Study looks at the relationship between post-accident drug testing, workers' compensation claims and accident reporting

ObjectiveTo examine the reciprocal longitudinal associations between depression or anxiety with work-related injury (WRI) at a large employer in the southwestern United States.MethodThree administrative datasets (2011–2013) were merged: employee eligibility, medical and prescription claims, and workers’ compensation claims. The sample contained 69 066 active employees. Depression and anxiety were defined as episodes of medical visits care (ie, claims) with corresponding ICD-9-CM codes. For an individual’s consecutive claims, a new case of depression or anxiety was defined if more than 8 weeks have passed since the prior episode. The presence of a workers’ compensation injury claim was used to identify WRI. Three-wave (health plan years 2011 or T1, 2012 or T2, and 2013 or T3) autoregressive cross-lagged models were used to estimate whether depression or anxiety predicted WRI, also if WRI predicted depression or anxiety in the following year(s).ResultsDepression predicted injury from T1 to T2 (β=0.127, p<0.001) and from T2 to T3 (β=0.092, p=0.001). Injury predicted depression from T1 to T3 (β=0.418, p<0.001). Effects of anxiety on WRI were small and inconsistent, from T1 to T2 (β=0.013, p=0.622) and from T2 to T3 (β=−0.043, p=0.031). T1 injury had a protective effect on T3 anxiety (β=−0.273, p<0.001).ConclusionsWe found evidence of reciprocal effects for depression with WRI after adjustment for prior injuries and depression. The evidence for the relationship between anxiety and WRI is less clear. WRI prevention and management programmes should incorporate depression prevention and management.

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Differences in Work Disability Duration for Immigrants and Canadian-Born Workers in British Columbia, Canada

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182211794 ◽

2021 ◽

Vol 18 (22) ◽

pp. 11794

Author(s):

Sonja Senthanar ◽

Mieke Koehoorn ◽

Lillian Tamburic ◽

Stephanie Premji ◽

Ute Bültmann ◽

...

Keyword(s):

British Columbia ◽

Work Disability ◽

Mitigation Strategies ◽

Workers Compensation ◽

Disability Benefits ◽

Severe Injuries ◽

Work Related ◽

Fracture Cohort ◽

Compensation Claims ◽

The Relationship

This study aimed to investigate differences in work disability duration among immigrants (categorized as economic, family member or refugee/other classification upon arrival to Canada) compared to Canadian-born workers with a work-related injury in British Columbia. Immigrants and Canadian-born workers were identified from linked immigration records with workers’ compensation claims for work-related back strain, connective tissue, concussion and fracture injuries requiring at least one paid day of work disability benefits between 2009 to 2015. Quantile regression investigated the relationship between immigration classification and predicted work disability days (defined from injury date to end of compensation claim, up to 365 days) and modeled at the 25th, 50th and 75th percentile of the distribution of the disability days. With a few exceptions, immigrants experienced greater predicted disability days compared to Canadian-born workers within the same injury cohort. The largest differences were observed for family and refugee/other immigrant classification workers, and, in particular, for women within these classifications, compared to Canadian-born workers. For example, at the 50th percentile of the distribution of disability days, we observed a difference of 34.1 days longer for refugee/other women in the concussion cohort and a difference of 27.5 days longer for family classification women in the fracture cohort. Economic immigrants had comparable disability days with Canadian-born workers, especially at the 25th and 50th percentiles of the distribution. Immigrant workers’ longer disability durations may be a result of more severe injuries or challenges navigating the workers’ compensation system with delays in seeking disability benefits and rehabilitation services. Differences by immigrant classification speak to vulnerabilities or inequities upon arrival in Canada that persist after entry to the workforce and warrant further investigation for early mitigation strategies.

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Medical and Legal Issues Raised by the Protz Decision Issued by the Pennsylvania Supreme Court

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2017.julaug03 ◽

2017 ◽

Vol 22 (4) ◽

pp. 12-13

Author(s):

LuAnn Haley ◽

Marjorie Eskay-Auerbach

Keyword(s):

Supreme Court ◽

Scientific Evidence ◽

Workers Compensation ◽

Sixth Edition ◽

Complex Concept ◽

The Supreme Court ◽

Compensation Claims ◽

Recent Edition ◽

Impairment Ratings ◽

Definition Of

Abstract Pennsylvania adopted the impairment rating provisions described in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) in 1996 as an exposure cap for employers seeking predictability and cost control in workers’ compensation claims. In 2017, the Supreme Court of Pennsylvania handed down the Protz decision, which held that requiring physicians to apply the methodology set forth in the most recent edition of the AMA Guides reflected an unconstitutional delegation of legislative power to the American Medical Association. The decision eliminates the impairment-rating evaluation (IRE) mechanism under which claimants were assigned an impairment rating under the most recent edition of the AMA Guides. The AMA Guides periodically are revised to include the most recent scientific evidence regarding impairment ratings, and the AMA Guides, Sixth Edition, acknowledges that impairment is a complex concept that is not yet defined in a way that readily permits an evidence-based definition of assessment. The AMA Guides should not be considered standards frozen in time simply to withstand future scrutiny by the courts; instead, workers’ compensation acts could state that when a new edition of the AMA Guides is published, the legislature shall review and consider adopting the new edition. It appears unlikely that the Protz decision will be followed in other jurisdictions: Challenges to using the AMA Guides in assessing workers’ compensation claims have been attempted in three states, and all attempts failed.

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