NIOSH Center for Workers' Compensation Studies (CWCS)

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Projects

Workers’ Compensation Data for Public Health Purposes

This document provides an overview of workers’ compensation systems and data sources. It presents background on the following aspects of workers’ compensation: (1) benefits and premiums; (2) the relationship between premiums and safety incentives; (3) roles of insurers, state agencies and third party administrators; (4) types of policies; (5) claims and other workers’ compensation insurance information on medical treatments, costs and disability status; (6) limitations of current industry data standards; (7) loss prevention programs; and (8) public health research, surveillance and regulations.

NIOSH Project Members: David Utterback, Ph.D., Alysha Meyers, Ph.D., Steve Wurzelbacher, Ph.D., Project Period: 2012-2013.

Project Publications:

Use of Workers’ Compensation Data for Occupational Safety and Health Workshops

NIOSH co-sponsored two workshops on the use of workers’ compensation for occupational safety and health. The proceedings have been assembled into two NIOSH publications.

NIOSH Project Members: David Utterback, Ph.D., Theresa Schnorr, Ph.D.; Project Period: 2010-2013.

Project Publications:

Workers’ Compensation Surveillance Funding Opportunity

The purpose of this cooperative agreement is to compile, analyze, and disseminate workers’ compensation data to promote the prevention of occupational injuries, illnesses, fatalities, and exposures to hazards within the states and throughout the nation. The Workers’ Compensation Surveillance Cooperative Agreements are intended to foster collaborations between state health departments, state workers’ compensation agencies, other eligible organizations and businesses and provide the resources to initiate or expand state-based workers’ compensation surveillance and intervention activities. The grant builds off the framework of the NIOSH State Surveillance Portfolio, in which a number of states have been collecting a series of occupational health indicators, including certain workers’ compensation  data.

As part of the grant, each awarded state is in the process of producing final reports and public data visualizations to summarize WC claims by industry and cause and suggest prevention activities:

NIOSH Project Contacts: Linda K. West, MSPH, Office of Extramural Programs; E-mail: lkw0@cdc.gov; Steve Wurzelbacher, Ph.D.; Project Period: 2015-current.

Ohio Bureau of Workers’ Compensation (OHBWC) Data Historical Trend Analysis (2001-present)

This study is generating multi-sector incidence rates for OHBWC workers’ compensation outcomes (e.g. case incidence, lost time case incidence, cost per employee per year) from 2001– present  and describing industry trends and high-risk industry segments by 3- to 5-digit North American Industrial Classification Codes (NAICS), size of company, and claim causes. The purpose of the analysis is to produce information that OHBWC-insured employers use to benchmark their safety and health performance versus industry peers and develop data-driven plans for prevention. OHBWC and researchers also use the information to understand industry risk trends and tailor safety, health, and disability management services to efficiently allocate resources by OHBWC service offices throughout the state. The overall goal is to protect workers, and reduce the frequency and cost of work-related injuries and illnesses in Ohio, especially for small businesses, which account for a majority of all workplaces.

NIOSH Project Contact: Steve Wurzelbacher, Ph.D., Division of Field Studies and Engineering; E-mail: srw3@cdc.gov; NIOSH Project Members: Alysha Meyers, Ph.D., Steve Bertke, Ph.D., Tim Bushnell, Ph.D., MPA; OHBWC Project Members: Mike Lampl, M.S., Dave Robins, A.A.S., Steven Naber, Ph.D.; Other Project Member: Abe Tarawneh, Ph.D.;  Project Period: 2011-present.

Project Publications:  

Workers’ Compensation Claims for Traumatic Brain Injuries—Ohio, 2001–2011

Annually, 1.7 million people are treated for traumatic brain injuries (TBIs) in the United States. Although there are many studies on nonfatal TBIs in the U.S. general population, research on work-related TBIs is limited. The Ohio Bureau of Workers’ Compensation (OHBWC) data are of particular benefit to the study of occupational TBI as each claim can have up to eight or more ICD-9-CM diagnosis codes that can be used by researchers to identify true work-related TBIs. The purpose of this proposed project was to describe work-related TBIs from 2001 through 2011. Specific objectives were to: (1) describe characteristics of the injured workers, (2) identify industry groups and occupation (if possible) at the highest risk for work-related TBIs, (3) examine the external causes of TBIs, (4) enumerate annual TBIs and assess trends of TBI rates over time, (5) assess the severity of these injuries, and (6) identify opportunities to prevent work-related TBIs.

NIOSH Project Contact: Srinivas Konda, M.P.H., Division of Safety Research; E-mail: itf2@cdc.gov; NIOSH Project Members: Audrey Reichard, Ph.D., Tiesman Hope, Ph.D., Steve Wurzelbacher, Ph.D., Scott Hendricks, Ph.D., James Collins, Ph.D., Alysha Meyers, Ph.D., Lynne Pinkerton, M.D.; OHBWC Project Members: Mike Lampl, M.S., Dave Robins, A.A.S.; Other Project Member: Abe Tarawneh, Ph.D.; Project Period: 2014-2019.

Project Publication:  

Workers’ compensation claims for traumatic brain injuries among private employers—Ohio, 2001‐2011external icon

Workers’ Compensation Claims for Private Sector Ambulance Services—Ohio, 2001–2011

Ambulance Services has one of the highest claim rates by industry subsector among all of Ohio Bureau of Workers’ Compensation (OHBWC) insured, single-location, private employers from 2001–2011 across all NIOSH industry sectors. This study further examined workers’ compensation (WC) claims for Ambulance Service workers. OHBWC insured workers’ compensation policies and claims for the Ambulance Services industry subsector were identified among single-location, private employers with a North American Industry Classification System (NAICS) code of 62191. Rates of WC claims per 100 adjusted full-time equivalent employees (FTEs) estimated from labor, productivity, and costs surveys were calculated. Causes of injury were manually- and auto-coded. In addition, injury diagnoses categories (e.g. contusion, fracture, or sprains, etc.) were assigned to each claim based on the ICD-9-CM diagnosis code for the most severe diagnosis. Occupational Injury and Illness Classification System (OIICS) codes were utilized to further determine the exposure of the injury claims.

NIOSH Project Contact: Audrey Reichard, M.P.H., O.T.R., Division of  Safety Research; E-mail: akr5@cdc.gov; NIOSH Project Members: Srinivas Konda M.P.H., Steve Wurzelbacher, Ph.D., Alysha Meyers, Ph.D., Steve Bertke, Ph.D.; OHBWC Project Members: Mike Lampl, M.S., Dave Robins, A.A.S.; Other Project Members: Abe Tarawneh, Ph.D., Chia Wei Ph.D.; Project Period: 2014-2018.

Project Publication:  

Workers’ compensation injury claims among workers in the private ambulance services industry—Ohio, 2001–2011external icon

Workers’ Compensation Claims for Temporary Agency Employers—Ohio, 2001–2013

Prior studies have indicated that temporary workers are at increased risk for injury/illness compared to permanent employees in similar industries and occupations. This study further examined the cause and of workers’ compensation claims for temporary agency workers to develop prevention strategies. The Ohio Bureau of Workers’ Compensation (OHBWC) insured workers’ compensation policies and claims for the temporary agency industry subsector were identified among single-location, private employers with a North American Industry Classification System (NAICS) code of 56132. Claim rates by manual class codes (industry/occupation insurance risk classes) were also calculated using employer payroll. Manual class code rates within temporary agency employers were compared to matched manual class code group rates in non-temporary agency employers to determine if temporary workers are at elevated risk for injury/illness. Causes of injury were manually- and auto-coded into Occupational Injury and Illness Classification System (OIICS) codes to determine the detailed cause (event/exposure) of the injury claims.

NIOSH Project Contact: Steve Wurzelbacher, Division of Field Studies and Engineering, E-mail: srw3@cdc.gov; Other Project Member: Abe Tarawneh, Ph.D.; NIOSH Project Member: Steve Bertke, Ph.D.; Project Period: 2014-2019.

Project Publication:  

Comparative analyses of workers’ compensation claims of injury among temporary and permanent employed workers in Ohioexternal icon

The relationship between age and workers’ compensation claims for musculoskeletal disorders related to overexertion: An analysis of claim rates and costs by age group and type among construction workers — Ohio, 2007–2012

The objective of this study is to examine the rate and cost of work-related musculoskeletal disorders workers’ compensation claims due to overexertion among most Ohio construction workers by age.  Workers’ compensation claims submitted to the Ohio Bureau of Worker’s Compensation by workers in the construction industry for injuries occurring from 2007-2012 are being analyzed to compute rates of allowed claims and claim costs by age group.

NIOSH Project Contact: Harpriya Kaur, Ph.D.; Division of Science Integration, E-mail: WDO6@cdc.gov; NIOSH Project Members: Steve Wurzelbacher, Ph.D.; Tim Bushnell, Ph.D., MPA; James Grosch, Ph.D., Chih-Yu Tseng, M.S.; Juliann C. Scholl, Ph.D., Alysha R. Meyers, Ph.D.; OHBWC Project Member: Mike Lampl, M.S; Project Period: 2018-present.

Evaluation of Claim Rates and Costs for Construction Sector Nail Gun Injuries in Ohio, 2001-2013

The goal of this project is to characterize Ohio Bureau of Workers’ Compensation (OHBWC) claims from 2001-2013 that resulted from a pneumatic nail gun injury in construction work with respect to claim rates, claim cost, and other predictor variables. From the identified claims the analysis will calculate a nail gun injury rate per 100 FTE in relevant industry classification codes (e.g. framing, roofing, siding, finish carpentry). Additional analyses will be conducted of the strength of association between nail gun injury rates and employer size and employee experience (age, days since hiring date). Nail gun injury claim costs (medical only and lost time) will also be summarized.

NIOSH Project Contact: Brian Lowe, Ph.D., Division of Field Studies and Engineering; E-mail: bfl4@cdc.gov; NIOSH Project Members: Steve Wurzelbacher, Ph.D., Jill Raudabaugh, M.S.; OHBWC Project Members: Mike Lampl, M.S., Dave Robins, A.A.S.; Other Project Member: Abe Tarawneh, Ph.D.; Project Period: 2014-present.

Using Informatics to Advance the Use of Workers’ Compensation Data

The purpose of this project is to provide a means to advance the goals of the NIOSH CWCS for maximizing the use of workers’ compensation (WC) data by providing a tool to automate the coding of the industry and occupation (I&O) data found on WC records. This project will modify the existing software known as the NIOSH Industry and Occupation Computerized Coding System (NIOCCS) in order to accept and process the unique and varied I&O data found on workers’ compensation records and convert this information into standardized I&O codes. The major output of this project is a new release of the NIOCCS software which is available free for public use via the internet. Intermediate outputs include software development lifecycle reports, testing results using different state WC data, updated user documentation, and new NIOCCS training materials.

NIOSH Project Contact: Susan Nowlin, M.S., Division of Field Studies and Engineering; NIOSH Project Team Members: Pamela Schumacher (NIOSH), Kelly Vanoli (SRA), Jeff Purdin (SRA), Elizabeth Smith (GAI), Steve Bertke (NIOSH); OHBWC Project Members: Mike Lampl, M.S.; Project Period: 2014-present.

Assessing the relationship between work-related accidents and injuries and exposures to noise and solvents

Major goals are to reduce accidents by learning more about the relationship between workplace accidents and injuries and exposure to noise and solvents. The Ohio Bureau of Workers’ Compensation (OHBWC) and NIOSH have been collecting noise and solvent exposure data from the OHBWC industrial hygiene consultation reports along with claim of injury data. A paper of the findings is being prepared.

NIOSH Project Contact: Cherie Estill, M.S., Division of Field Studies and Engineering; E-mail: clf4@cdc.gov; NIOSH Project Members: Alysha Meyers, Ph.D., Steve Wurzelbacher, Ph.D.; OHBWC Project Members: Jeff Hutchins, Mike Lampl, M.S., Dave Robins, A.A.S.; Project Period: 2014-present.

Effectiveness of Intervention Programs Provided by the Ohio Bureau of Workers’ Compensation (OHBWC)

OHBWC offers over 15 programs and services to reduce workers’ compensation incidence, severity, and cost for clients. The purpose of this study is to determine the effectiveness and return-on-investment (ROI) of the OHBWC sponsored programs for all industry sectors from 1999–2013. This will allow OHBWC to focus on evidence based programs and allocate resources appropriately. Best practices will also be shared for all employers nationwide. The main program of interest is the Safety Intervention Grants (SIG) Program (where OHBWC provided matching funds to implement engineering controls at hundreds of insured employers since 1999) but all programs will be researched. The current SIG analysis involves comparing employers before/after intervention, controlling for the change in workers’ compensation rates that are independent of the interventions. Other analyses will evaluate the effectiveness of multiple OHBWC programs, including onsite OHBWC consultation services. The method will be to compare pre/post workers’ compensation rates of participant companies versus non-participant companies, while controlling for industry type, company size, self-rated safety and health programs, prior loss history, and participation in other programs and loss control consultation frequency. Outputs will include peer reviewed journal manuscripts and a web-based intervention effectiveness summary.

NIOSH Project Contact: Steve Wurzelbacher, Ph.D.; Division of Field Studies and Engineering; E-mail: srw3@cdc.gov; NIOSH Project Members: Alysha Meyers, Ph.D., Steve Bertke, Ph.D., Tim Bushnell, Ph.D., MPA; OHBWC Project Members: Mike Lampl, M.S., Dave Robins, A.A.S., Steven Naber, Ph.D.; Other Project Member: Abe Tarawneh, Ph.D.; Project Period: 2011-present.

Project Publication: 

The effectiveness of insurer-supported safety and health engineering controls in reducing workers’ compensation claims and costs.external icon

Evaluating the Effectiveness of Individual Elements of Employer Injury/Illness Prevention Programs (I2P2) in the Wholesale Retail Trade Sector

NIOSH and the OHBWC are examining the association between survey-assessed I2P2 leading indicators (organizational policies, procedures, practices) and workers’ compensation outcomes in a sample of OHBWC-insured wholesale/ retail trade (WRT) firms from 2013–2015. Crucial I2P2 elements and practices with particularly high impact on workers’ compensation losses will be identified in this study and disseminated to the WRT sector. An evidence-based I2P2 evaluation tool will also be disseminated. Planned outputs include peer reviewed journal manuscripts and a web-based summary.

NIOSH Project Contact: Steve Wurzelbacher, Ph.D.; Division of Field Studies and Engineering; E-mail: srw3@cdc.gov; NIOSH Project Members: Ed Krieg, Ph.D.; OHBWC Project Members: Mike Lampl, M.S., Dave Robins, A.A.S.; Steven Naber, Ph.D.; Project Period: 2011-present.

The effectiveness of ergonomic interventions in material handling operations

NIOSH and the Ohio Bureau of Workers’ Compensation (OHBWC) have been collaborating to determine the effectiveness of material handling engineering controls in a multi-site prospective study at OHBWC-insured companies from 2012–2017. Interventions included controls designed to improve heavy material handling during delivery, installation, and receiving in a number of industries. The costs of the interventions were funded through existing OHBWC Safety Intervention Grant  funds and participating employers. Outcomes included employee-reported low back/upper extremity pain and safety incidents at baseline, every three months, and annually for up to two years. Best practices will be shared with employers nationwide and planned outputs include peer reviewed journal manuscripts and a web-based intervention effectiveness summary.

NIOSH Project Contact: Steve Wurzelbacher, Ph.D.; Division of Field Studies and Engineering; E-mail: srw3@cdc.gov; OHBWC Project Members: Mike Lampl, M.S.; NIOSH Project Members: Steve Bertke, Ph.D.; Chih-Yu Tseng, M.S.; Project Period: 2011-present.

Workplace Wellness Grant Program Effectiveness Evaluation

From 2012 to July 2017, the OHBWC Workplace Wellness Grant Program has awarded over $2 million to implement wellness programs to thousands of employees at over 300 Ohio employers. The goals of this evaluation study include:

  • Measure effectiveness of wellness programs by comparing data from pre- and post-implementation of a wellness program on the following outcomes: a) workers’ compensation claim, severity (days lost per claim), and cost rates, b) aggregate health metrics c) absenteeism rates, d) turnover rates, and e) healthcare cost per employee
  • Determine the relationship between workers’ compensation claim, severity, and cost rates and changes in yearly measures pre- and post-implementation for a) wellness program elements, b) occupational safety and health program elements, and c) wellness-occupational safety and health program integration measures
  • Determine the total costs, savings, and savings (benefits) to cost ratios associated with grant-supported wellness programs from the perspective of the OHBWC and the participating employers.

Best practices will be shared with employers nationwide and planned outputs include peer reviewed journal manuscripts and a web-based intervention effectiveness summary.

NIOSH Project Contact: Alysha Meyers, Ph.D.; Division of Field Studies and Engineering; E-mail: itm4@cdc.gov; NIOSH Project Members: Steve Wurzelbacher, Ph.D., Tim Bushnell, Ph.D.; OHBWC Project Members: Mike Rienerth, M.S., Dayona Turner, Dave Robins, A.A.S.; Other Project Members: Abe Tarawneh, Ph.D.; Project Period: 2014-present.

Project Publications: 

Degree of Integration Between Occupational Safety and Health Programs and Wellness Programs: First-year Results from an Insurer-Sponsored Wellness Grant for Smaller Employersexternal icon

Construction industry experiences with equipment interventions for health and safety

This study reviewed 153 case studies of equipment interventions funded through the Ohio Bureau of Workers’ Compensation (OHBWC) Safety Intervention Grant (SIG) program from 2003–2016. The source data in the review were extracted from employer grant applications and final reports of the case studies. Results were aggregated by type of construction equipment and included the reduction in safety and ergonomic hazards (risk factors for work-related musculoskeletal disorders), and an assessment of the quality of the case studies as determined through criteria established by the authors.

NIOSH Project Contact: Brian Lowe, Ph.D.; Division of Field Studies and Engineering; E-mail: bfl4@cdc.gov; NIOSH Project Members: James Albers, M.S.,  Marie Hayden, M.S., Steve Wurzelbacher, Ph.D.; OHBWC Project Members: Mike Lampl, M.S., and Steven Naber, Ph.D. Project Period: 2017-2020.

Project Publication: 

Construction industry experiences with equipment interventions for health and safetyexternal icon

Barriers and Aids to Intervention Effectiveness

This purpose of this study is to identify barriers and aids to implementing interventions for musculoskeletal disorder prevention in the residential construction industry. CWCS researchers are interviewing employers and workers who participated in past Ohio Bureau of Workers’ Compensation Safety Intervention Grants. Interventions included safety improvements relevant to residential construction such as specific engineering interventions, as well as safety program development and implementation. Barriers/aids may include locating/identifying/receiving safety intervention information and broader issues such as company culture or beliefs about safety.

NIOSH Project Contact: Libby Moore, Ph.D.; Division of Field Studies and Engineering; E-mail: lls0@cdc.gov; NIOSH Project Members: I-Chen Chen, Ph.D, Steve Wurzelbacher, Ph.D.; OHBWC Project Members: Mike Lampl, M.S., and Steven Naber, Ph.D. Project Period: 2017-present.

Safety Program Survey Leading Indicators

This purpose of this study is to examine the association between survey-assessed safety/health program leading indicators (organizational policies, procedures, practices, reported exposures) and workers’ compensation claims outcomes in a cohort of Ohio Bureaus of Workers’ Compensation-insured employers from 2013–2016. The survey surveypdf iconexternal icon, was developed by OHBWC. Crucial elements and practices with particularly high impact on workers’ compensation losses will be identified in this study and disseminated. Planned outputs include peer reviewed journal manuscripts and a web-based summary.

NIOSH Project Contact: Libby Moore, Ph.D.; Division of Field Studies and Engineering; E-mail: lls0@cdc.gov; NIOSH Project Members: I-Chen Chen, Ph.D, Steve Wurzelbacher, Ph.D.; OHBWC Project Members: Mike Lampl, M.S., and Steven Naber, Ph.D. Project Period: 2017-present.

Evaluation of Slip, Trip, and Fall Prevention Practices in Food Services

The purpose of this research project was to evaluate the efficacy of slip, trip, and fall (STF) prevention practices in the food services industry. A randomized controlled trial was conducted to evaluate the effectiveness of slip-resistant shoes in reducing slips and falls injuries. One of the largest food service companies in the US collaborated in this NIOSH-led research by providing access to its workforce. The findings of this study involved data from approximately 9,000 employees over a four and a half year period.  By demonstrating the effectiveness of STF prevention measures, it is anticipated that food service companies initially hesitant to expend time and money on prevention programs with unknown effectiveness could use these research findings to help justify implementing prevention strategies.

NIOSH Project Contact: Jennifer L. Bell, Ph.D.; Division of Safety Research; E-mail: JBell@cdc.gov; Project Period: 2010-2019.

Project Publication: 

Effectiveness of a No-Cost-to-Workers, Slip-Resistant Footwear Program for Reducing Slipping-Related Injuries in Food Service Workers: a Cluster Randomized Trialexternal icon

Effectiveness of Targeted Risk Control

This purpose of this study is to determine the effectiveness of a targeted risk control model where higher-risk employers receive repeated insurer risk control service. CWCS researchers are partnering with the California State Compensation Insurance Fund (SCIF) to conduct this study. The analyses will involve comparing pre/post risk assessment scores (completed by SCIF consultants) and workers’ compensation claim rates of participant companies versus non-participant companies. Analyses will control for industry type, company size, prior loss history, and risk control consultation frequency. Outputs will include peer reviewed journal manuscripts and a web-based intervention effectiveness summary.

NIOSH Project Contact: Libby Moore, Ph.D.; Division of Field Studies and Engineering; E-mail: lls0@cdc.gov; NIOSH Project Members: Ed Krieg, Ph.D, Steve Wurzelbacher, Ph.D.; Project Period: 2017-present.

Workers’ compensation insurer risk control systems: Opportunities for public health collaborations

The purpose of this study was to understand the potential impact of insurer risk control systems on workplace safety/health research and practice. CWCS researchers interviewed nine insurers, compared risk control systems, and highlighted future research collaboration opportunities to evaluate risks/controls and disseminate safety/health best practices.

NIOSH Project Contact: Libby Moore, Ph.D.; Division of Field Studies and Engineering, NIOSH. E-mail: lls0@cdc.gov ; NIOSH Project Members: Steve Wurzelbacher, Ph.D.; Project Period: 2016-2018.

Project Publication:

Workers’ compensation insurer risk control systems: Opportunities for public health collaborationsexternal icon

Standardizing industrial hygiene data collection forms used by workers’ compensation insurers

NIOSH Project Contact: Taylor Shockey, Ph.D.; Division of Field Studies and Engineering, NIOSH. E-mail: von3@cdc.gov; NIOSH Project Members: Libby Moore, Ph.D., Steve Wurzelbacher, Ph.D.; Other Project Member: Kelsey Babik, M.S.; Project Period: 2016-present.

The purpose of this study was to compare and help standardize industrial hygiene (IH) data collection among workers’ compensation insurers and other organizations and determine the feasibility of pooling collected data. IH air and noise survey forms were collected from ten organizations. Data fields on the forms were evaluated for importance and a study list of core fields was developed. The core study list was presented to an IH review panel for review before finalization. The final core study list was compared to recommendations published by the American Conference of Governmental Industrial Hygienists (ACGIH) and the American Industrial Hygiene Association (AIHA).

Project Publication:

Standardizing industrial hygiene data collection forms used by workers’ compensation insurersexternal icon

Occupational exposure monitoring data collection, storage, and use among state-based and private workers’ compensation insurers

The purpose of this study was to understand current industrial hygiene practices among insurers. Both state-based and private insurers were surveyed about the collection and use of industrial hygiene data for risk reduction and safety and health research.

NIOSH Project Contact: Taylor Shockey, Ph.D.; Division of Field Studies and Engineering, NIOSH. E-mail: von3@cdc.gov; NIOSH Project Members: Steve Wurzelbacher, Ph.D., Libby Moore, Ph.D.; Other Project Member: Kelsey Babik, M.S. Project Period: 2017-present.

Project Publication:

Occupational exposure monitoring data collection, storage, and use among state-based and private workers’ compensation insurersexternal icon

Ohio BWC Health Services Impact

CWCS is developing a series of studies with the Ohio Bureau of Workers’ Compensation (OHBWC) to assess the impact of healthcare and other factors on worker health outcomes (including functional status, pain, and return-to-work status). Healthcare factors under study include access and quality of care, type of treatments, prescription drug usage, and care coordination. Other factors include injury cause and diagnoses, re-injury, patient occupation/industry, employer size and location.

NIOSH Project Contact: Brian Chin, M.S., Ph.D. Candidate; Division of Field Studies and Engineering, NIOSH. E-mail: olj9@cdc.gov; NIOSH Project Members: Kayla English, M.P.H., Edward Krieg, Ph.D., I-Chen Chen, Ph.D., Steve Wurzelbacher, Ph.D.; Project Period: 2017-present.

How Can Workers’ Compensation Systems Promote Occupational Safety and Health? Stakeholder Views on Policy and Research Priorities

NIOSH-CWCS sponsored a study by RAND to interview key stakeholders about ways to improve the workers’ compensation system.

NIOSH Project Contact: Steve Wurzelbacher, Ph.D.; Division of Field Studies and Engineering, NIOSH. E-mail: srw3@cdc.gov; RAND Project Contacts: Michael Dworsky, Ph.D. and Nicholas Broten, M.S.; Project Period: 2017-2018.

Project Publication:

How Can Workers’ Compensation Systems Promote Occupational Safety and Health? external icon

Correlates of Opioids Dispensing

NIOSH-CWCS sponsored a study by the Workers Compensation Research Institute that identified factors leading to higher opioid dispensing rates in 27 states.

NIOSH Project Contact: Steve Wurzelbacher, Ph.D.; Division of Field Studies and Engineering, NIOSH. E-mail: srw3@cdc.gov; WCRI Project Contacts: Vennela Thumula, Ph.D. and Te-Chun Liu, Ph.D.; Project Period: 2017-2018.

Project Publication:

Correlates of Opioids Dispensingpdf iconexternal icon

Total Burden of Work-Related Injuries and Illnesses White Paper

A white paper on the total burden of work-related injuries and illnesses, including the usefulness of workers’ compensation data for this burden’s estimation was co-authored for presentation and discussion at the second Workers’ Compensation Workshop that was co-sponsored by NIOSH and resulted in the creation of the NIOSH CWCS. The paper was a collaborative effort among economists from NIOSH, Boston University, University of British Columbia, and the Institute for Work and Health (IWH). We are now pursuing publication of a succinct version of the white paper in a peer-reviewed journal and publication of the white paper as a document co-branded by NIOSH and IWH.

NIOSH Project Contact: Rene Pana-Cryan, Ph.D.; Office of the Director; E-mail: rfp2@cdc.gov; NIOSH Project Members: Tim Bushnell, Ph.D., MPA; External Project Members: Les Boden, Ph.D., Boston University; Chris McLeod, Ph.D., University of British Columbia; Emile Tompa, Ph.D., Institute for Work and Health.

Relationship of Workers’ Compensation, Group Health, Short/ Long Term Disability Costs

In 2007, NIOSH obtained access to several years of MarketScan data (from Thomson-Reuters) on medical claims and the health and productivity of workers at several large employers. Data on health-related costs for family members of these employees also are included. Data are being analyzed to better understand the relationship between workers’ compensation, group health, and short-term disability costs, and the associated health and productivity consequences for employees and their family members. In 2011, additional years and modules of data were purchased and a series of articles were published or continued to be drafted and are at different stages of review and clearance. In addition, through a partnership with the Social Security Administration (SSA), NIOSH, and Boston University, linkages between state-based workers’ compensation and long-term disability benefits data will be studied to better understand the long-term effects of work on health. The National Death Index will also be linked to SSA and state-based workers’ compensation data to assess long-term effects of work injury on mortality.

NIOSH Project Contact: Rene Pana-Cryan, Ph.D.; Office of the Director; E-mail: rfp2@cdc.gov; NIOSH Project Members: Abay Getahun, Ph.D., Frank Hearl, Ph.D.; Anasua Bhattacharya, Ph.D., Tim Bushnell, Ph.D., MPA.

Incidence and Cost of Depression after Occupational Injury

This study examined if injured workers were more likely than non-injured workers to be treated for depression after an occupational injury and estimated the cost paid by group medical insurance. Nearly 367,900 injured and non-injured workers were drawn from the 2005 Thomson Reuters MarketScan data and we used descriptive, logistic, and two-part model regression analyses. The odds of injured workers being treated for depression within the study period were 45% higher than those of non-injured workers (95% confidence interval, 1.17–1.78). The unconditional average cost of outpatient depression treatment was 63% higher for injured workers than for non-injured workers. Conclusions: Injured workers were more likely than non-injured workers to suffer from depression during the study period. Consequently, additional costs are incurred for treating injured workers’ depression; these costs were not covered by the workers’ compensation system.

NIOSH Project Contact: Abay Asfaw, Ph.D.; Office of the Director; E-mail: hqp0@cdc.gov; NIOSH Project Members: Kerry Souza, Ph.D.

Project Publication: Incidence and cost of depression after occupational injuryexternal icon

Workers’ Compensation Claim Acceptance or Denial: Effects on Group Health Insurance Utilization and Costs within Two Weeks of Injury

Workers’ compensation programs were established as a social insurance against medical expenses and lost wages that result from occupational injuries and illnesses. Filing for workers’ compensation is a lengthy, complicated process and research suggests that workers under-file for workers’ compensation benefits. Previous research suggests that non-workers’ compensation insurance systems, such as group health insurance (GHI), Medicare, or Medicaid, at least partially cover work-related injury and illness costs. This project further examined GHI utilization and costs by comparing those outcomes immediately following specific injuries for which workers’ compensation claims either were accepted or denied. We focused on a narrow two-week time window between the occurrence of injury and GHI utilization to limit the influence of other factors not associated with a workers’ compensation claim.

NIOSH Project Contact: Abay Asfaw, Ph.D.; Office of the Director; E-mail: hqp0@cdc.gov; NIOSH Project Members: Roger Rosa, Ph.D.; and Rebecca Mao, Ph.D.

Analysis of Medical Cost Records from MarketScan MedStat Database

This project aims at examining whether workers with workers’ compensation claims also have elevated health care utilization costs associated with the same injury or illness event that appear in their medical insurance and disability compensation systems. This project will also investigate if work-related injury or illness has consequences on employment status, such as, early retirement, from full time status to part time status, and others.

NIOSH Project Contact: Anasua Bhattacharya, Ph.D; Office of the Director; E-mail: fwa4@cdc.gov; Project Period: 2011-2018.

Estimating the Direct and Indirect Costs of Injuries and Illnesses in Wholesale and Retail Trade Sectors (2007-2013)

This study will estimate the direct and indirect costs of all occupational fatal and nonfatal injuries in the various sectors and sub-sectors of wholesale and retail trade.

NIOSH Project Contact: Anasua Bhattacharya, Ph.D; Office of the Director; E-mail: fwa4@cdc.gov; Project Period: 2011-present.

Costs and Benefits of Workplace Health Improvements

This project encompasses several efforts to improve methods of evaluating the costs and benefits of health and safety improvements. One of the components of this project that addresses workers’ compensation costs focuses on the methods for estimating costs and benefits of health and safety improvements for the individual employer. Various methods used to estimate these costs and benefits are being compared and assessed in order to develop a comprehensive inventory of potentially relevant costs and benefits, and a summary of methods for estimating them. The results will be published as a journal article which can be used as a basis for guidance that can be used by both employers and researchers. Another component of this project supports another NIOSH project by contributing to publications on the relationship between injuries of workers’ compensation claimants and subsequent changes in health care claims of workers’ family members.

NIOSH Project Contact: Tim Bushnell, Ph.D., MPA; Office of the Director; E-mail: plb4@cdc.gov; Project Period: 2011-2018.

Forecasting the Burden of Injuries and Illnesses in Small Businesses (2008-2013)

This study performed a trend analysis on fatal and nonfatal occupational injuries in small businesses, employing less than one hundred employees. It also estimated the economic burden of occupational fatal and nonfatal injuries in these small businesses for the past five years and will forecast the burden of these injuries and illnesses in small businesses. The study will also estimate the impact of forecasted injuries in small businesses on future national economic output, expressed as gross domestic product (GDP) and employment. It is a multi-phase study using multiple national level datasets from various sources, such as, workers’ compensation costs from NCCI, work-related fatalities from Bureau of Labor Statistics’ (BLS) Census of Fatal Occupational Injuries (CFOI) research files, work-related investigations on fatal and nonfatal injuries from Occupational Safety and Health Administration’s (OSHA) Integrated Management Information System (IMIS), employment, wages and salary related data from BLS, and U.S. Census Bureau, and others. All these data sources were merged with each other by industry sector, year of injury, gender, age groups and other variables to estimate rates and numbers of fatal and nonfatal injuries in small businesses. Direct and indirect costs of these injuries were estimated using workers’ compensation costs, wages, salaries, and other costs related variables following the literature. Multiple reports have been generated and will be published in peer reviewed journals.

NIOSH Project Contact: Anasua Bhattacharya, Ph.D; Office of the Director; E-mail: fwa4@cdc.gov; Project Period: 2011-2018.

Page last reviewed: May 6, 2019