Trends in the health care use and expenditures associated with no-lost-time claims in Ontario: 1991 to 2006

Nature of Injury and Risk of Multiple Claims Among Workers in Manitoba Health Care

In industrial societies, work-related musculoskeletal disorders are common among workers, frequently resulting in recurrent injuries, work disability, and multiple compensation claims. The risk of idiopathic musculoskeletal injuries is thought to be more than twice the risk of any other health problem among workers in the health care sector. This risk is highly prevalent particularly among workers whose job involves frequent physical tasks, such as patient lifting and transfer. Workers with recurrent occupational injuries are likely to submit multiple work disability claims and progress to long-term disability. The objective of this study was to explore the influence of injury type and worker characteristics on multiple compensation claims, using workers' compensation claims data. This retrospective study analyzed 11 years of secondary claims data for health care workers. Workers' occupational groups were classified based on the nature of physical tasks associated with their jobs, and the nature of work injuries was categorized into non-musculoskeletal, and traumatic and idiopathic musculoskeletal injuries. The result shows that risk of multiple injury claims increased with age, and the odds were highest for older workers aged 55 to 64 (odds ratio [OR] = 3.5). A large proportion of those who made an injury claim made multiple claims that resulted in more lost time than single injury claims. The study conclusion is that the nature of injury and work tasks are probably more significant risk factors for multiple claims than worker characteristics.

Working and Living in Northern vs Southern Ontario Is Associated with the Duration of Compensated Time off Work: A Retrospective Cohort Study

Background:

Northern Ontario, Canada has a larger elder population, more resource-based employment, and limited access to physicians and specialists compared to southern Ontario. Given these important differences, it is possible that work disability rates will vary between the two Ontario jurisdictions.

Objective:

To determine the association between time lost due to workplace injuries and illnesses occurring in northern vs southern Ontario and work disability duration from 2006– 2011.

Methods:

The study base included all lost-time claims approved by the Workplace Safety and Insurance Board in Ontario, Canada for workplace injury or illness compensation occurring between January 1, 2006 and December 31, 2011. All eligible participants had to be 18 years of age or older at the time of making the claim and participants were excluded if one of the three variables used to determine location (claimant home postal code, workplace geographical code, and WSIB firm location) were missing. Multivariable proportional hazards regression models were used to estimate hazard ratios and 95% confidence intervals adjusted for sex, age, occupation, part of body, and nature of injury relating Ontario geographical location to compensated time off work.

Results:

A total of 156 453 lost-time claims were approved over the study period. Injured and ill workers from northern Ontario were 16% less likely to return to work than those from southern Ontario. Adjustment for potential confounding factors had no effect.

Conclusion:

The disability duration in northern Ontario is longer than that in southern Ontario. Future research should focus on assessing the relevant factors associated with this observation to identify opportunities for intervention.

The relationship between worker, occupational and workplace characteristics and whether an injury requires time off work: a matched case-control analysis in Ontario, Canada

BACKGROUND

The objective of this study was to examine individual, occupational, and workplace level factors associated with time loss following a similar injury.

METHODS

Seven thousand three hundred and forty-eight workers' compensation claims that did not require time off work were matched with up to four claims that required time off work on the event, nature, and part of body injured as well as injury year. Conditional logistic regression models examined individual, occupational, and workplace level factors that were associated with the likelihood of not requiring time off work.

RESULTS

Employees from firms with higher premium rates were more likely to report no time loss from work and workers in more physically demanding occupations were less likely to report no time loss from work. We observed no association between age or gender and the probability of a time loss claim submission.

CONCLUSIONS

Our results suggest that insurance costs are an incentive for workplaces to adopt policies and practices that minimize time loss following a work injury.

The incidence and impact of recurrent workplace injury and disease: a cohort study of WorkSafe Victoria, Australia compensation claims

OBJECTIVE

To determine the incidence and impact of recurrent workplace injury and disease over the period 1995-2008.

DESIGN

Population-based cohort study using data from the state workers' compensation system database.

SETTING

State of Victoria, Australia.

PARTICIPANTS

A total of 448 868 workers with an accepted workers' compensation claim between 1 January 1995 and 31 December 2008 were included into this study. Of them, 135 349 had at least one subsequent claim accepted for a recurrent injury or disease during this period.

MAIN OUTCOME MEASURES

Incidence of initial and recurrent injury and disease claims and time lost from work for initial and recurrent injury and disease.

RESULTS

Over the study period, 448 868 workers lodged 972 281 claims for discrete occurrences of work-related injury or disease. 53.4% of these claims were for recurrent injury or disease. On average, the rates of initial claims dropped by 5.6%, 95% CI (-5.8% to -5.7%) per annum, while the rates of recurrent injuries decreased by 4.1%, 95% CI (-4.2% to -0.4%). In total, workplace injury and disease resulted in 188 978 years of loss in full-time work, with 104 556 of them being for the recurrent injury.

CONCLUSIONS

Recurrent work-related injury and disease is associated with a substantial social and economic impact. There is an opportunity to reduce the social, health and economic burden of workplace injury by enacting secondary prevention programmes targeted at workers who have incurred an initial occupational injury or disease.

Comparing the risk factors associated with serious versus and less serious work-related injuries in Ontario between 1991 and 2006

BACKGROUND

The objective of this study was to examine and compare the demographic and labor market risks for more serious and less serious work-related injuries and illnesses.

METHODS

Secondary analysis of accepted workers' compensation claims in Ontario, combined with labor force estimates for the period 1991 to 2006. Serious injuries and illnesses were claims resulting in wage replacement. Less serious injuries and illnesses were claims only requiring health care. Regression models examined the relationship between demographic and labor market characteristics (age, gender, industry, job tenure, and unemployment) and claim type.

RESULTS

Relative risk estimates for serious and less serious claims were not concordant across age, gender and industry employment groups. For example, while the mining and utilities and the construction industry had an increased probability of reporting NLTCs, they had a decreased probability of reporting LTCs.

CONCLUSIONS

The risk for serious and less serious work-related injury and illness claims differ by demographic and labor market groups. The use of composite measures that combine wage-replacement and health care only claims should be considered when using compensation data for surveillance and primary prevention targeting strategies.