Lag Times in Reporting Injuries, Receiving Medical Care, and Missing Work

Besen, Elyssa; Harrell, Mason; Pransky, Glenn

doi:10.1097/jom.0000000000000591

Cited by 15 publications

(4 citation statements)

References 18 publications

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“…In SA, the change in claim reporting time was driven by reductions in worker reporting time. While a decrease in worker reporting time is a positive outcome, since delays in this time period are predictive of claims becoming long-duration [ 9 , 10 ], the implication is that these reductions are indirectly attributable to ERIs, or to another cause entirely. One possibility is that provisional liability, which grants injured workers WC services while awaiting a decision on their claim, fostered a sense of certainty of benefits and encouraged workers to engage with the system earlier [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…This can delay the claim lodgement process and access to services, which can in turn lead to more time off work [ 2 – 5 ], higher claim costs [ 4 , 6 , 7 ], and poorer long-term anxiety, depression, disability, and quality of life [ 8 ]. Further, delays at different stages in the claim lodgement process – such as initial reporting of the injury, claim lodgement, insurer liability decision, and receipt of treatment – have each been linked to more time off work [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of employer financial incentives in reducing time to report worker injury: an interrupted time series study of two Australian workers’ compensation jurisdictions

et al. 2018

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BackgroundEarly intervention following occupational injury can improve health outcomes and reduce the duration and cost of workers’ compensation claims. Financial early reporting incentives (ERIs) for employers may shorten the time between injury and access to compensation benefits and services. We examined ERI effect on time spent in the claim lodgement process in two Australian states: South Australia (SA), which introduced them in January 2009, and Tasmania (TAS), which introduced them in July 2010.MethodsUsing administrative records of 1.47 million claims lodged between July 2006 and June 2012, we conducted an interrupted time series study of ERI impact on monthly median days in the claim lodgement process. Time periods included claim reporting, insurer decision, and total time. The 18-month gap in implementation between the states allowed for a multiple baseline design. In SA, we analysed periods within claim reporting: worker and employer reporting times (similar data were not available in TAS). To account for external threats to validity, we examined impact in reference to a comparator of other Australian workers’ compensation jurisdictions.ResultsTotal time in the process did not immediately change, though trend significantly decreased in both jurisdictions (SA: −0.36 days per month, 95% CI −0.63 to −0.09; TAS: 0.35, −0.50 to −0.20). Claim reporting time also decreased in both (SA: −1.6 days, −2.4 to −0.8; TAS: -5.4, −7.4 to −3.3). In TAS, there was a significant increase in insurer decision time (4.6, 3.9 to 5.4) and a similar but non-significant pattern in SA. In SA, worker reporting time significantly decreased (−4.7, −5.8 to −3.5), but employer reporting time did not (−0.3, −0.8 to 0.2).ConclusionsThe results suggest that ERIs reduced claim lodgement time and, in the long-term, reduced total time in the claim lodgement process. However, only worker reporting time significantly decreased in SA, indicating that ERIs may not have shortened the process through the intended target of employer reporting time. Lack of similar data in Tasmania limited our ability to determine whether this was a result of ERIs or another component of the legislative changes. Further, increases in insurer decision time highlight possible unintended negative effects.Electronic supplementary materialThe online version of this article (10.1186/s12889-017-4998-9) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effectiveness of employer financial incentives in reducing time to report worker injury: an interrupted time series study of two Australian workers’ compensation jurisdictions

et al. 2018

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“…More studies may be needed to understand all the factors outside the scope of this analysis which may drive the total cost of claims when the injuries are not reported promptly. 36 , 37 …”

Section: Resultsmentioning

confidence: 99%

Medical Cost of Workers’ Compensation Claims Related to Patient Handling and Mobility Tasks Within Skilled Nursing Facilities, Continuing Care Retirement Communities and Assisted Living Facilities

Pieretti

Sylvester

Siegfried

2020

Journal of Occupational &Amp; Environmental Medicine

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Objective: Evaluate the medical costs related to patient handling & mobility (PH&M) claims. Methods: Closed medical only and indemnity workers’ compensation claims were utilized for this exploratory study. In addition to the PH&M tasks, the claimants’ gender, age, tenure, and the claim lag time were also analyzed. Results: Generalized linear models indicated that variables related to tasks, claims’ number of open days and age of the claimants had meaningful effects on the adjusted medical costs for medical only claims. For indemnity claims, the number of open days of claims, age and tenure had meaningful effects. Gender had meaningful effects only for indemnity claims when classifying the claims by patient handling tasks versus non-patient handling tasks. Conclusions: Results showed that factors, other than the type of injury; meaningfully influenced the adjusted medical costs of indemnity claims.

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“…Long MRI waiting times can be a challenge and have been associated with delays in diagnoses, canceled appointments, poorer outcomes, and financial losses 10 - 12 . Additionally, lag times in receiving care predict the length of disability 13 .…”

mentioning

confidence: 99%

Workers’ Societal Costs After Knee and Shoulder Injuries and Diagnosis with In-Office Arthroscopy or Delayed MRI

et al. 2021

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Background: The goal of this study was to evaluate the societal costs of using in-office diagnostic arthroscopy (IDA) compared with magnetic resonance imaging (MRI) for the diagnosis of intra-articular knee and shoulder pathology in employed patients receiving Workers’ Compensation or disability coverage. The prevalence is estimated at 260,000 total cases per year. Methods: A cost-minimization analysis of IDA compared with MRI was conducted. Direct costs (in 2018 U.S. dollars) were calculated from private reimbursement amounts and Medicare. Indirect costs were estimated from a societal perspective including effects of delayed surgical procedures on the ability to work, lost income, Workers’ Compensation or disability coverage, and absenteeism. Four regions were selected: Boston, Massachusetts; Detroit, Michigan; Denver, Colorado; and San Bernadino, California. Sensitivity analyses were performed using TreeAge Pro 2019 software. The base assumption was that it would take approximately 4 weeks for a diagnosis with MRI and 0 weeks for a diagnosis with IDA. Results: Direct costs to determine a knee diagnosis with IDA were $556 less expensive (California) to $470 more expensive (Massachusetts) than MRI. Assuming a 4-week wait, societal costs (indirect and direct) for knee diagnosis were anywhere from $7,852 (Denver) to $11,227 (Boston) less using IDA. Direct costs were similar for shoulder pathology. In order for MRI to be the less costly option, the MRI and the follow-up visit to the physician would need to occur directly after consultation. Under Medicare, direct costs were similar for both the knee and shoulder when comparing IDA and MRI. Including indirect costs resulted in IDA being the less costly option. Conclusions: The use of IDA instead of MRI for the diagnosis of knee and shoulder pathology reduced costs. The potential savings to society were approximately $7,852 to $11,227 per operative patient and were dependent on scheduling and follow-up using MRI and on Workers’ Compensation. Level of Evidence: Economic and Decision Analysis Level IV . See Instructions for Authors for a complete description of levels of evidence.

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Lag Times in Reporting Injuries, Receiving Medical Care, and Missing Work

Cited by 15 publications

References 18 publications

Effectiveness of employer financial incentives in reducing time to report worker injury: an interrupted time series study of two Australian workers’ compensation jurisdictions

Effectiveness of employer financial incentives in reducing time to report worker injury: an interrupted time series study of two Australian workers’ compensation jurisdictions

Medical Cost of Workers’ Compensation Claims Related to Patient Handling and Mobility Tasks Within Skilled Nursing Facilities, Continuing Care Retirement Communities and Assisted Living Facilities

Workers’ Societal Costs After Knee and Shoulder Injuries and Diagnosis with In-Office Arthroscopy or Delayed MRI

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