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Part 1: Why your employee’s compensation claims are doubling
For most people, “comorbidity” is a term we don’t use often here. So what does this concept mean? And how does this affect your claims costs? Comorbidity is a condition that exists at the same time as the treatment of another condition. In general, the conditions are independent of each other. In other words, a patient being treated for a back injury may also have diabetes. In this case, diabetes is considered a comorbidity. The four most common comorbidities are obesity, diabetes, and hypertension and substance abuse. Now that we know what comorbidities are, let’s discuss how they impact your employees’ costs. …
Part 1: Why your employee’s compensation claims are doubling
For most people, “comorbidity” is a term we don’t use often here. So what does this concept mean? And how does this affect your claims costs? Comorbidity is a condition that exists at the same time as the treatment of another condition. In general, the conditions are independent of each other. In other words, a patient being treated for a back injury may also have diabetes. In this case, diabetes is considered a comorbidity. The four most common comorbidities are obesity, diabetes, and hypertension and substance abuse.
Now that we know what comorbidities are, let’s discuss how they impact your employees’ costs.
1. Comorbidities are becoming more common.
A recent study by the National Council on Compensation Insurance (NCCI) showed that the percentage of workers' compensation claims with a comorbid diagnosis of obesity, diabetes or hypertension nearly tripled between 2000 and 2009. While a comorbid diagnosis of substance abuse (including tobacco and alcohol abuse) actually quadrupled over the same period.
2. Comorbidities slow recovery and return to work.
Comorbidities are generally not covered by workers' comp, but that doesn't mean they can't have a drastic impact on how quickly the patient (your employee) recovers and returns to work. As a rule, the majority of claims are classified as “medical-only”, i.e. h. the injured employee returned to work so quickly that no compensation (or lost time) payments were required. Only 19 percent of all claims include these payments.
In contrast, in the case of a comorbid diagnosis, only medical services and those liable for compensation are usually divided equally. For substance abuse, 50% of claims include lost time. For diabetes, 55% includes lost time. Obesity falls at the high end with 81% of claims resulting in non-payment.
3. Comorbidities place a heavy burden on our aging workforce.
The older you are, the more susceptible you become to some of the more common comorbidities such as high blood pressure and diabetes. This fact combined with a workers’ compensation claim can be a long and frustrating process for you and your employee.
4. Comorbidities dramatically increase claims costs.
According to NCCI, the average cost for cases with comorbidities was twice as high as for cases without. After adjusting numbers for injured worker condition, year of injury, gender, industry, and type of injury:
- Die durchschnittlichen Kosten für medizinische Ansprüche wegen Drogenmissbrauchs betrugen 13.717 US-Dollar.
- Die durchschnittlichen Kosten für medizinische Ansprüche für Diabetes betrugen 15.897 US-Dollar.
- Die durchschnittlichen Kosten für medizinische Ansprüche wegen Bluthochdruck betrugen 15.656 US-Dollar.
When compared to $2,490 (the cost if no comorbidity is present), it is easy to see how dramatic an impact comorbidities can have on claim costs.
So what can we do? One of the reasons we are seeing more cases of these common comorbidities in workers' comp is because they are increasing in the general population. Even if there are no quick solutions,Part 2This series will talk about some steps you as an employer can take to improve the overall health of your employees.
Inspired by David Yohn