The study, Comorbidities in Workers' Compensation, builds on previous research that focused on obesity and includes additional medical conditions. It shows that increasingly more claims have a comorbidity diagnosis, they are more likely to result in lost time from work, and they typically involve more transactions and visits.
A comorbidity diagnosis is defined in the study as "any medical transaction with a recorded ICD9 code indicating specified comorbidity." In addition to obesity, hypertension, drug abuse, diabetes, and chronic pulmonary are especially prevalent.
"The share of workers' compensation claims with a comorbidity diagnosis nearly tripled from Accident Year 2000 to Accident Year 2009, growing from a share of 2.4 percent to 6.6 percent," the study says. "Over a nine-year span, the share of claims with drug abuse diagnoses (inclusive of alcohol and tobacco) more than quadrupled, and the shares for diabetes, hypertension, and obesity diagnoses have tripled."
Hypertension was the most prevalent of the diagnoses investigated by NCCI and occurred in 2.8 percent of all workers' comp claims in 2009.Males accounted for 67 percent of all such claims.
In terms of the costs, the authors compared the per-claim cost for claims with a comorbidity diagnosis to all claims with or without a comorbidity diagnosis. "As we have shown, the characteristics of the population of claims with a comorbidity diagnosis differ markedly from those of the general population," the study says. "Such differences in demographics contribute significantly to the six fold increase in per-claim costs for claims with a comorbidity diagnosis over All Claims."
For example, the study shows:
- Claims with a diabetes diagnosis went from a cost of $12,728 to $15,897.
- The addition of drug abuse added nearly $3,000 to the claim cost from $10,718 to $13,717.
- Hypertension added $2,687 to the cost, pushing the claim from $12,969 to $15,656,
- Chronic pulmonary added about $2,500 to the claim cost, driving it from $12,218 to $14,719.
Lost time from work is more prevalent in claims with comorbidities, the study says. It shows 81 percent of claims involving obesity resulted in lost time while 56 percent involving hypertension did.
The authors also found that the initial comorbidity diagnosis tends to occur early in the life of a claim, and hospital and physician visits account for a majority of the visits resulting in a recorded comorbidity diagnosis. "The absence of such a diagnosis does not mean that the claimant does not suffer from the comorbidity nor that the health care professional did not make such a diagnosis," the study says. "Its absence only implies that a health care professional did not record such a diagnosis as part of the workers' compensation claim."
The authors further explained that the workers' comp shares are significantly lower than those from the Centers for Disease Control and Prevention, "suggesting that most workers' compensation claimants with a given comorbidity are not diagnosed through the workers' compensation system for that comorbidity."
Read more at the WorkersComp Forum homepage.
January 3, 2013
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