Repeat workers compensation claims: risk factors, costs and work disability Dr Rasa Ruseckaite & Dr Alex Collie

Transcription

1 Repeat wrkers cmpensatin claims: risk factrs, csts and wrk disability Dr Rasa Ruseckaite & Dr Alex Cllie Institute fr Safety, Cmpensatin and Recvery Research

2 Why lk at repeat claims?

3 Why lk at repeat claims? 38% f Australian wrkers receiving cmpensatin reprt making a previus claim. Surce: Australian & New Zealand RTW Mnitr (2009/10).

4 Why lk at repeat claims?

5 Ratinale Occupatinal injury preventin initiatives are strngly influenced by analysis f wrkers cmpensatin data. It appears that 40% - 50% f wrkers cmpensatin claims are repeat claims.

6 Ratinale (cntd) Vast majrity f analysis in this area treats the claim as a discrete event. Very limited understanding f: Risk factrs. Csts. Disability.

7 Objectives 1. Describe factrs assciated with repeat wrkers cmpensatin claims and time between repeat claims. 2. Cmpare csts and disability arising in wrkers with single and multiple claims.

8 Data Wrkers cmpensatin dataset Victrian wrkers > 14 years f age Claim inclusin criteria: 1 st claim: 1 st Jan st Dec 2000, accepted 2nd claim: 1 st Jan 1996 t 31 st Dec 2009, accepted Claim exclusin criteria: First claims ccurring after 31 st Dec 2000 Any third and subsequent claims

9 Data (cntd.) Perid 1 = all claims included in dataset Perid 2 = all secnd claims frm thse wh ldged a claim in perid 1 included in dataset

10 Data analysis Define tw grups: 1. Single claim 2. Multiple claims Descriptive analysis Cmpare grups by age, gender, industry and ccupatin Analysis 1: Initial claim is due t injury Analysis 2: Initial claim is due t disease

11 Data analysis (cntd.) Descriptive analysis f first and secnd claims in Grup 2: % secnd claims injury vs disease by type f afflictin & bdily lcatin by ccupatin & industry by emplyer & wrkplace lcatin Cx prprtinal hazards mdel t cmpare impact f these factrs n time between claims T-tests t cmpare csts and disability (days incapacity fr wrk) assciated with initial and repeat claims.

12 Results (Injury as first claim)

13 Nature f afflictin and lcatin (Injury as first claim)

14 Occupatin and industry (Injury as first claim)

15 Emplyer and wrkplace (Injury as first claim)

16 Emplyer segment size (Injury as first claim)

17 Benefits and wrk disability (Injury as first claim)

18 Results (Disease as first claim)

19 Nature f afflictin and lcatin (Disease as first claim)

20 Occupatin and industry (Disease as first claim)

21 Emplyer and wrkplace (Disease as first claim)

22 Emplyer segment size (Disease as first claim)

23 Benefits and wrk disability (Disease as first claim)

24 An impact f repeat wrkers cmpensatin claims ( )

25 Grup 1 Grup 2 Impact Initial claim Initial claim Repeat claim Sig* Ttal N (%) f claims 586,795 (33%) 356,346 (20%) 843,375 (47%) A,b,c Ttal N (%) f claimants 586,795 (62%) 356,346 (38%) 356,346 (38%) A,b Male, N (%) 346,214 (59%) 249,034 (69.9%) a Female, N (%) 213,760 (36.4%) 89,511 (25.1%) a Unknwn, 26,821 (4.6%) 17,801 (5%) na Mean age (std) f claimants 36.6 (13) 35.4 (11.8) a N (%) f injury claims 453,260 (77.2%) 305,105 (85.6%) 635,327 (75.3%) A,b,c N (%) f disease claims 133,535 (22.8%) 51,241 (14.4%) 208,048 (24.7%) A,b,c N (%) medical claims 193,665 (33%) 106,999 (30%) 315,403 (37.4%) A,b,c N (%) time lss claims 368,866 (67%) 223,512 (70%) 514,852 (61%) A,b,c N (%) claimants per emplyer size categry Small 135,822 (23.1%) 59,920 (16.8%) 126,035 (14.9%) A,b,c Medium 209,620 (35.7%) 128,051 (35.9%) 337,667 (40%) A,b,c Large 125,658 (21.4%) 79,951 (22.4%) 219,628 (26%) A,b,c Gvernment 41,509 (7.1%) 33,138 (9.3%) 91,074 (10.8%) A,b,c Unknwn 74,186 (12.6%) 55,286 (15.5%) 68,971 (8.2%) A,b,c

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27 Indicatrs f claim impact Grup 1 Grup 2 Impact Initial claim Initial claim Repeat claim Sig* Ttal number f days ff 45,018,554 16,724,329 54,146,064 A,b,c wrk in time lss claims Mean (std) days f ff wrk 122 (400) 75 (273) 105 (354) A,b,c in time lss claims per claimant Ttal cst f cmpensatin Fr all claims $10,514,601,881 $3,813,154,567 $15,220,981,415 A,b,c Fr time lss claims $9,874,084,962 $3,551,289,283 $14,389,038,532 A,b,c Fr medical nly claims $573,288,477 $222,097,887 $780,283,422 A,b,c Ttal cst f incme replacement Fr all claims $4,065,545,890 $1,349,919,946 $5,870,138,560 A,b,c Fr time lss claims $4,030,458,810 $1,330,831,513 $5,843,869,176 A,b,c Fr medical nly claims $275,048 $425,780 $252,811 A,b,c Ttal cst f medical/like services Fr all claims $2,175,882,728 $784,175,761 $2,929,738,326 A,b,c Fr time lss claims $2,050,241,561 $717,980,492 $2,737,897,874 A,b,c Fr medical nly claims $115,451,081 $59,394,725 $182,597,847 A,b,c

28 Repeat wrkers cmpensatin claims: Wh is at risk? (Replicatin f Alberta study)

29 Alberta s WCB vs. WrkSafe Victria

30 Repeat wrkers cmpensatin claims. Cmparisn f ISCRR and IWH (Ontari) data

31 Ontari Victria Factr Value Single Multiple Single Multiple n Rw Cl n Rw Cl n Rw Cl n Rw Cl All 327,688 77% 100% 96,168 23% 100% 64,352 75% 100% 14,253 18% 100% Sex Male 208,651 76% 64% 64,538 24% 67% 37,625 73% 58% 8,972 19% 63% Female 119,037 79% 36% 31,630 21% 33% 26,437 78% 41% 5,257 17% 37% Missing trivial trivial % 0% 24 8% 0% Age Mean (SD) 36.3 (12.3) 36.1 (11.0) 36.6(12. 5) 36.3 (11.9) Age ,204 84% 6% 3,372 16% 4% 4,613 74% 7% 1,120 20% 8% ,873 80% 11% 9,248 20% 10% 9,204 76% 14% 1,922 17% 13% ,963 76% 11% 10,882 24% 11% 8,606 75% 13% 1,811 17% 13% ,642 75% 12% 12,868 25% 13% 7,808 75% 12% 1,704 18% 12% ,594 75% 14% 15,892 25% 17% 7,291 75% 11% 1,669 19% 12% ,127 75% 14% 15,458 25% 16% 7,678 73% 12% 1,976 20% 14% ,706 76% 12% 12,482 24% 13% 7,309 74% 11% 1,710 19% 12% ,435 78% 10% 9,092 22% 9% 6,071 74% 9% 1,409 19% 10% ,233 81% 6% 5,106 19% 5% 3,709 78% 6% % 5% ,614 87% 3% 1,592 13% 2% 1,647 83% 3% % 2% 65+ 2,297 93% 1% 176 7% 0% % 1% 27 6% 0%

32 ONTARIO Grup 1 N=327,682 Grup 2 N=96,174 Initial Claim N=96,144 Secnd Claim N=91,287 Mean STD Mean STD Mean STD Ttal benefit expenditure Wage replacement benefits $8,523 $26,401 $2,641 $9,821 $7,499 $23,628 Medical care benefits $2,125 $16,893 $715 $2,286 $1,810 $10,003 Days n benefits VICTORIA Grup 1 N=64,352 Grup 2 N=14,253 Initial Claim Repeat Claim Mean STD Mean STD Mean STD Ttal cst per claim $29,656 $105,505 $17,660 $66,677 $22,082 $76,095 Cst f weekly cmpensatin paid $10,750 $36,870 $6,292 $24,386 $8,677 $28,977 Cst f medical and like services paid $6,388 $31,244 $4,125 $12,224 $4,856 $15,488 Days f incapacity fr wrk

33 Injury as first claim Summary > 37% filed a repeat claim 4 in 5 repeat claims fr subsequent injury Mean time between claims ~ 3 years 65.6% f repeat claims made while wrking fr same emplyer as initial claim Disease as first claim > 32% filed a repeat claim 2 in 5 repeat claims fr subsequent disease Mean time between claims ~ 3 years 63.5% f repeat claims made while wrking fr same emplyer as initial claim

34 Summary (cntd.) Rate f repeat claims is cnsistent with selfreprt data frm RTW Mnitr telephne survey (35%) Repeat claimants: Yunger Greater prprtin f men Greater prprtin f blue cllar ccupatins Csts & wrk disability Sme substantial differences bserved but questins regarding methd.

35 Hwever Sme wrkers with initial claims will have had subsequent injuries that were nt cvered by WrkSafe Victria. Sme wrkers will have had initial injuries in anther jurisdictin, r minr injuries, prir t their first accepted claim in Victria. Sme wrkers will have psychlgical and scial cnditins subsequent t an initial claim that des nt appear n the database. We d nt have the cmplete picture f wrkplace injury and disease in Victria, but we have a pretty gd estimate.

36 Cnclusins & Next steps Repeat claims are cmmn, expensive, assciated with substantial wrk disability. There is a substantial pprtunity t reduce the scial, health and ecnmic burden f wrkplace injury by preventing reinjury in wrkers with a single claim. Further characterizatin f repeat claims is necessary and warranted. Cmparisn f Victria t Ontari, specifically lking at the impact f aging n repeat claims.

37 Thank Yu!