NIOSH Center for Workers' Compensation Studies (CWCS)
In 2013, NIOSH established the Center for Workers’ Compensation Studies (CWCS) to integrate NIOSH’s traditional research efforts aimed at preventing worker injury and illness with workers’ compensation efforts aimed at providing medical care and wage benefits to workers with a work-connected injury or illness.
In 1970, Congress passed the Occupational Safety and Health Act because “personal injuries and illnesses arising out of work situations impose a substantial burden upon, and are a hindrance to, interstate commerce in terms of lost production, wage loss, medical expenses, and disability compensation payments.” In establishing the CWCS, NIOSH believes that increased efforts need to be made by the public and private sectors to better integrate the injury prevention and injury compensation research and practice communities to the purpose of protecting the health and safety of the American worker and the economic vitality of the Nation.
In addition to sponsoring educational conferences in 2009 and 2012 on the use of workers’ compensation data for worker safety and health, the NIOSH CWCS is interested in conducting collaborative research with commercial insurers, self-insured entities, academic investigators, state and federal workers’ compensation administrators, and with organizations such as the National Council on Compensation Insurance (NCCI)external iconexternal icon Currently, CWCS researchers are conducting integrated prevention and compensation research across a wide range of industry sectors, including:
- Healthcare and social assistance
- Public safety
- Wholesale and retail trade
Steve Wurzelbacher is the Director of the CWCS at the National Institute for Occupational Safety and Health (NIOSH). In this role, he coordinates workers’ compensation claim analyses, exposure assessment research, safety/health intervention effectiveness studies, and health services research with public and private sector partners. Steve has worked in the safety and health field since 1998, as both a researcher at NIOSH and as a risk control practitioner for a workers’ compensation insurer. Steve earned a PhD in Occupational Safety and Ergonomics from the University of Cincinnati, a BS in Chemical Science from Xavier University, is a Certified Professional Ergonomist (CPE), and holds the Associate in Risk Management (ARM) designation.
Alysha R. Meyers
Alysha R. Meyers, PhD, CPE is an epidemiologist and ergonomist dedicated to promoting musculoskeletal health. Since 2010, Dr. Meyers has been an epidemiologist in the NIOSH Division of Field Studies and Engineering (DFSE). Dr. Meyers has been working with the CWCS since its inception. Her main research interests are using workers’ compensation data for occupational safety and health, preventing work-related musculoskeletal disorders, and Total Worker Health®. Alysha earned a PhD in Occupational and Environmental Health from the University of Iowa and is a CPE.
Chih-Yu has worked for NIOSH since 1998 and has been involved in CWCS projects since 2013. She became a full-time member of the CWCS team in 2015. She earned her Master of Science degree in Statistics from The Ohio State University. Prior to joining NIOSH, she was a Research Data Analyst at the University of Cincinnati, Department of Environmental Health, Epidemiology and Biostatistics Division. As an IT Specialist, Chih-Yu provides programming, database and data visualization support to research projects. She enjoys working with the team members of CWCS and hopes to continually learn new computer skills in order to fulfill the needs of the growing center.
Libby Moore is a Health Scientist in the CWCS at the National Institute for Occupational Safety and Health (NIOSH). She received an MA and PhD in experimental psychology from the University of Cincinnati. Prior to joining NIOSH, Libby worked as an ergonomics consultant in the commercial insurance industry assisting policyholders reduce injury risk and severity. As a researcher, she uses the knowledge and skills gained in her previous role to collaborate with workers’ compensation insurers to understand risk control processes and identify evidence-based injury prevention strategies.
Steve Bertke is a Mathematical Statistician involved in planning and providing advice for any statistical analysis methods used in the various studies associated with the NIOSH CWCS. Steve has worked since 2009 in the safety and health field as a statistician at NIOSH. Steve earned a PhD in Mathematics with a concentration in Statistics from the University of Cincinnati.
Nhut Nguyen is a Data Visualization Analyst at NIOSH. Her primary role is to improve and promote data interpretation through the development of data visualization dashboards for CWCS. Prior to joining NIOSH, Nhut worked as a Public Health Associate stationed at the Tennessee Department of Health working on emergency preparedness. Nhut earned her MPH at Mercer University and a BA in Public Health and Classical Languages and Literature at Agnes Scott College.
Kierstyn Oldham is an Occupational Health Services Fellow at NIOSH. Her projects at the CWCS focus on examining opioid overdoses among worker populations of the United States during the COVID-19 pandemic. Kierstyn earned a MS in Health Informatics from Northern Kentucky University and is looking to pursue a PhD in the healthcare field.
Brian Chin is an Occupational Health Services Fellow in the NIOSH CWCS. His primary role is to improve work disability and return-to-work efforts by examining access, quality, and cost of health care services for injured workers. Brian earned his MS in Industrial Hygiene at the University of Illinois and is currently a PhD candidate in Health Services at the University of Washington, where he is investigating access, utilization, and outcomes of physical therapy services among injured workers with back pain.
Edward F. Krieg, Jr.
Edward F. Krieg, Jr. is a statistician who has been at NIOSH since 1987. He joined the Center for Workers’ Compensation Studies in 2019. Prior to that he was in the Division of Biomedical and Behavioral Science and the Division of Applied Research and Technology. Edward has an MS and PhD in Psychology from Tulane University in New Orleans, Louisiana. He has an MBA from Xavier University in Cincinnati, Ohio.
Goals & Mission
Strategic Goal 1:
Intermediate Goal 1.1
Understand the uses and limitations of workers’ compensation systems for research and surveillance of work-related health conditions
- Inform NIOSH staff and public health partners on workers’ compensation systems and procedures. This includes training on administrative, institutional, and legal variations that affect claim filing and acceptance. Information may be provided through:
- development of a workers’ compensation primer
- study of successful state models and partnerships
- meetings on identified areas of need such as loss prevention
- insurance certification programs
- Develop a broad understanding of the workers’ compensation insurance market by
- documenting private insurers catering to specific industry sectors
- developing collaborations with commercial workers’ compensation insurance carriers
Intermediate Goal 1.2
Existing state-level workers’ compensation data are analyzed and the results are used to identify research and intervention priorities
- NIOSH, state departments of health, state workers’ compensation agencies, and workers’ compensation organizations such as NCCI and IAIABC will partner to:
- Identify state workers’ compensation programs with sufficiently robust data to characterize occupational conditions and costs associated with lost-time and medical only workers’ compensation cases over a period of years
- Conduct analyses of state level data for health conditions and costs to identify intervention priorities
- Develop state-level indicators for the burden of occupational injuries and illnesses using data from state workers’ compensation agencies
- Compare workers’ compensation record systems with other data reported by states on occupational injuries and illnesses to estimate total numbers and rates
- Develop ways of classifying injuries and illnesses that better correspond with the purposes of surveillance and research. For example, develop ways to use text fields in the first reports of injury or other fields to gain insight into the causes of injuries and illnesses.
- Understand the relationship between WC data and the BLS annual survey. Summarize the existing body of work and frame additional research based on the limitations and advantages of each.
- Measure the direct cost burden of occupational injury and illness as reflected through lost-time and medical only workers’ compensation claims.
- Understand and develop methods to link workers’ compensation data to state unemployment insurance data to estimate rates based on the number of employed workers.
Intermediate Goal 1.3
Integrate key workers’ compensation data with electronic medical record systems
- Promote adoption of uniform coding standards and the recording of information useful for tracking in workers’ compensation record systems such as injury/illness nature, source, event, exposure, part of body, and detailed diagnoses (e.g. International Classification of Disease, ICD9-10), use of personal protective equipment, incident description, injured worker gender, hire date, occupation, age, and number of dependents.
For example, there are already data elements for part of body, nature of injury, and cause of Injury, shared by both IAIABC for FROI/SROI, and WCIO for unit statistical reporting in a large number of states. Unit statistical data is the audited exposure, premium, and loss information for a workers’ compensation policy.
- Encourage continued use of accepted health information technology standards to interface electronic workers’ compensation medical records and personal electronic health records with appropriate restrictions to protect the patient’s non-work-related medical information
For example, there is already a strong use of standards in medical data. When NCCI developed their Medical Data Call, they relied on national medical coding standards already established, such as: HIPAA (Health Insurance Portability and Accountability Act), and Current Procedural Terminology (CPT) codes set by the American Medical Association (AMA).
Strategic Goal 2:
Intermediate Goal 2.1
Characterize occupational injury and illness risk, severity, and cost using workers’ compensation data across states, industries, size of employers, and occupations
- Characterize risks for occupational injuries and illnesses across risk classifications, industries and occupations by utilizing the workers’ compensation claims data, loss prevention records, and related program information. This includes identifying workers’ compensation data sets with sufficient data quality to characterize risk. Key resources may include:
- first and subsequent reports of injury
- transactional claims history
- medical treatments and guidelines
- administrative processes
- litigation reports
- benefit payments and lost-time duration
- Link workers’ compensation data with group medical (non-workers’ compensation health insurance) and other data. This linkage is important to investigate occupational condition cost-shifting between workers’ compensation and group health plans.
- Evaluate the relationships among workers’ compensation costs and other economic factors and those of other health and social insurance programs that result from occupational injuries, illnesses and fatalities
- Conduct intervention research and activities to address identified occupational conditions or hazards
- Continue to develop and test crosswalks between insurance industry and public health coding systems for industry and occupation [e.g. NCCI manual classes versus North American Industry Classification System (NAICS) and Standard Occupational Classification (SOC)], and for injury and illness nature, event or exposure, source, and part of body
For example, the International Risk Management Institute (IRMI) has a crosswalk that cross references workers’ compensation class codes (NCCI and the independent bureaus) with NAICS and general liability class codes.
Intermediate Goal 2.2
Identify employer, carrier, and state policies, programs and characteristics that significantly impact injury and illness rates and costs among workers
- Evaluate the factors (such as employer size, geographical location, etc.) associated with higher workers’ compensation claim frequency and severity within industries and states
- Evaluate leading indicators associated with lower workers’ compensation claim frequency and severity to identify evidence-based safety and health programs, practices, and policies for:
- management commitment
- employee participation
- management/labor health and safety committees
- hazard identification and communication
- hazard elimination and control through prevention through design, engineering, administrative, work practice, and personal protective equipment (PPE) approaches
- program evaluation
- early symptom reporting
- return-to-work programs
- job accommodation and light duty jobs
- Evaluate the effects of individual state mandates and policies for workers’ compensation programs on occupational injuries and illnesses including:
- health and safety program requirements
- large/ small deductible policies
- experience rating, retrospective rating, and schedule rating
- group and individual discounts
- safety grants (to support engineering controls and other prevention activities at insured employers)
- owner and contractor controlled policies
- loss prevention services
- Encourage development of best practices for case-management and return-to-work programs
- Partner with insurers and states to develop a research framework agenda for predictors of disability duration and evaluate the effectiveness of return-to-work programs
- Encourage insurers and employers to analyze their data and use findings to develop best practices for primary, secondary, and tertiary injury and disability prevention
- Encourage examination of underreporting of claims by employees and employers
Evaluate the effect of contingent worker arrangements (part-time, temporary, or contract workers) and professional employer organizations on the frequency and severity of employer workers’ compensation rates
The mission of the NIOSH Center for Workers’ Compensation Studies (CWCS) is to use workers’ compensation data and systems to improve workplace safety and health. The CWCS supports the overall NIOSH Strategic Plan, which focuses on key issues facing different industrial sectors:
- Reduce occupational cancer, cardiovascular disease, adverse reproductive outcomes, and other chronic diseases
- Reduce occupational hearing loss
- Reduce occupational immune, infectious, and dermal disease
- Reduce occupational musculoskeletal disorders
- Reduce occupational respiratory disease
- Improve workplace safety to reduce traumatic injuries
- Promote safe and healthy work design and well-being
With help from partners like you, our main program objectives/goals are to:
Maximize the use of workers’ compensation data for prevention purposes
- Determine what caused an injury/ illness: Workers’ compensation claims data can be analyzed to better understand what job factors caused a past injury or illness. This helps find ways to improve workplace safety and health in the future. For example, workers’ compensation claims data may include cause codes (such as “slip/trip/fall”) for each claim. If not, auto-coding methods can be applied to descriptions of the incident (such as “slipped on ice and hurt my back”) to code claims.
- Identify trends in injury/ illness: Workers’ compensation claims data can be used to estimate the numbers of work-related injuries/ illnesses by cause, industry, or occupation. When linked with employment information (employee counts or hours), data can be presented as rates per full-time employee to compare across industries.
- Identify evidence-based prevention approaches: Workers’ compensation employer data can be used to understand what safety/ health programs effectively prevent and reduce the severity of past injuries/ illnesses. This helps design more effective systems moving forward.
- Identify workplace factors that predict future injuries/ illnesses: Workers’ compensation employer data can help develop “leading indicators” that identify workplace hazards and controls that most impact future injuries/ illnesses. Prediction leads to prevention.
Communicate new study findings
- Share study links using our website: Useful workers’ compensation research is being conducted, but results may never reach people who need to know. One of our goals is to regularly update a list of workers’ compensation studies.
- Host webinars and workshops: We host webinars several times per year and hold regular workshops to share study findings and bring together those involved in workers’ compensation research or practice.
Develop new research collaborations
We encourage workers’ compensation research between NIOSH and external public or private partners. We also act as a “match-maker” to introduce external researchers to other external researchers who have workers’ compensation data and analysis needs.
Share best study practices in workers’ compensation
We also encourage peer-to-peer networking among internal and external partners in the following areas:
- Claims Trends: Sharing methods to determine causation in workers’ compensation claims and identify trends by linking claims to employment data on industry and employee counts.
- Prevention Effectiveness: Sharing methods to evaluate how employer, carrier, and state policies, programs, practices, and engineering controls impact workers’ compensation claims.
- Economic Impact: Using workers’ compensation data as a starting point to understand the total economic impact of work-related injury/ illness.
- Health Services: Encouraging the development of best practices for workers’ compensation patient care, case-management and return-to-work programs.
- Exposure Assessment: Sharing methods assess employer safety, ergonomic, and industrial hygiene risks and controls.