A Great Workers Comp Study With No Claims or Risk Input
A recent Workers Comp study on Zero Cost Claims makes me wonder if the researchers decided to ask an adjuster or risk manager their opinion before they published the article. I found the study in a recent Insurance Journal article.
Reading through the study, one can quickly see that no Workers Compensation personnel were consulted. The database used was from a Thomson Reuters database on self insureds. As we all know, the self-insurance community is a different animal from the rest of the WC world.
If an employer actually took the time to report the claim as WC, then the employee would have been referred for treatment under WC. Almost all employers that I have ever seen paying WC claims under health would not have bothered filing any type of WC forms or recording the injury as work-related. One cannot read the article without wondering if the authors were trying to say the employers were shifting WC costs to their health insurance.
The researchers were thorough in their analyses. There is no doubt in their numbers. The first thing I usually do is go directly to the bottom of a study to see if there were any study limitations and what references were used to draw their conclusions.
The study did not consider :
- Workers with individual health coverage, or without any coverage
- Denied claims which would overestimate the impact of zero-cost WC medical claims.
- Preexisting health conditions such as diabetes could aggravate the negative effects of workplace injuries on the health status of injured workers
- Data came from large employers who are clients of Thomson Reuters, and these employers are more likely to be self-insured for health or WC. Therefore, their findings may not be generalizable to all employers.
One of the main references used in the study was from a source article and study that I questioned in this blog two years ago.
One area that would have been mentioned if they had interviewed just one risk manager or workers compensation claims personnel is that employers file many reportable-only claims where the employee does not seek treatment. I am unsure of how this would have directly affected the study, but they should have covered that fact in detail.
Is the study worth reading? I do think it is worth your time. If you decide to read it, please feel free to draw your own conclusions.
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