Joint pain-related work injuries increase expense

While only 2.6 percent of California's workers' comp claims are due to joint pain, nearly 7 percent of all system payments go toward these claims, says a new report. The data reflects the "subjective nature of many of these injuries."

The California Workers' Compensation Institute analyzed data on workers' comp claims in which the primary diagnosis was a degenerative, infective, or metabolic joint disorder for its latest Score Card. The information is based on CWCI's Industry Claims Information System database and is the fifth in a series examining the top 10 work injury categories that account for nearly two-thirds of all job injuries in California and three-quarters of all claim payments.

"Joint pain has consistently resulted in significantly higher than average expense among workers' compensation claims in California," the Score Card says. "Joint pain related injuries are relatively severe and costly, as more than 40 percent of them result in permanent disability, compared to 16.7 percent for all injuries, and another 18.7 percent result in temporary disability, vs. about 16 percent of all injuries."

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The claim closure rate for joint pain at 24 months is 52.2 percent compared to 73.3 percent for all claims, according to the report, which it says is due to the "relatively high rate of permanent disability claims among joint pain claims" and the low claim closure rates for all types of joint pain injury claims.

"At 24 months postinjury, claim closure rates for joint pain permanent disability cases have been consistently below claim closure rates for all permanent disability cases," the report explains. "This is somewhat surprising given the relatively low rate of attorney involvement on joint pain permanent disability claims. However, the tendency of soft tissue injuries to linger may be driving the relatively low closure rates on joint pain claims. Since AY 2002, the claim closure rates at 24 months on permanent disability cases have increased for both joint pain claims and for all claims."

Injuries from slips or falls were cited as the number one cause of work-related joint pain claims. Nearly one-third of all joint pain claims are caused by a strain.

Most joint pain disorders have a diagnosis of pain that involves a variety of body parts, the researchers said. The lower leg joint is most often diagnosed with pain followed by the shoulder, forearm, hand, and ankle-foot.

Chondromalacia of the patella -- also called runners' knee -- is diagnosed in 4.6 percent of joint pain claims but accounts for 8.3 percent of the payments "due to the comparatively costly nature of this injury," the report says. Other diagnoses such as osteoarthrosis, old disruption of anterior cruciate ligament, and derangement of the medial meniscus account for 31.7 percent of the claims.

Hydrocodone topped the list of most prescribed drugs for joint pain, according to the report. Also high on the list was oxycodone. The painkillers Vicodin, Percocet, and Darvon represented 35 percent of the prescriptions and more than 38 percent of the payments for joint pain injuries.

The report said men account for nearly two out of three joint pain claims. Four industry sectors -- professional/clerical, construction, manufacturing, and mercantile -- account for over half of all joint pain injuries, although that shifted with the recession, likely due to changes in California's job market.

Read more at the WorkersComp Forum homepage.

January 3, 2013

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