State workers' compensation policies affect costs and disability time
Some policies linked to higher or lower impact of occupational back pain
Certain workers' compensation (WC) policies explain much of the state-level variation in costs and outcomes of claims for low back pain (LBP), reports a study in the December Journal of Occupational and Environmental Medicine, official publication of the American College of Occupational and Environmental Medicine (ACOEM).
Dr. Glenn Pransky of Liberty Mutual Research Institute for Safety, Hopkinton Mass., and colleagues analyzed data on more than 59,000 LBP claims from 49 states. They found that state-level factors explained about five percent of the total variation in medical costs and disability time, after adjusting for differences in worker characteristics.
Of this variation, 43 to 50 percent was explained by differences in state WC policies. Medical costs were and disability times were both increased in states that had a longer retroactive period — that is, a longer disability time before the injured worker starts receiving benefits for lost work time. Costs and disability were also higher in states that allowed injured workers to choose the treating provider, rather than employers.
States that had a schedule of fees reimbursed for specific medical services had longer disability times, as did states that limited the option to change providers. However, policies allowing a one-time change in the treating provider were linked to lower medical costs as well as shorter disability times.