Longer indemnity benefit durations correlated with opioid use, study shows

"Duration for claims with prescribed opioid pain medication is clearly higher than for claims without opioids prescribed," says a new NCCI study. While acknowledging opioids do not necessarily cause longer durations, the researchers say it may be an area that warrants further research.

The findings are included in NCCI's latest study on temporary total disability indemnity benefit durations. While the duration rate has continued to increase since the onset of the recession, the growth has generally been more moderate lately -- with some exceptions.

"Within selected natures of injury, claims with at least one prescription for opioids have over 50 percent longer TTD durations than claims without opioids prescribed," the report says. Laceration claims, for example, typically had relatively short duration claims. However, those with opioid prescriptions "have 50 percent to 100 percent longer durations."

CWCI: Compound drugs are more potent, costly (03/11/13)
State legislators to address controversial meds in workers' comp (03/04/13)
NCCI: Physician dispensing on the rise in most states (10/06/11)
Florida Legislature targets repackaged drug costs (01/30/12)
Workers' comp physicians not following guidelines for opioid use, study shows (10/25/12)

The authors expanded on previous research and included the first six months of 2011. It shows a continued association of TTD duration rates and the economy.

"We estimate that the ultimate mean duration of TTD indemnity benefits rose from 130 days for accident year 2005 to 147 days for AY 2009, and rose again to 149 days for claims in the first half of AY 2011," the report says. "The national unemployment rate deteriorated from 4.6 percent in December 2007 to 8.9 percent in December 2011."

The latest study included claims with injury dates from January 1998 to June 30, 2011. It also included TTD indemnity benefit durations by nature of injury, the injured body part, and trends in industry groups.

"Contracting consistently has the highest duration of all the industry groups," the report says. "Contracting claims tend to be for more severe injuries than claims in other industries because of the relatively high exposure to hazardous work conditions, e.g., roofing."

Changes in TTD duration by nature of injury were fairly consistent, "reflecting increasing duration in the late 1990s as small claim frequency was declining rapidly countrywide, and minor annual changes mirroring countrywide trends thereafter," the report says. "One exception was that hernia claim TTD duration shortened throughout the review period, reflecting improved surgical results, and more rapid return to work."

In terms of body part injured and TTD benefit duration, the researchers said ankle injuries were associated with increased TTD duration from 1998 to 2010. Compared with TTD benefit duration for finger, hand, and wrist injuries, the TTD duration for ankle injuries "increased significantly more, by about 44 percent." Workers with fractured ankles were out of work for about twice as long as employees with sprained and strained ankle injuries.

Read more at the WorkersComp Forum homepage.

September 13, 2012

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