Trend to telecommuting, home offices pose challenges for occupational health
Ensuring workers’ safety at home requires a few new tricks
If your client’s employee is a telecommuter working from home, does she have a workers’ comp injury when she trips over the cat and sprains her ankle? What if she gets carpal tunnel syndrome because her home office equipment was not ergonomically sound? Can an employer require a home worker to follow the same safety precautions implemented at the work site?
Those are just some of the questions that face occupational health providers as more workers move from the traditional workplace to working from their homes telecommuting. These workers differ from contractors or freelancers who may work from home. Unlike those workers, telecommuters are still employees in every sense of the word. They are covered by health plans and workers’ compensation, and employers exercise a great deal of control over how they perform at their jobs.
Some of the issues concerning telecommuting require innovative solutions by occupational health professionals, but luckily, some of the questions are more novel than they are difficult. The good news is that, in many instances, the traditional theories and practices of occupational health will transfer quite well to a worker’s home.
First, occupational health providers must realize the scope of telecommuting in today’s work force; the popularity of the arrangement may have snuck up on you. There are at least 10 million telecommuters in the United States and some estimates go as high as 20 million, says Robert Moskowitz, president of the 100,000-member American Telecommuting Association, an advocacy group for telecommuters in Washington, DC. Those numbers exclude self-employed contractors. For most employers, "telecommuting" means the employee works from home at least two days a week, using computer e-mail, fax, and other methods to stay in touch.
"Telecommuting is growing very rapidly," Moskowitz says. "It’s a win-win situation for everybody. The employee gets a better work situation, and the worker’s productivity typically goes up at least 10%. The cost benefits alone, in terms of needing less office space and other requirements, can justify the arrangement for employers."
Even for experienced occupational health providers, telecommuters can pose a real challenge, warns Melissa D. Tonn, MD, MBA, MPH, medical director of Occupational Health Services at Memorial/Sisters of Charity Health Network in Houston and Presbyterian Healthcare System in Dallas. Her clients are increasingly asking about how to deal with telecommuters, and Tonn says many occupational health providers are just beginning to address the special concerns that come with home office workers.
"It seems to be uncharted territory for a lot of us, and we’re in a difficult position when it comes to advising our clients," Tonn says. "They’re looking to us for answers, and we’re just now coming up with some of those answers."
Fortunately, telecommuting does represent merely uncharted territory, not an entirely new set of problems and solutions. Employers and health providers often come up with a great many worries and questions when workers first move to home offices, but many problems prove more theoretical than real. One of the first questions to arise with employers involves workers’ compensation claims: Won’t claims rise if workers are on their own, beyond the watchful eye and safety regulations of the employer?
Not really. An attorney familiar with telecommuting issues tells Occupational Health Management that workers’ comp claims and other occupational health costs should not rise when workers move to a home office. Jeffrey M. Tanenbaum, JD, an attorney specializing in workers’ compensation with Littler, Mendelson, Fastiff, Tichy, and Mathiason in San Francisco notes that rather than taking on additional risks, the employer merely trades one set of risks for another. (See story, p. 116, for more on workers’ comp and other legal matters.)
That idea is endorsed by Gil Gordon, a telecommuting consultant in Monmouth Junction, NJ. Gordon advises telecommuters and their employers, and he tells OHM that companies often are worried about increased liability and the occupational health concerns. In most cases, he says, those fears are never realized.
"We’re not setting up people with drill presses and lathes in their living rooms," Gordon says. "These are essentially office workers with nothing inherently dangerous and risky about their work."
Gordon notes employers are increasingly addressing the occupational health concerns of telecommuting; the more advanced employers take a proactive approach that includes home inspections, safety training, and providing ergonomically correct equipment for the home. But many other employers take a casual approach to telecommuting and don’t address the occupational health issues at all.
For employers and occupational health providers, the telecommuting arrangement requires a new way of thinking. Since the worker still is an employee of the company, the occupational health provider remains responsible for ensuring the worker’s safety and seeing that he or she complies with all appropriate safety precautions and regulations. That obligation, however, can run head on into privacy issues when the worker is in his or her own home.
"The employer still has an obligation to make sure the workplace at home is safe," Moskowitz says. "The problem is that there are privacy concerns, and the employer doesn’t really have the right to go barging in and dictate how it’s set up."
Advise, don’t enforce
There is no way to avoid that obligation to maintain safety, in Moskowitz’s opinion. Many employers are inclined to write an agreement with the employee saying the employer is not liable for accidents in the worker’s home, for instance, but he is confident that such an agreement would not hold up in court. Moskowitz says the best approach for occupational health providers may be to concentrate on being an advisor, rather than trying to act as the client’s enforcer.
"It’s not like you’re trying to do something the worker doesn’t want," he explains. "If the employer wants him to use a certain kind of chair because it’s better for him and the employer makes it relatively easy for that to be done, why would the employee object?"
Tanenbaum also points out that many federal and state regulations may require inspections of the telecommuter’s home office. Since the home office is officially a worksite, most rules could be interpreted to mean that they must be inspected like any other worksite.
"I think it would be easy to look at OSHA regulations and say you have to visit the home, assess the hazards, and take steps to correct or minimize the hazards," he says. "The good thing is that, for the most part, you’re talking about a limited universe of hazards in somebody’s home."
Moskowitz downplays the novelty of telecommuters, saying they are simply today’s version of the traveling salesperson. While far more numerous and therefore requiring more attention, telecommuters can be handled just as traveling salespeople always have been. That means they are employees, they are subject to the employer’s requirements, and they are covered by workers’ comp and other protections.
Telecommuters may require modifications of some traditional policies and occupational health practices, but Moskowitz suggests that a flexible approach will solve most problems.
"These concerns are legitimate, but telecommuting doesn’t have to be a threat to the way employers have always handled these concerns," he says. "It’s more like unfamiliar territory. You have to figure out how to work in this new arena, and that usually just means a new twist on what has worked for you all along."
That was the approach taken by Merrill Lynch, the financial management company based in New York. The company put a formal telecommuting plan in place in 1996 after several years of studying related issues, including many of the occupational health concerns. About 30 Merrill Lynch employees telecommuted in 1993, and now 400 telecommute under the company’s more formal policy, explains Camille R. Manfredonia, vice president and director of alternative work arrangements.
Begin with training
The company puts prospective telecommuters through a process that includes a workshop in which the employee and managers discuss how to telecommute successfully, plus two weeks of practice in a telecommuting lab. The lab is located within the company’s facilities, but the employee works alone and communicates with others only by phone and e-mail to simulate working at home. The time in the lab also gives the new telecommuter a chance to troubleshoot problems with computers and other equipment.
Occupational health issues were a significant concern when the company was formalizing its telecommuting policy, says Eileen M. Keyes, assistant vice president with Merrill Lynch. The company has worked hard in past years to make sure that its employees, mostly white-collar office professionals, work in an ergonomically correct environment, so Keyes says there was a concern that much of that effort would be lost if employees left the premises and were free to set up their own offices.
"We got a task force together with people at very high levels, including the Merrill Lynch medical area, and decided that we had to do something to make sure these employees didn’t fall through the cracks," Keyes says. "Our telecommuters now spend two hours in training on how to set up an ergonomically correct office, covering everything from lighting to monitors, lumbar support, placement of the keyboard, and a lot of other issues."
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