 434.1 568.5
Plastic and Reconstructive Surgery 3 2472.8 749.6 478.5 6190.3
Private Hospitals ('A' - Status) 10 665.1 490.2 421.3 893.1
Private Hospitals ('B' - Tariff) 7 3149.8 893.1 875.8 6542.7
Private Hospitals : Mine Hospital 167 991.1 231.1 110.8 651.9
Surgery 14 829.9 871 261.3 1132.3
Results-Injury Category by BranchAverage authorised PD Amount and PD award percent, 2012
NHIL Open Wound of finger (s)/thumb
K C J R W M K C J R W M
Authorised Pd Award Percent
8.62 7.83 9.28 11.3 8.88 7.94
Authorised Amount
3755.8 5043.1 6537.2 7005.4 8779.2 11578.9
13579
11
100030005000700090001100013000
Authorised Pd Award Percent Authorised Amount
RMA Branch
Auth
orise
d PD
awar
d pe
rcen
t
Auth
orise
d am
ount
C W J M D R K C W J M D R K
Autho-rised Pd Award Percent
4.64 4.25 4.09 4.09 8 5.51 4.15
Autho-rised Amount
613.6 706.5 778.4 1034.6 1171 1330 2633.6
0.5
2.5
4.5
6.5
8.5
2507501250175022502750
Authorised Pd Award Percent Authorised Amount
RMA Branch
Auth
orise
d PD
awar
d pe
rcen
t
Auth
orise
d am
ount
N=1 event
Results: Outstanding claims
Controlling for Year Controlling for Reason and YearReason Year
OpenedNumber of
Outstanding Claims (%) per YearStill on Active Medical Treatment 2013 42 57%Still on Active Medical Treatment 2014 313 29%Liability Decision 2014 201 19%Final Medical Report Outstanding 2014 182 17%Employee Banking Details (RMD20) 2014 44 4%Identity Documents 2014 43 4%Medical Reports - Progress 2014 31 3%Payment Needs Authorisation 2014 30 3%Impairment Assessment Clinic 2014 26 2%First Medical Report Outstanding 2014 20 2%Finance have Reversed a Payment Request 2014 15
1%Medical Account Payment Outstanding 2014 13
1%Possible 3rd Party Claim 2014 13 1%Outstanding days off 2014 12 1%Capture Valid Injury 2014 9 1%Outstanding Medical Assessment 2014 9 1%
2003
2006
2011
2012
2013
2014
Total
0 200 400 600 800 1000 1200 1400
8
3
3
5
74
1081
1174
NumberofOustandingClaims
Number of claims
Year
Ope
ned
Discussion and conclusionChallenges experienced - externally
• Reporting (in and out)• Document submission• Rehabilitation• Return to work
Challenges – internally• Retain and recruit competent staff• ICD 10 coding• Case management• Communication and feedback to stakeholder
Mitigating factor – RMA system• Electronic claims submission and invoice processing• Communication and Reporting to stakeholders
Thank you!
