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Cost Analysis of Injury Claims in the Fire Service
Juliet C. Pena*1, Stephanie C. Griffin1, Gary R. West2, Wayne F. Peate1, & Jefferey L. Burgess1
1The University of Arizona Mel & Enid Zuckerman College of Public Health, 1295 N. Martin Ave. Tucson, AZ 85724
2Northwest Fire District, 5225 W. Massingale Rd., Tucson, AZ 85743
Introduction
•To describe direct and indirect costs of injury claims in a
suburban fire district.
•The fire service is a high-risk industry.
•Over 70,000 injuries occurred among 1.1 million career
and volunteer firefighters in the U.S. in 2011 (~6.4 injuries
per 100 firefighters), costing the U.S. Fire Service up to
$7.8 billion/year1,2.
•Currently, there is a paucity of studies on injury costs in the
fire service, and even less information on indirect costs.
•Cost information is essential for the economic evaluation of
health and safety programs, particularly for estimating the
return on investment for competing intervention options,
e.g. injury prevention and loss control programs.
Results (cont.)
Fig. 1. Overview of Injury Claims Process
Methods
Primary source: Workers’ compensation (WC) reports, fire
district human resources records and in-person interviews
with personnel from both organizations.
Study population: All fire district employees (N=325) who
filed injury claims from July 2007 through June 2013.
Main outcome measures:
Backfill costs = 1.5 X normal hourly wages + benefits*
*Benefits = 16.29% PSPRS + 4.78% workers’ compensation + 1.45% Medicare
= 22.52% gross wages, (PSPRS: Public Safety Personnel Retirement System)
EMOD Factor: Insurance experience rating = Actual/Expected losses
References
1. Karter MJ, Molis JL. U.S. Firefighter Injuries 2011. Quincy, MA, USA: National Fire
Protection Association, 2012.
2. Karter MJ, Stein GP. U.S. Fire Department Profile Through 2011. Quincy, MA, USA:
National Fire Protection Association, 2012.
3. Jallon R, Imbeau D, de Marcellis-Warin N. Development of an indirect-cost calculation
model suitable for workplace use. J Safety Res. 2011a;42(3):149-164.
4. Jallon R, Imbeau D, Marcellis-Warin N. A process mapping model for calculating indirect
costs of workplace accidents. J of Safety Res. 2011b;42(5):333-344.
•By using cost multipliers based on more easily available
data, fire departments and similar industries may estimate
their related expenses and potential savings (as well as
return on investment) associated with specific injury risk
prevention program components.
•The study should be replicated in other departments to
determine if the results can be generalized to the wider fire
service.
Discussion/Conclusions
Objective
Keywords: Accident costs; Economic evaluation methods; Direct cost; Indirect cost; Risk management; Occupational safety
Fiscal Year
(FY)
EMOD
Factor
Annual
Premium
Injury
Claims
(n)
Paid
Indemnity
by FD
(A)
Paid
Medical
by FD
(B)
Backfill
Cost
(C)
Other
Indirect
Costs*
(D)
Total
Incurred by
FD
(A+B+C+D)
Total
Incurred by
Insurance**
2012-2013 1.24 $618,804 31 $44,424 $2,764 $67,795 $86,957 $201,940 $147,227
2011-2012 1.10 $514,872 59 $68,013 $5,349 $109,306 $88,409 $271,077 $237,481
2010-2011 1.18 $451,539 51 $62,856 $4,759 $100,110 $91,008 $258,733 $190,108
2009-2010 0.90 $462,244 53 $55,801 $5,047 $92,928 $92,856 $246,632 $150,210
2008-2009 0.98 $382,413 79 $92,103 $7,592 $149,744 $93,721 $343,161 $754,790
2007-2008 1.01 $498,493 52 $53,386 $5,068 $90,091 $95,049 $243,595 $78,519
Sum N/A $2,938,842 325 $375,627 $30,414 $607,982 $547,536 $1,561,555 $1,547,469
FY Avg 1.07 $489,807 54 $62,604 $5,069 $101,330 $91,256 $260,259 $257,912
Std Dev 0.13 $104,411 17 $16,439 $1,612 $27,741 $0 $39,142 $240,236
Median 1.06 $466,438 53 $58,934 $4,913 $95,854 $91,256 $250,910 $172,199
Table 1: EMOD factors, insurance premiums, and other costs to fire district (FD)
and insurance (for FY 2007 to 2013).
*”Other Indirect Costs”: Administrative (i.e. paperwork, scheduling, follow-up), Investigative, +/-
Training. **“Total Incurred by Insurance”: Paid Indemnity and Medical expenses by Insurance.
No-lost time claim (~40%)
Sche duling Officer backfill
arrangement for lost-time/
modified duty/ pe rmanent loss
District Physician PAT
evaluation & Release
Lost-time claim (~10% )
Minor injury (no hosp italization
or care by physician)
Supervisor investig ation of
injury & interview of witnesse s
First-aid only internal
rep orting (~50% *)
Ope rations Personne l notification
to on-duty Battalion Chief (BC)
Supervisor SRI
SRI copy to Safety Officer
HR filing of SRI
BC re view of SRI, cover letter
insertion to COC
Care by Physician/ Hospitalization
Notification to Division Head
and Safety Officer to Fire Chief
Serious injury/
Death (<1%)
Notification to BC
throug h COC
Re turn to regular duty
**2
nd
Medical opinion
(75% of injury claims)
(Re)training (for ≥1
months off regular duty)
Lost wages + b ene fits set b y HR
Med ical care of injury
Employee notification to Supervisor
Fig. 2. Direct and Indirect Costs to the Fire District
•Fire district uninsured costs for injuries were on average
equivalent to 53% of their insurance premium costs and
approximately equal to the total WC claims costs covered
by insurance.
•Based on 2-yr impact scores, a 5-22% increase in the
EMOD factor yielded an 11-37% increase in the insurance
premium.
Results
AI: Administrative &
Investigative costs
DIRECT COSTS INDIRECT COSTS
Fire
District
Paid indemnity (wages & benefits
paid by fire district while injured
worker is on modified duty OR off
duty), Medical (2nd-opinion consults
and exams), Insurance premium.
Backfill replacement,
Administration,
Investigations,
(Re)Training.
Insurance Paid indemnity (wage
replacements only while off duty),
Medical expenses.
N/A
The fire district response to workplace injuries is mapped
in Figure 1.
Percentages of fire district injury-related costs are
shown in Figure 2, and compared to annual premiums
in Table 1.