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Leigh is a professor at the University of California at Davis, with decades of work in econometrics, health and labor economics. He is experienced in counting the number and types of occupational health conditions, using disparate data sources and extrapolation techniques. Much of his research compares databases, like state disease registries and workers' compensation claims databases, to arrive at a complete picture, or map, of worker injuries and illnesses.

In 2004 Leigh and a colleague concluded that workers' compensation payers missed upward of 93.8 percent of medical costs of occupational diseases and 98.9 percent of occupational disease deaths. Instead of the Bureau of Labor Statistics fatality figure of about 6,200 in 1997, they proposed 55,200 deaths.

A multi-data source estimation method called capture-recapture has empowered several research teams to estimate that many recordable injuries are not recorded on Occupational Safety and Health Administration logs, and that many compensable injuries never result in workers' compensation claims.

The weight of the evidence from many studies suggest to me that roughly 40 percent of all compensable injuries do not become claims.

OSHA told me in July that a special study found that 17 percent of all recordable injuries were not recorded at all and 6 percent of injuries recorded as non-lost time actually incurred lost time.

Getting over my surprise on reading the estimates of Leigh and others, I admire the value of the entire epidemiological enterprise of shining light upon the unknown. The workers' compensation field should in fact support this kind of talent, though it is easy to fear that all this research brings is trouble.

Here are examples of why we should value and support these analytical skills.

First, the workers' compensation field needs this talent to forcefully underscore the potential long-term economic harm to workers of their injuries. The harm extends well after claims closure. This was found only when researchers melded together workers' comp and employment databases to show that even short-term disabilities can lead to long-term wage declines. The unmistakable lesson is that everything imaginable should be done to expedite return to work. We have been in effect underselling early return to work.

Second, we need this skill to build an emerging case about personal health conditions in the American workforce. The Affordable Care Act changes the game of healthcare. Every worker will have a health plan. Workers should be accountable for getting medical treatment for personal conditions that impede recovery from work injuries.

These researchers can map throughout the working age population, the incidence of and payment streams for treatable co-morbid conditions, such as depression, anxiety, and metabolic syndrome conditions such as hypertension and diabetes.

There might be a temptation to sweep under the rug the findings of Leigh and others. But the workers' compensation field would be invigorated were we to constructively engage these map makers.

PETER ROUSMANIERE is an expert on the workers' compensation industry. He can be reached at riskletters@lrp.com.

August 22, 2012

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