California researchers explore high costs of carpal tunnel claims

"Carpal tunnel injury claims are among the most expensive work injury claims in California, with higher than average indemnity and medical payments," says a new report. They typically involve "not only high medical costs, but long periods of recuperation and permanent disability, which push up indemnity costs."

The comments are included in a report from the California Workers' Compensation Institute. It is the sixth in a series of CWCI "Scorecards" examining the top 10 workplace injury categories.

The researchers analyzed California workers' comp claims starting with accident year 2001. Their review sheds light on why carpal tunnel syndrome accounts for under 1 percent of the state's work-related injuries but almost 2.5 percent of the benefit payments.

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Average claim durations for carpal tunnel claims are much longer than for other types of claims, a result that holds true for medical only, temporary disability and permanent disability claims, the authors say. The average claim duration for all carpal tunnel claims is nearly 31 months -- 968 days -- from the claim filing date to the case closure date, nearly triple the average of 10.8 months -- 325 days -- for all other claims.

The researchers cite the following factors that likely contribute to the longer claims durations.

Uncertainty and disputes over the cause and nature of the injury.
Notification and initial treatment delays.
High levels of attorney involvement.
High incidence of lost time claims, especially permanent disability cases.
Treatment plans that often involve surgery followed by physical therapy.

Claim duration is among the major cost drivers in carpal tunnel cases, a factor the researchers say reflects the time needed for treatment and recuperation from the injuries. Only 38 percent of these claims close within two years of injury, which is barely half the claim closure rate for all workers' comp claims.

More than two-thirds of carpal tunnel injuries result in lost time. For accident years 2001-11, more than half the claims resulted in permanent disability -- three times the percentage for all claims. In fact, carpal tunnel injury claims have one of the highest PD incidence rates in California.

Also driving the costs of the claims was attorney involvement. For AY 2001-10, attorneys were involved in two out of three carpal tunnel indemnity claims compared to just 48 percent for all claims, "which reflects the high percentage of these claims that result in a PD as well as the complexity of the claims."

The Scorecard also includes the following findings:

While nearly half of all carpal tunnel claims involve workers in the professional/clerical and mercantile sectors, the hospital sector registered the largest proportional increase after the recession hit, more than doubling from 6.3 percent of the carpal tunnel claims in the pre-recession period to 13.9 percent of the 2008-11 claims.
The most commonly cited cause of carpal tunnel injuries is repetitive motion. The cause of injury is often unclear.
Both the average age and average tenure for carpal tunnel claimants has increased in recent years.

Read more at the WorkersComp Forum homepage.

February 25, 2013

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