Robot Effects on Worker's Compensation Benefits.

Many nations have established workers' compensation systems as a feature of their social protection system. These systems typically provide time-limited entitlements such as wage replacement benefits and funding for medical treatment. Entitlements may end for workers with long-term health conditions before they have returned to employment. We sought to determine the prevalence of transitions to alternative forms of social protection, specifically social security benefits, among injured workers with long-term disability, when workers' compensation benefits end. We linked Australian workers' compensation and social security data to examine receipt of social security payments one year before and after workers' compensation benefit cessation. Study groups included (1) injured workers whose workers' compensation benefits ceased due to reaching a 260-week limit introduced by legislative reform (N = 2761), (2) a control group of injured workers with at least 104 weeks workers compensation income support (N = 3890), and (3) a matched community control group (N = 10,114). Adjusted binary logistic regression examined the odds of transitions to social security in the injured worker groups relative to the community control group. Within 12 months of workers' compensation benefit cessation, 60% (N = 1669) of the exposed group received social security payments, of which 41% (N = 1120) received the unemployment allowance and 19% (N = 516) the disability pension. Among the work injured control group, 42% (N = 1676) received social security payments after workers compensation benefits ceased. Transitions to social security payments were significantly more common than community levels for both exposed (OR 25.0, 95%CI = 20.7, 30.1) and work injured control groups (OR 4.7, 95%CI = 4.2, 5.3). Many injured workers with long-term health problems transition to social security when their workers’ compensation benefits cease. Transitions were more common among workers whose claims ended due to legislative reform which time-limited benefits. Design and implementation of system level policy reform should consider the social and economic impacts of transitions between separate social protection systems.

Introduction Many nations have established workers’ compensation systems as a feature of their social protection system. Wage replacement entitlements may end for workers with long-term health conditions before they have returned to employment. We sought to determine the prevalence of transitions to social security benefits among injured workers with long-term disability, when workers’ compensation benefits end. Methods Australian workers’ compensation and social security data were linked to examine receipt of social security payments after workers’ compensation benefit cessation. Study groups included (1) injured workers whose workers’ compensation benefits ceased due to reaching a 260-week limit introduced by legislative reform (N=2,761), (2) a control group of injured workers with at least 104 weeks workers compensation benefits (N=3,890), and (3) a matched community control group (N=10,114). Adjusted binary logistic regression examined the odds of transitions to social security. Results Within 12 months of workers’ compensation benefit cessation, 60% (N=1669) of the exposed group received social security payments, of which 41% (N=1120) received the unemployment allowance and 19% (N=516) the disability pension. Among the work injured control group, 42% (N=1676) received social security payments after workers compensation benefits ceased. Transitions to social security payments were significantly more common than community levels for both exposed (OR 25.0, 95%CI=20.7, 30.1) and work injured control groups (OR 4.7, 95%CI=4.2, 5.3). Discussion and conclusion Many injured workers with long-term health problems transition to social security when their workers’ compensation benefits cease. Design and implementation of policy reform should consider the social and economic impacts of transitions between separate social protection systems.

In Reply

BackgroundGiven workplace risks from COVID‐19, California policymakers passed Senate Bill (SB) 1159 to facilitate access to workers' compensation (WC) benefits for frontline workers. However there has been no review of the available evidence needed to inform policy decisions about COVID‐19 and WC.MethodsWe conducted a literature review on worker and employer experiences surrounding COVID‐19 and WC, adhering to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines.ResultsForty articles were included (16 about worker experiences and 24 about employer practices). Most were not about experiences and practices related to COVID‐19 and WC. Worker studies indicated that paid sick leave reduced new COVID‐19 cases and COVID‐19 activity. Studies also found that rural agricultural and food processing workers lacked sick leave protection and faced severe housing and food insecurity. Studies on workplace health and safety indicated that healthcare workers with access to personal protective equipment had lower stress levels. Studies about employer practices found that unrestricted work in high‐contact industries was associated with increased risks to at‐risk workers, and with health disparities. No studies examined worker COVID‐19 experiences and WC claims or benefits, job loss, retaliation, workers' medical care experiences, and return‐to‐work or leave practices.ConclusionsOur review identified experiences and practice related to COVID‐19 and the WC system, but not specifically about WC and COVID‐19 WC claims or benefits. Further research is needed to document and understand evidence underpinning the need for WC coverage for COVID‐19 and to evaluate the impact of the current SB 1159 bill on WC in California.

Anatomic total shoulder arthroplasty for patients receiving workers' compensation

It is generally acknowledged that compensation payments (WCB) influence rehabilitation outcome in a negative manner. Patients receiving WCB have more treatment over a longer time period than their non compensated (NWCB) cohorts. It is not clear whether therapists (PT) perceive WCB clients as being more impaired and expect them to have a worse outcome than clients without WCB. The purpose of this study was to determine whether PTs' clinical judgments are influenced by the knowledge of a patients WCB status and whether this knowledge influences their assessment findings or prognostic judgments. A convenience sample of 69 physical therapists (PTs) participated. Each PT viewed three videotaped assessments, of patients with low back pain (LBP) that differed in severity. The PT was provided with a brief history of the patient. Included in the history was a statement that the patient was (WCB group), or was not (NWCB group) in receipt of workers compensation benefits (WCB). The third group of PTs was given no information (control group) about the patient. PTs recorded physical assessment findings and made prognostic judgments about the patients. Data for the physical assessment findings and prognoses recorded by the PTs was analyzed across information groups using ANOVA. Knowledge of compensation status did not influence the PTs' physical assessment findings but did influence prognostic judgments. WCB status was deemed to have a negative effect on outcome in patients with mild LBP. Additionally, NWCB status was deemed to have a positive influence on outcome in patients with severe LBP. The differences were most marked in the short term (1 month). It was concluded that PTs expectations of outcome are influenced by prior knowledge of compensation status.

We present quasi-experimental estimates of the effect of changes in workers' compensation benefits on benefit duration and application frequency, using administrative data for California. Our design exploits two increases in temporary disability benefits occurring during the mid-1990s. We find consistent increases in the duration among injured workers whose benefits were affected by the schedule changes, and some evidence indicating that the likelihood of filing for benefits conditional on being injured is responsive to benefit levels. Finally, we evaluate whether the frequency effect on applying for indemnity benefits introduces a sample selection bias into standard quasi-experimental estimates of duration benefit elasticities.

The effect of Workers’ Compensation on clinical outcomes of arthroscopic-assisted autogenous patellar tendon anterior cruciate ligament reconstruction in an acute population

Medical expenditures associated with nonfatal occupational injuries among U.S. workers reporting persistent disabilities

A LTHOUGH public policy analysts are revaluating income maintenance and income support programs, economists have devoted little attention to empirical research on one such program. Workers' Compensation (WC), a program in search of quantitative researchers, is about the same size as the Unemployment Insurance (UI) and Social Security Disability Insurance (SSDI) programs, and WC may have stronger supply effects than the UI program.' The state and federal no-fault insurance programs which constitute America's WC insurance system cost over $25 billion in 1980, and they covered, approximately, 90% of all wage and salary workers.2 During the period 1972 to 1978, the cost of WC as a percentage of covered payroll doubled and was probably equal to 2% of covered payroll.3 The WC program has enjoyed the support of both labor and industry. Employers favor this form of no-fault insurance because it guarantees a limit on the liabilities that they will incur due to the work-related injuries and diseases of their employees, and employees value the guaranteed medical expenses and payments that they receive under the program.4 Labor can view Workers' Compensation as a vast improvement over either the common law, which seemed to be designed to provide employees with strong safety incentives rather than to replace their lost income, or the employer liability laws that prevailed in most states until the early part of this century. Perhaps another reason for the position that the Workers' Compensation program has held in American social insurance has been that it is specialized in nature, and has constituted a relatively small share of the employers' overall cost. However, in recent years as the claim frequency under Workers' Compensation has risen dramatically and as policymakers and practitioners alike have consistently underestimated the cost consequences of liberalized Workers' Compensation benefits, analysts are beginning to reevaluate this very important form of social insurance. In this paper we analyze the two classes of Workers' Compensation injuries which account for most of the Workers' Compensation costs in the United States: temporary total and permanent partial injuries. In the next section we briefly describe some of the rudiments of the program after which we sketch an economic model of injury rates and suggest how they interact with wages and hours of work as levels of benefit change. In the fourth section of the paper we present empirical results which indicate that recent changes in the Workers' Compensation laws have had subReceived for publication April 1, 1982. Revision accepted for publication December 1, 1982. * Brigham Young University and Rutgers University, respectively. We wish to thank Steve Zrebiec for competent research assistance, and Monroe Berkowitz, Tom Brown, John F. Burton, Jr., Jennifer Field, and Fred Siskind for comments on an earlier draft. The views expressed herein are our own, and do not necessarily reflect those of Brigham Young University. ' Danziger, Haveman, and Plotnick (1981) guesstimate the reduction of work hours by transfer recipients as a percentage of total work hours of all workers as 1.2%, 0.7%, and 0.3% for SSDI, WC, and UI, respectively. 2 Dan Price's estimate (1981) that the WC program cost $20 billion in 1979 is a conservative one. He correctly attributes the full premium paid to private insurers, $14.3 billion, and to state funds to that year's cost, but he attributes only the benefits paid in 1979 by federal programs and firms that were selfinsured plus a 5%-to-10% markup for administrative cost to 1979 costs. This is equivalent to assuming that the federal programs and the firms which self-insure incur all of their WC losses during a calendar year. Actually, 1979 losses may be paid over many years, and injury or illness claims may arise many years after the end of calendar year 1979. These incurred losses and future claims should be fully reflected in current costs, but are so only to the extent that the actuarial price (premium) paid to private carriers and state funds is fully reflected in premiums collected. In addition, Price did not include the federal black lung benefits program funded by general revenues. 3Elson and Burton (1981) have examined the increasing trend in Workers' Compensation insurance. They present evidence which indicates that costs have doubled, for homogeneous classes of employers, in most states over the 1972 to 1978 period. 4There has been erosion of the certainty aspect of benefit payments due to litigation of claims. Vroman (1978) pointed out that certain permanent partial disability claims would be litigated with probability one. The high incidence of controversion has played a prominent role in calls for reform of the WC system and certainly was a factor in the state of Florida's decision to institute a wage loss system on August 1, 1979.

The aim of this prospective study was to evaluate the results of arthroscopic subacromial decompression (ASAD) in the treatment of impingement syndrome in patients without full thickness rotator cuff tears. Sixty patients (64 operative procedures) underwent ASAD during the study period; 37 men and 23 women, average age 46 years (range 28-63), average duration of symptoms 37 months (range 8-132). Patients with calcifying tendintis were not included. Evaluation preoperatively and one year postoperatively included: Constant score, clinical examination and radiological evaluation (supraspinatus outlet view). All follow-up examinations were done by an independent observer. Fifty-six patients (60 procedures) were available for follow-up. The average length of follow-up was 13 months (range 10-23). Forty-six patients (77%) achieved a good or excellent result according to Constant score criteria. Preoperatively twenty-four patients had applied for worker's compensation benefits (WCB). Only half of the patients in the WCB group achieved a satisfactory result, whereas 94% of the non-WCB patients had a good or an excellent result. Arthroscopic subacromial decompression is an effective procedure for the majority of patients with stage II impingement syndrome. In this study WCB claims were associated with inferior results.

Workers' compensation (WC) includes wage replacement, medical cost coverage, and vocational rehabilitation services. We aimed to examine the impact of WC on health-related quality of life (HRQOL) scores among working adults with burn injury. The Burn Model System National Database was queried for self-reported working adult participants who answered the Veterans RAND 12-Item Health Survey (VR-12) at discharge (pre-injury recall) and 6-, 12-, and 24-months post-injury. Participants were stratified into those with and without WC. HRQOL scores were calculated by transforming VR-12 responses to Short Form-6D (SF-12). Mixed-effects linear regression modeling was used to assess impact of WC on HRQOL scores over 2-years post-injury. 495 participants were analyzed (94 with WC, 401 without WC). Males accounted for 87% of WC beneficiaries and 72% of those without WC. Mean pre-injury HRQOL scores were 0.72 for WC beneficiaries and 0.73 for those without WC (P = .99) and decreased significantly in both groups at each study timepoint post-injury. Greater HRQOL loss was seen in WC beneficiaries compared to those without WC at 6-months (P = .07), 12-months (P = .02), and 24-months (P = .03) post-injury. All workers experienced a drop in HRQOL scores post-injury. WC beneficiaries experienced greater HRQOL loss than non-WC participants. These findings align with investigations among working adults with non-burn upper extremity and back injuries, suggesting there is opportunity to improve the delivery of WC benefits for all injured workers. To enhance vocational rehabilitation service delivery, the intensity of interventions should be tailored to person-specific needs, risks of complicated return-to-work, and unique recovery journeys.

This survey covers extensively the theoretical and the empirical work that was done on the incentive effects related to the existence of workers’ compensation (WC) in the North American context. It first analyzes the economic rationale for compulsory WC. Then it studies the impact of WC on behavior. Three types of effects can be distinguished: 1) WC may influence frequency, duration and nature of claims through a variety of incentive effects. Under asymmetrical information about accident prevention activities, WC may affect safety behavior of both employers and employees and the risk level in the market place. Under asymmetrical information about the true nature of workplace injuries, insured workers may attempt to report false or off-thejob accidents and to undertake activities in order to obtain higher WC benefits, especially in the case of hard-to-diagnose injuries. Moreover, substitution between WC and other insurance programs may be observed. The decision of reporting a workplace accident may also be affected by the generosity of WC benefits. 2) WC may induce changes in occupational wages rates and 3) WC may affect firms’ productivity. So far, the literature has focused mainly on the first type of effects. The main results show that increases in WC insurance are associated with an increase in the frequency of injuries (elasticities ranging from 0.4 to 1), and with an increase in the average duration of claims (elasticities ranging from 0.2 to 0.5). Furthermore, increases in WC are associated with more reporting of injuries that are hard-todiagnose and, in the same line, there are some evidence (at least in Canada) of substitution between unemployment insurance and WC insurance. Lastly, there are empirical results showing that the presence of WC insurance induces important reductions in wage rates, while an emerging literature suggests that changes in WC insurance may also have negative productivity effects.

We examine whether workers who experience permanently disabling injuries covered by workers' compensation (WC) end up on Social Security Disability Insurance (SSDI) and whether Social Security Administration (SSA) seems to offset WC payments for permanently disabling injuries against SSDI benefits, when appropriate. Methods: We capture data on WC benefit receipt from the Health and Retirement Study and link it to SSA data on WC and SSDI recipients to study descriptive information on these questions. Results: We find that SSA seems to be missing data on WC benefits for a sizable share of recipients of WC benefits and that the frequency with which SSDI benefits are reduced because of the WC offset seems surprisingly low. Conclusions: For a variety of reasons, WC benefits for permanently disabling injuries may not be appropriately offset against SSDI benefits, possibly shifting the cost of these workplace injuries to SSDI.

Dependent frequency–severity modeling of insurance claims