I have long assumed individuals working at employers that do not offer health insurance are more likely to file workers comp claims. With the number of employers offering health insurance declining, a logical corollary is more claims will be filed.
Logical, but wrong.
The RAND Corporation published a study way back in early 2005 that examined the relationship between employer-based health insurance and workers comp claims frequency.
It turns out that my assumption is not only wrong, it is backwards – frequency is actually lower at employers that do not provide/offer health insurance.
In fact, among the factors that lead injured workers to file claims, whether or not their employer offers health insurance is the single most important factor. It is even more significant than that worker’s health insurance coverage status (if that individual worker has health insurance is less significant than if their employer offers health insurance).
The RAND study is long and rather dense, but should be required reading for anyone puzzled by the decline in frequency. For among its other conclusions is this statement:
“Workers’ compensation provides insurance against job-related injuries, but as many as half of injured workers choose not to file.”
What does this mean for you?
The oft-cited decline in frequency likely way understates the actual rate of workplace injuries.
But here’s the bold-type headline. If health reform does come and includes universal coverage, the frequency rate may well dramatically increase.
Other studies have shown that many, maybe most, work injuries do not result in WC claims. However, at least one study shows that the non-claiming rate goes way down for injuries involving some duration of off work. One study strongly suggests that non-claimers use other resources to cover their lost time, which could be wage continuation, sick leave and/or short time disability. I am inclined to speculate that a worker with health benefits also has some of these other benefits available, and that healthcare coverage is in effect a proxy for these other benefits.
However, if you go to industries where across the board there is little or no healthcare and other benefits noted above you may well have more claiming of non work injuries.
The Rand study results are interesting – a reality may be that employers with health insurance actually have an organizational infrastructure (a staff person or department designated for employee benefits) to support making a Work Comp claim. Those employers without health insurance may not have the administrative infrastructure to take a Work Comp claim. One characteristic of employers that do not provide health insurance is that they often are small businesses with few employees – there is no-one in the business who knows where the paperwork is to even file a claim! And that is one reason why the small business segment is so profitable to carriers!
“The oft-cited decline in frequency likely way understates the actual rate of workplace injuries.”
There are really two different issues here: the absolute magnitude, and the direction of change. The non-filing evidence gives us reason to doubt the absolute magnitude, but until there is evidence of a long-term decline in the claim filing rate, we have less reason to doubt the declining trend, especially if the trend is consistent across states. It is possible that injuries could be BOTH under-reported and declining.
Mike – that is indeed possible, and I would guess, likely.
Another factor to consider, however, is the decline in the number of employers providing health insurance. Given RAND’s conclusion, it appears that this may be an equally likely contributor to the decline in frequency.
Paduda
At my health plan they have a sign by the receptionist’s desk – please tell us if this injury occurred at work.
I think folks with insurance are more likely to see a doctor, and the doctor and staff may be inclined to push the person to file a claim.
I find these comments interesting. However, one thing you may or may not know, is Large Corps who have their own people don’t all play by the rules. They hide the facts by use of other means. I was injured on the job, in 2002. I was placed off work on the Family Med. Leave Act. far as I know, Nobody ever questioned them on it’s legality. For this company (one of America’s top 2) it was just another of doing business to produce whatever they want you to believe.. So now how do factor that one into your future?
I am just one person, so if this was my instance. I wouldn’t think,they did this just one time. I can’t say whether knowing this helps matters or not or not.. just wanted to share it