Workers Compensation System Research Articles

Incidence, trends and factors associated with psychological injury among health and social care workers in New South Wales, Australia: a retrospective cohort study of workers' compensation claims.

To describe and compare the incidence and trends of workers' compensation (WC) claims for psychological injury: (1) between health and social care (HSC) industry and other industries; (2) among specific occupations in the HSC industry; and (3) to determine if psychological injury claim rates differ by age and gender in the HSC industry and among specific occupations. A retrospective cohort study was conducted using data from the New South Wales WC system. Workers with accepted psychological injury claims between July 2012 and June 2021 were included. Negative binomial regression models were employed to estimate incidence rate ratios and 95% CIs. The HSC industry had a higher incidence (2.4 per 1000 workers) than all other industries combined (1.1 per 1000 workers). In the HSC industry, the incidence increased from 1.8 in 2013-2015 to 3.4 in 2019-2021. Ambulance officers had the highest incidence (24.9 per 1000 workers) and the highest growth rate. Nurses and midwives, and aged and disability care workers also had fast-growing incidence over the 9 years. Risk of psychological injury claims was highest among female workers and older adults. The increasing incidence and trend of psychological injury claims among HSC workers in New South Wales signify a growing public health issue. Greater efforts are needed to prevent work-related psychological injury in the HSC industry and support affected workers. The different patterns of psychological injury claims across occupations suggest that interventions should be tailored to each occupational group.

Identifying factors associated with physical therapy use versus non-use among injured workers with back pain in Washington State.

There is little information about predictors of physical therapy (PT) use among injured workers with back pain. The primary objective of this study is to investigate the associations between PT use and baseline factors not routinely captured in workers' compensation (WC) data. We conducted a secondary analysis using the Washington State Workers' Compensation Disability Risk Identification Study Cohort, which combines self-reported surveys with claims data from the Washington State Department of Labor and Industries State Fund. Workers with an accepted or provisional WC claim for back injury between June 2002 and April 2004 were eligible. Baseline factors for PT use were selected from six domains (socio-demographic, pain and function, psychosocial, clinical, health behaviors, and employment-related). The outcome was a binary measure for PT use within 1 year of injury. Bivariate and multivariable logistic regression models were conducted to evaluate the associations between PT use and baseline factors. Among the 1370 eligible study participants, we identified 673 (49%) who received at least one PT service. Baseline factors from five of the six domains (all but health behaviors) were associated with PT use, including gender, income, pain and function measures, injury severity rating, catastrophizing, recovery expectations, fear avoidance, mental health score, body mass index, first provider seen for injury, previous injury, and several work-related factors. We identify baseline factors that are associated with PT use, which may be useful in addressing disparities in access to care for injured workers with back pain in a WC system.

Injured worker participation in assessment during the acute phase of workers compensation rehabilitation: a scoping review.

Rates of return to work (RTW) are declining in the Australian workers compensation system alongside significant economic and social costs, disputes, and secondary psychological injury. Non-medical assessment of workplace injuries now considers psychosocial and workplace factors, and worker participation in the assessment process is limited. This scoping review examines studies regarding non-medical assessment during the acute phase of rehabilitation in terms of costs, disputes, secondary psychological injury, and worker participation. An electronic and manual search of relevant articles across four databases was conducted using PRISMA guidelines, followed by quality assessment. Of the 1,630 studies retrieved, 12 met the inclusion criteria with most focused on assessment for risk of obstructed or delayed RTW. Non-medical assessment in the acute stage of rehabilitation identifies risk for delayed or complicated RTW, overlooking potential for the process of assessment to contribute to disputes and development of secondary psychological injury. Doubt around the capacity of workers to participate objectively in assessment persists. These are aspects of assessment worthy of further exploration for their impact on RTW outcomes.

사회복지사 보상체계가 삶의 만족도에 미치는 영향

This study examined the parallel multiple mediating effect of work-life balance and family support on the effect of the social worker compensation system on life satisfaction. The life satisfaction of social workers is the most fundamental factor that prevents impaired quality of life, turnover, and burnout among social workers. Moreover, to improve the life satisfaction of social workers, it is important to consider work-life balance and family support together. Therefore, this study examined the relationship between the compensation system, life satisfaction, work-life balance, and family support among 475 social workers, and the results were as follows: First, it was found that the social worker compensation system had a positive effect on the parameter work-life balance and family support. Second, it was found that the parameters of work-life balance and family support both had positive effects on life satisfaction. Finally, it was found that the compensation system of social workers had an indirect effect on life satisfaction through certain parameters. Both work-life balance and family support, which are parameters, showed indirect effects on the path from the compensation system to life satisfaction. With these results, this study provided basic data for service and policy establishment to improve the compensation system for social workers, and it lastly suggested directions for follow-up studies.

Online Perspectives of Workers Navigating Workers' Compensation Systems: A Content Analysis of the Reddit Social Media Platform.

Social media platforms are increasingly used by the general public as a source of information on health-related and legal concerns, among other topics. Reddit.com, one of the top 10 most visited websites in the United States, is a popular social media platform that allows users to anonymously discuss various topics, including workers' compensation (WC). Understanding the candid concerns of workers who are navigating WC systems will allow for the development of more effective educational resources that are tailored to the needs of this population. Methods: In January-March 2023, a cross-sectional review of anonymous public posts submitted to the r/WorkersComp section of the Reddit social media website between December 2021 and December 2022 was performed. Post content was extracted from a systematic random sample and coded into themes/sub-themes and emotional tones by two independent reviewers. A third reviewer resolved any discrepancies in coding in order to reach consensus prior to data analysis. The data were analyzed using Microsoft Excel 2019 (Microsoft Corporation, Redmond, WA, USA). Content from 200 original posts submitted to r/WorkersComp was reviewed and analyzed. Nearly 94.0% of posts (n =187) specified a state of residence, with posters most frequently residing within the United States in California (32.0%), New York (7.0%), Pennsylvania (5.0%), and Florida (5.0%). The most common primary theme was "medical" (27.0%, n = 54), with questions and comments related to provider complaints, medical care access, referral denials, maximum medical improvement, and independent medical examinations being the most frequent within this category. The second most common primary theme was "legal" (26.5%, n = 53), with questions and comments related to lawyer retainment and settlements being the most frequent within this category. The third most common primary theme was "general" (18.5%, n = 37), with questions and comments related to the general claims process, eligibility for WC, claim denial, and communication issues with claims adjusters being the most frequent within this category. The fourth most common primary theme was "employer" (14.0%, n = 28), with questions and comments related to employer retaliation, job security, and work restrictions being most frequent within this category. Only 37.0% of posts (n = 74) expressed a clear emotional tone, with frustration (13.5%, n = 10), fear (13.5%, n = 10), and confusion (13.5%, n = 10) being the most frequent tones observed in this sample of posts. Our findings indicate that there are workers who are navigating WC systems who use social media platforms such as Reddit to obtain information and advice on various aspects of WC, including medical issues, legal advice, and employer concerns. These findings may be used to address the information and education needs of workers who are navigating WC systems, which may help attenuate some of the frustrations surrounding the WC claims process.

학대피해아동쉼터의 근로환경에 관한 현장의 목소리

Objectives: The purpose of this study is to examine in depth how the shelter's working environment is perceived by the head of a shelter for abused children, and to derive alternatives to improve the working environment of shelter workers.
 Methods: A total of 3 FGIs were conducted by recruiting 13 facility heads who voluntarily agreed to participate, targeting shelter facility heads across the country. The FGI results were recorded after informed consent, the concepts found from the FGI analysis were coded, and the sub-topics extracted by categorizing the concepts were categorized into major themes. Results: As a result of the analysis, 4 major themes and 10 sub-theme are as follows. First, poor working conditions at shelters include lack of time for continuing education, no standardized work model, absence of job training manuals and training courses, necessity of supervisors and supervisors, second, the sub-topic of regional variation in remuneration system is local governments, third, the sub-topic of the need to protect the human rights of workers is the absence of guidelines for the protection of human rights of workers, the absence of sanctions against protected children who engage in violent behavior, and fourth, the psychological burnout of workers is related to cooking, etc. increased burnout due to housework and sacrifice of personal life in case of emergency.
 Conclusion: The policy proposal derived from the research results is to establish a replacement manpower system for workers who can be put into shelter overtime or weekend and night work in the community, provide a standardized manual for shelters, but include human rights protection, and a unified worker compensation system It was an improvement in the working environment, such as provision of supervision and supervision.

Long COVID Among Wisconsin Workers in the Workers' Compensation System: Associations With Sociodemographics, Vaccination, and Predominant Variant Period From March 1, 2020 to July 31, 2022.

This analysis aimed to determine the likelihood of developing long COVID among Wisconsin workers while adjusting for sociodemographics, COVID-19 vaccination, industry, and occupation. This retrospective analysis determined the odds ratios of developing long COVID among Wisconsin workers who were compensated for COVID-19 lost time during March 1, 2020 to July 31, 2022. A total of 234 workers (11.7%) were determined to have long COVID. Factors associated with long COVID were age ≥40 years, non-White race, infection occurrence during the initial and Omicron variant dominant periods, and the absence of COVID-19 vaccination. Workers in manufacturing and public administration were more likely to develop long COVID compared with those in health care and social assistance. Long COVID disproportionately affects some worker groups. This calls for more worker protection and preventative care to mitigate its impact.

Determining Unmet Needs Among Workers' Compensation Stakeholders to Prevent Work Disability in the State of Vermont.

Vermont has high rates of young people receiving federal disability benefits leading to substantial gaps in the workforce. The purpose of this project was to determine the unmet needs of interested parties in the workers' compensation (WC) process. A type of focus group, experience groups, was used to elicit key parties' experiences in the WC system. Facilitators used open-ended prompts to encourage discussion among participants about their experience with the WC system. Data were analyzed using thematic coding procedures to identify common motifs. Common themes emerged including challenges in navigating the WC system, lack of communication among stakeholders, and providing and receiving appropriate health care to facilitate RTW. Understanding unmet needs of interested parties in the WC process allows for the creation of targeted, high-value, early intervention strategies to reduce long-term work disability.

Employees with mental disorders seeking support from the workers compensation system - experiences from Denmark.

In Europe it is commonly accepted that psychosocial hazards may influence the mental health of employees. However, mental disorders such as depression are generally not acknowledged as an occupational disease covered by the workers compensation system. Studies indicate that workers compensation claim processes may affect employee's health negatively due to a demanding case process. If filing a workers' compensation claim can harm the employees' health, it is highly relevant to pay attention to employees with mental health claims, as they are most likely vulnerable and face a very low chance of compensation. This study investigates how employees with work-related mental disorders experience the process of seeking workers compensation from the Danish Workers' Compensation System. Interview (N = 13) and questionnaire (N = 436) data from claimants were analysed. Analysis showed that even though many employees wished for the claim to influence the conditions at the workplace, there seemed to be a lack of preventive health and safety initiatives in the workplaces. Central stakeholders such as health and safety representatives were often not involved. Management involvement was often experienced negatively, and the Danish Working Environment Authority rarely conducted workplace inspections. Employees experienced inadequate information about the workers' compensation process and experienced a lack of coordination between stakeholders. A more supportive and coordinated approach in the Workers' Compensation System is recommendable. The processes in the system could be evaluated using the Social Insurance Literacy concept, to ensure sufficient support of the claimants and reduce potential harmful aspects of the process.

Return to Work Experiences of Ontario Public Safety Personnel with Work-Related Psychological Injuries.

Public safety personnel (PSP) perform work that puts them at greater risk of psychological injury than the general public. PSP who subsequently develop posttraumatic stress disorder (PTSD) or other mental health conditions may need to take time off of work and use the workers compensation system. Very little is known about the experiences of PSP making this type of claim in Ontario to the Workplace Safety and Insurance Board (WSIB), or which healthcare professionals (HCP) PSP access as part of the treatment and return to work (RTW) process. This study captures the experiences of Ontario PSP in their RTW journeys, including with employers, WSIB, and HCPs. A survey-based study was conducted, using email and social media platforms to distribute the survey to PSP across Ontario. Quantitative data were summarized using means and frequencies, and open text results were analyzed using qualitative framework analysis. 145 survey respondents met the inclusion criteria for the study. On a scale out of 5, PSP rated their experience with WSIB and employer support as poor on their first RTW attempt with an average rating of 2.93 and 2.46 respectively. The top three HCPs accessed by PSP were psychologists (61%), occupational therapists (OT; 60%) and general practitioners (GP; 44%). Respondents identified the cultural competence of HCPs in understanding their work demands and work culture as very important. To improve RTW experiences for PSP who make a workers compensation claim for a psychological injury, an increase in HCP cultural competence related to PSP work is indicated, as well as improved RTW processes and workplace support.

Lost time: COVID-19 indemnity claim reporting and results in the Wisconsin workers' compensation system from March 12 to December 31, 2020.

The COVID-19 pandemic introduced a new compensable infectious disease to workplaces. This was a descriptive analysis of Wisconsin COVID workers' compensation (WC) claims between March 12 and December 31, 2020. The impact of the presumption law (March 12 to June 10, 2020) was also evaluated. Less than 1% of working-age residents with COVID-19 filed a claim. COVID-19 WC claim rates (per 100,000 FTE) were notably low for frontline industry sectors such as Retail Trade (n = 115), Manufacturing (n = 88), and Wholesale Trade (n = 31). Healthcare workers (764 claims per 100,000 FTE) comprised 73.2% of COVID-19 claims. Most claims (52.8%) were denied and the proportion of denied claims increased significantly after the presumption period for both first responders and other occupations. The presumption law made benefits accessible primarily to first responders. Further changes to WC systems are needed to offset the individual and collective costs of infectious diseases.

Filing a Workers' Compensation Claim for Low Back Pain and Associated Factors: Analysis of 2015 National Health Interview Survey.

The aim of this study was to examine the degree of reporting work-related low back pain (LBP) by workers' compensation (WC) claim filing and associated factors among US workers. We conducted multivariable logistic regression using the 2015 National Health Interview Survey data. Among 1203 US workers with self-reported work-related LBP diagnosis, only 19.6% filed for WC. Compared with non-Hispanic White workers, Black, Asian, and Hispanic workers were less likely to file for WC. Workers' compensation filing was less frequent among workers in independent work arrangement and who stopped working, changed jobs, or made a change in work and more frequent among workers 45 to 64 years of age and having high LBP frequency. Our study findings suggest underreporting of work-related LBP to the WC system is common. Barriers to WC filing should be addressed especially for racial/ethnic minorities and independent workers.

Development of a Computational Policy Model for Comparing the Effect of Compensation Scheme Policies on Recovery After Workplace Injury

Introduction The direct comparison of real-world workers’ compensation scheme management policies and their impact on aspects of scheme performance such as health and return to work outcomes, financial sustainability, and client experience metrics is made difficult through existing differences in scheme design that go beyond the factors of interest to the researcher or policymaker. Disentangling effects that are due purely to the result of policy and structural differences between schemes or jurisdictions to determine ‘what works’ can be difficult. Method We present a prototype policy exploration tool, ‘WorkSim’, built using an agent-based model and designed to enable workers’ compensation system managers to directly compare the effect of simulated policies on the performance of workers compensation systems constructed using agreed and transparent principles. Results The utility of the model is demonstrated through and case-study comparison of overall scheme performance metrics across 6 simple policy scenarios. Discussion Policy simulation models of the nature described can be useful tools for managers of workplace compensation and rehabilitation schemes for trialing policy and management options ahead of their real-world implementation.

Explaining the Invisibility of Asbestos-Related Diseases in the Taiwan Workers' Compensation System.

Occupational asbestos exposure was prevalent in Taiwan, but asbestos-related diseases (ARDs) have rarely been recognized. We conducted in-depth face-to-face interviews with 16 patients with ARDs. All of them had worked in industries known for high asbestos exposure. However, only three patients had filed workers' compensation (WC) claims, and of them, only two patients were approved. Reasons for the low compensation rate of ARDs could be divided into institutional barriers related to the flaws of the WC system and non-institutional barriers related to the knowledge status, causal interpretation, and social situations of individual workers. The Labor Occupational Accident Insurance and Protection Act passed in April 2021 has responded to the under-compensation of occupational diseases. However, the new act's effects toward improving the recognition of ARDs remain questionable. Our findings indicated that additional efforts are needed to remove non-institutional barriers hindering workers' ability to ensure their compensation rights.

Worker and employer experiences with COVID-19 and the California Workers' Compensation System: A review of the literature.

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.

Percepción sobre las atenciones de terapia ocupacional en modalidad de telerrehabilitación en pacientes atendidos en la sección de Terapia Ocupacional del Hospital del Trabajador, Santiago de Chile

Hospital del Trabajador is part of the biggest workers compensation system in Chile, it provides care for workers who suffered job related accidents or occupational diseases. Occupational Therapy delivers rehabilitation interventions through a comprehensive and functional perspective in order to facilitate personal autonomy, job reintegration and social participation of its users. Prior to this contingency, services were delivered 100% on site, but with the arrival of COVID-19, the mobility of people was limited through the implementation of quarantines, preventing or hindering participation in face-to-face treatment sessions. To guarantee the continuity of the treatments, a care protocol was designed with a tele-rehabilitation system, where each area designed activities that were possible to be replicated at the users' homes. Given how untimely and fast these changes happened, it was considered important to carry out a self-evaluation within the occupational therapy team three months after implementing the system, carrying out a descriptive study that seeks to know the perceived advantages and disadvantages of the system. The main conclusions show that this modality is highly beneficial to maintain the continuity of treatment at home, being even more productive when combined with face-to-face activities, where tele-rehabilitation modality reinforce activities carried out directly. The main disadvantage is the need for the user to have access and use of technology that allows daily connection or, otherwise, to have supportive networks to facilitate the process.

Appraisal of Washington State workers' compensation-based return-to-work programs and suggested system improvements: A survey of workers with permanent impairments.

Following a work-related permanent impairment, injured workers commonly face barriers to safe and successful return to work (RTW). Examining workers' experiences with the workers' compensation (WC) system could highlight opportunities to improve RTW outcomes. Objectives included summarizing workers': (1) appraisal of several WC-based RTW programs, and (2) suggestions for vocational rehabilitation and WC system improvements to promote safe and sustained RTW. In telephone interviews, 582 Washington State workers with work-related permanent impairments were asked whether participation in specified WC-based RTW programs helped them RTW and/or stay at work. Suggestions for program and system improvements were solicited using open-ended questions; qualitative content analysis methods were used to inductively code responses. Most respondents reported positive impacts from RTW program participation; for example, 62.5% of vocational rehabilitation participants reported it helped them RTW, and 51.7% reported it helped them stay at work. Among 582 respondents, 28.0% reported that no change was needed to the WC system, while 57.6% provided suggestions or critiques. Reduce delays/simplify process/improve efficiency was the most frequent WC system theme-mentioned by 34.9%. Among 120 vocational rehabilitation participants, 35.8% reported that no change was needed to vocational rehabilitation, while 46.7% (N = 56) provided suggestions or critiques. More worker choice/input into the vocational retraining plan was the most frequent vocational rehabilitation theme-mentioned by 33.9%. This study's findings suggest that there is substantial room for improvement in workers' experience with the WC system. In addition, injured workers' feedback may reflect opportunities to reduce administrative burden and to improve worker health and RTW outcomes.

Uncovering inefficiencies in the workers’ compensation industry using Lean methodology

PurposeThe purpose of this paper is to apply Lean in the workers’ compensation industry. It focuses on identifying patterns of repetitive non-value-added transnational activities for physical-therapy patients and healthcare providers. It addresses the research gap in this field.Design/methodology/approachIn this study, we designed and deployed multiple case studies to better understand the journey of an injured worker within the worker compensation system in the United States of America. We partnered with Concentra Inc., a leading national healthcare provider in the field of workers’ compensation having 520 medical centers in 44 states. Both case studies included conducting direct observations, Gemba walk, in five clinics in two states: Florida and Pennsylvania. We analyzed the data of 263 injured workers with 8 or more physical therapy visits who got admitted to Concentra clinics in both states over the period of 31 days.FindingsThe results revealed that the time intervals at which activities associated with physical therapy treatment pre-authorization accounted for 91.59% of the total non-value-added activities and are thus the key administrative factor leading to process inefficiency in the state of Florida. The Process Cycle Efficiency of Pennsylvania was 75.36% compared to 53.16% of Florida. The injured workers in Florida needed 39.58 days on average to complete eight physical therapy visits compared to 27.92 days in Pennsylvania (a median of 34.09 vs 22.15 days).Research limitations/implicationsThis study is limited as it only focuses on processes on the healthcare provider side. An expanded value stream map that includes the treatment pre-authorization process on the insurance side would be beneficial for generating more potential solutions to streamline the process.Practical implicationsThis study shows that Lean could play a critical role in identifying and quantifying continuous improvement opportunities that could accelerate patient’s treatment, reduce administrative burden on healthcare providers and improve the overall claim cost of insurance companies. It provides data-driven argument for insurance companies to consider eliminating physical therapy pre-authorization.Originality/valueThis is the first study to apply Lean methodology in the workers’ compensation field.

Temperature, Workplace Safety, and Labor Market Inequality

Using data covering the universe of injury claims from the nation's largest worker's compensation system (2001-2018), we explore the relationship between temperature and workplace safety and its implications for labor market inequality. Hotter temperature increases workplace injuries significantly, causing approximately 20,000 injuries per year. The effects persist in both outdoor and indoor settings (e.g. manufacturing, warehousing), and for injury types ostensibly unrelated to temperature (e.g. falling from heights), consistent with cognitive or cost-related channels. The risks are substantially larger for men versus women; for younger versus older workers; and for workers at the lower end of the income distribution, suggesting that accounting for workplace heat exposure may exacerbate total compensation inequality. We document a decline in the heat-sensitivity of injuries over the study period, suggesting significant scope for adaptation using existing technologies.

Analyzing Workers' Compensation Claims and Payments Made Using Data from a Large Insurance Provider.

Background: All states in the USA have established Workers’ Compensation (WC) insurance systems/programs. WC systems address key occupational safety and health concerns. This effort uses data from a large insurance provider for the years 2011–2018 to provide estimates for WC payments, stratified by the claim severity, i.e., medical only, and indemnity. Methods: Besides providing descriptive statistics, we used generalized estimating equations to analyze the association between the key injury characteristics (nature, source, and body part injured) and total WC payments made. We also provide the overall cost burden for the former. Results: Out of the total 151,959 closed claims, 83% were medical only. The mean overall WC payment per claim for the claims that resulted in a payment was $1477 (SD: $7221). Adjusted models showed that mean payments vary by claim severity. For example, among medical only claims, the mean payment was the highest for amputations ($3849; CI: $1396, $10,608), and among disability and death related claims, ruptures cost the most ($14,285; $7772, $26,255). With frequencies taken into account, the overall cost burden was however the highest for strains. Conclusions: Workplace interventions should prioritize both the costs of claims on average and the frequency.