Workers’ compensation costs may not reflect the true cost of work-related illness and injury, according to two new studies that crunched the numbers on how work-related injuries affect companies’ health care costs – even when workers comp is available. Key finding: the usual method of studying reported injuries using workers comp records may underestimate the true number of injuries due to underreporting and use of group health insurance.

To understand the actual cost of workplace injuries and illnesses, NIOSH-supported researchers at the Harvard T.H. Chan School of Public Health study the cost of health insurance and patterns of underreporting. The following summaries present findings from two of their studies. The first appeared in the Journal of Occupational and Environmental Medicine and the second in the Scandinavian Journal of Work, Environment & Health.

Health insurance costs rise after work-related injury

Workers’ compensation benefits were nearly $62 billion in 2015 according to the most recent statistics from the National Academy of Social Insurance. However, the actual cost of work-related injuries and illnesses may be much higher since other insurance plans, including employer-based group health insurance, may also cover healthcare costs. The question is what share of these costs are borne by group health insurance?

To find out, researchers reviewed information on injuries recorded by OSHA for 2,495 healthcare workers from 2010 to 2013. All of the healthcare workers in the study were female and working with patients as either a nurse or an aide in one of two large hospitals in the northeastern part of the country. For comparison, the study included 2,697 non-injured healthcare workers.

Study results showed that work-related injuries led to increases in costs to employer-based group health insurance, even though workers’ compensation is available to cover costs related to these injuries. The injured workers’ combined insurance claims were significantly higher 3 and 6 months after the injury, compared to the costs among non-injured workers. At 3 months, these combined costs were $275 greater, and 6 months post-injury they had climbed by $587.

These findings indicate that workers’ compensation costs may not reflect the true cost of work-related illness and injury. Additionally, they show that employers could use this study’s methods to understand how work-related injuries and illnesses affect group health insurance costs.

Injuries more often under-reported among black workers

Although many work-related injuries are unreported, it is unclear whether reporting patterns differ among racial groups. By studying these patterns, researchers hope to gain a better understanding of the true burden of work-related injuries and illness among different groups of people.

Accordingly, researchers compared the number of workers’ self-reported injuries to the number recorded by their employer’s official injury-reporting system among a group of patient-care workers in a U.S. hospital. They analyzed self-reported injuries for 1,568 workers who had participated in a survey that asked about work-related injuries during the previous year.

The results showed that 244 workplace injuries had occurred. In comparison, the hospital’s computerized injury-reporting system logged 126 workplace injuries. Among black workers, self-reported injuries were more likely to go unreported to the hospital than were injuries to white workers, according to the study. These findings indicate that racial differences in the frequency of workplace injury may be greater than official injury reports indicate, due to more frequent underreporting among black than among white workers. However, more research is needed to understand these differences

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