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Why Your Workers’ Comp Claims Are Doubling

Why Your Workers’ Comp Claims Are Doubling

For most people, “comorbidity” is a term we don’t here often. So what does this concept mean? And how is it impacting your claims costs? Comorbidity is a medical condition that exists at the same time another condition is being treated. Generally, the conditions are independent from one another. In other words, a patient who is being treated for a back injury might also have diabetes. In this case, diabetes is considered the comorbidity. The four most common comorbidities are obesity, diabetes, and hypertension and drug abuse.

Now that we know what comorbidities are, let’s discuss how they impact your workers’ comp costs?

1. Comorbidities are becoming more prevalent.

A recent study performed by the National Council on Compensation Insurance (NCCI) showed that, nationally, the percentage of workers’ comp claims with a comorbid diagnosis of obesity, diabetes, or hypertension nearly tripled during 2000-2009. While a comorbid diagnosis of drug abuse (including the abuse of tobacco and alcohol) actually quadrupled during the same time period.

2. Comorbidities slow recovery and return to work.

Comorbidities are not generally covered under workers’ comp, but that doesn’t mean they can’t have a drastic effect on how quickly the patient (your employee) recovers and returns to work. Usually, the majority of claims are classified under “medical-only”, meaning the injured employee returned to work quickly enough that there was no need for indemnity payments (or lost-time wage payments). Only 19 percent of all claims include these payments.

On the other hand, in cases with a comorbid diagnosis, medical-only and those needing indemnity payments are usually evenly split. In cases of drug abuse, 50% of claims include lost time. In cases of diabetes, 55% include lost time. Obesity falls on the higher end with 81% of claims resulting in lost time payments.

3. Comorbidities seriously burden our aging workforce.

The older you are the more susceptible you become to some of the more common comorbidities, like hypertension and diabetes. That fact combined with a workers’ comp claim can be a long and frustrating process for you and your employee.

4. Comorbidities increase the costs of claims dramatically.

According to the NCCI, the average cost of cases with comorbidities was twice as costly as claims without. After adjusting the numbers for the injured workers’ state, year of injury, gender, industry, and type of injury:

 

  • The average medical claim cost for drug abuse was $13,717.
  • The average medical claim cost for diabetes was $15,897.
  • The average medical claim cost for hypertension was $15,656.

 

When compared to $2,490 (the cost when no comorbidity is present), it’s easy to see how dramatically comorbidities can impact the cost of claims.

So what can we do? Part of the reason we see more cases of these common comorbidities in workers’ comp is because they are on the rise in the general population. While there may not be any quick solutions, Part 2 of this series will talk about some steps you can take as an employer to help improve your employees overall health.

David Yohn is President of iBusinessSolutions, Inc. iBusinessSolutions was founded by David Yohn and Jamie Dunnam to give Business Owners a fresh and new way of doing business with their insurance agents. We feel that the days of “quick sales” and miss-informed agents will no longer be tolerated by the more savvy Business Owner today. We have developed a unique system to dig deep and broad into the needs of our clients in order to uncover exposed risks and lost profits. Our proven system has been tried and tested time and time again.

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