A recent study conducted by the Workers’ Compensation Research Institute (WCRI) has linked the increase in Workers’ Compensation claims to high group health insurance plan deductibles. According to the research of Dr. Olesya Fomenko and Jonathan Gruber, injured workers are 1.4% more likely to file for Worker’s Compensation if they have group health deductibles worth $550 or more. Between the years of 2008 and 2017, a 5.3% increase in total comp-claim value was noted, with “soft-tissue claims” registering the largest boost.
The findings further indicate that the biggest increases in comp claims were found in states where it is legal for employees to choose their own healthcare providers. The researchers believe that when workers are free to select their own private physicians, there may be unique opportunities for them to attain lower costs of claim filing, President and CEO of WRCI John Ruser said, “In the past, workers may have chosen to have a work injury covered within their group health plan. However, the increasing cost of deductibles may cause them to consider having the injury covered – where it potentially belongs – in the workers’ compensation system, where there are no deductibles or copayments for the medical care they receive”.
In other words, as the costs of group health insurance policies rise, the amount of comp claims may also continue increasing, as employees find ways to avoid expenses related to workplace injury.
Overall, the WCRI study suggests that workers are not “forward looking” when it comes to making decisions about Workers’ Compensation, and often decide based on out-of-pocket payments and/or substantial financial burden at the time they are injured. The positive take from this is that upon estimating the rise in comp filings from the growth of group health policies, it appears that the results have partially offset the general decline in comp claims over the last decade, marking a turn-around of the previous trend and giving the Workers’ Compensation system more chances to perform the services it was designed for.
A brief video explanation by Dr. Fomenko herself was uploaded onto YouTube and can be viewed by clicking here.
- Do Higher Deductibles in Group Health Plans Increase Injured Workers’ Propensity to File for Workers’ Compensation?
(Olesya Fomenko, Jonathan Gruber)