scholarly journals 229Step-downs reduce workers’ compensation payments to encourage return to work. Are they effective?

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Tyler Lane ◽  
Luke Sheehan ◽  
Shannon Gray ◽  
Alex Collie
Keyword(s):  
Mental Health ◽  
Return To Work ◽  
Injured Workers ◽  
Practical Significance ◽  
Administrative Claims ◽  
Workers Compensation ◽  
Negative Effects ◽  
Compensation Systems ◽  
Meta Analyses ◽  
A Minor

Abstract Background Workers’ compensation systems throughout Australia implement “step-downs,” which cut the amount paid to injured workers after they have received benefits for several months. Though initially introduced to control rising insurance premiums, step-downs are currently justified as an incentive return to work. Whether they have this effect has never been formally tested. Methods Using administrative claims data, we applied a regression discontinuity study design to test whether step-downs affected weekly scheme exit rates, a proxy for return to work, within eight state, territory, and Commonwealth workers’ compensation systems. We also examined effects by injury type (fractures, musculoskeletal, mental health, and other trauma). To derive generalised effects, we combined results using meta-analyses and conducted meta-regressions to determine whether timing or magnitude of step-downs significantly moderated effects. Results Step-downs reduced scheme exit by 0.86 percentage points (95% CI: -1.45, -0.27). Neither timing nor magnitude of step-downs was a significant effect moderator. There were significant effects in fractures (-0.84, 95% CI: -1.61, -0.07) and sensitivity analysis suggested possible effects within mental health and musculoskeletal conditions. Conclusions The negative effects suggest some workers’ compensation recipients anticipate step-downs and return to work early to avoid a reduction in income. However, the effects were small and suggest step-downs have marginal practical significance. We conclude that step-downs are generally ineffective as a return to work policy initiative. Key messages Reducing the amount of compensation paid to injured workers has a minor incentivising effect on their return to work rates.

scholarly journals Step-downs reduce workers’ compensation payments to encourage return to work: are they effective?

2020 ◽  
Vol 77 (7) ◽  
pp. 470-477 ◽  
Author(s):  
Tyler J Lane ◽  
Luke Sheehan ◽  
Shannon E Gray ◽  
Dianne Beck ◽  
Alex Collie
Keyword(s):  
Mental Health ◽  
Return To Work ◽  
Combined Effect ◽  
Practical Significance ◽  
Administrative Claims ◽  
Workers Compensation ◽  
Significant Heterogeneity ◽  
Compensation Systems ◽  
Meta Analyses ◽  
Significant Moderator

ObjectiveTo determine whether step-downs, which cut the rate of compensation paid to injured workers after they have been on benefits for several months, are effective as a return to work incentive.MethodsWe aggregated administrative claims data from seven Australian workers’ compensation systems to calculate weekly scheme exit rates, a proxy for return to work. Jurisdictions were further subdivided into four injury subgroups: fractures, musculoskeletal, mental health and other trauma. The effect of step-downs on scheme exit was tested using a regression discontinuity design. Results were pooled into meta-analyses to calculate combined effects and the proportion of variance attributable to heterogeneity.ResultsThe combined effect of step-downs was a 0.86 percentage point (95% CI −1.45 to −0.27) reduction in the exit rate, with significant heterogeneity between jurisdictions (I2=68%, p=0.003). Neither timing nor magnitude of step-downs was a significant moderator of effects. Within injury subgroups, only fractures had a significant combined effect (−0.84, 95% CI −1.61 to −0.07). Sensitivity analysis indicated potential effects within mental health and musculoskeletal conditions as well.ConclusionsThe results suggest some workers’ compensation recipients anticipate step-downs and exit the system early to avoid the reduction in income. However, the effects were small and suggest step-downs have marginal practical significance. We conclude that step-downs are generally ineffective as a return to work policy initiative.Postprint link: https://www.medrxiv.org/content/10.1101/19012286

scholarly journals Step-downs reduce workers’ compensation payments to encourage return to work. Are they effective?

2019 ◽  
Author(s):  
Tyler J Lane ◽  
Luke R Sheehan ◽  
Shannon E Gray ◽  
Dianne Beck ◽  
Alex Collie
Keyword(s):  
Mental Health ◽  
Return To Work ◽  
Combined Effect ◽  
Injured Workers ◽  
Administrative Claims ◽  
Workers Compensation ◽  
Exit Rate ◽  
Policy Objective ◽  
Compensation Systems ◽  
New Findings

AbstractObjectiveTo determine whether step-downs, which cut the rate of compensation paid to injured workers after they have been on benefits for several months, are effective as a return to work incentive.MethodsWe aggregated administrative claims data from seven Australian workers’ compensation systems to calculate weekly scheme exit rates, a proxy for return to work. Jurisdictions were further subdivided into four injury subgroups: fractures, musculoskeletal, mental health, and other trauma. The effect of step-downs on scheme exit was tested using a regression discontinuity design. Results were pooled into meta-analyses to calculate combined effects and the proportion of variance attributable to heterogeneity.ResultsThe combined effect of step-downs was a 0.86 percentage point (95% CI -1.45 to -0.27) reduction in the exit rate, with significant heterogeneity between jurisdictions (I2 = 68%, p = .003). Neither timing nor magnitude of step-downs was a significant moderator of effects. Within injury subgroups, only fractures had a significant combined effect (-0.84, 95% CI -1.61 to -0.07). Sensitivity analysis indicated potential effects within mental health and musculoskeletal conditions as well.ConclusionsThe results suggest some workers’ compensation recipients anticipate step-downs and exit the system early to avoid the reduction in income. However, the effects were small and suggest step-downs have marginal practical significance. We conclude that step-downs are generally ineffective as a return to work policy initiative.Key messages1.What is already known about this subject?A number of workers’ compensation systems around the world reduce payments to injured workers after they have been in the system for several months. In Australia, where each state, territory, and Commonwealth system employs step-downs, the stated policy objective is to increase the rate of return to work through financial incentives. However, there is little empirical evidence to either support or reject this claim.2.What are the new findings?The rate at which claimants exited workers’ compensation systems increased ahead of step-downs taking effect, suggesting an anticipatory effect. However, the effect was relatively small, changing the exit rate by less than a percentage point overall, with substantial heterogeneity between systems.3.How might this impact on policy or clinical practice in the foreseeable future?While statistically significant, the findings suggest that step-downs provide workers’ compensation claimants little incentive to return to work. Policymakers may need to reconsider step-downs as a component of scheme design, or justify them according to their original purpose, which was to save costs.

Scoping review of claimants’ experiences within Australian workers’ compensation systems

2019 ◽  
Vol 43 (4) ◽  
pp. 457 ◽  
Author(s):  
Anne-Marie Dean ◽  
Mandy Matthewson ◽  
Melissa Buultjens ◽  
Gregory Murphy
Keyword(s):  
Return To Work ◽  
Scoping Review ◽  
Occupational Rehabilitation ◽  
Injured Workers ◽  
Future Research ◽  
Workers Compensation ◽  
Rehabilitation Outcomes ◽  
Cooperative Approach ◽  
Compensation Systems ◽  
Legislative Reforms

Objective The aim of this scoping review was to map the literature on the lived experiences of injured workers in Australia in order to better understand the factors that inhibit the transition back to work and improved health. The ultimate aim of the study was to identify areas for further research into workers’ compensation systems and practices that are associated with improved occupational rehabilitation outcomes. Methods PubMed, ProQuest, Embase and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched for eligible articles published in English in peer-reviewed journals from 2001 to 2017. Narrative data synthesis was used to analyse the data collected from included articles. Results Twelve articles examining injured workers’ experiences within Australian workers’ compensation systems were identified. Injured workers reported similar experiences across states and territories in Australia. Four common themes and three subthemes were noted, namely: (1) relationships and interactions; (2) injured workers’ perceptions (subthemes: mental health effects, social effects and financial effects); (3) the workers’ compensation process; and (4) independent medical evaluations. Conclusions There are common difficulties that injured workers experience within Australian workers’ compensation systems that are reported to impede rehabilitation and return to work. A less harmful, more cooperative approach to worker rehabilitation and compensation is needed. What is known about the topic? Different workers’ compensation systems exist throughout Australia. Little is known about injured workers’ perceptions of their experiences within these systems in Australia and whether these experiences are similar or different across systems. What does this paper add? This scoping review synthesises available evidence showing that injured workers report negative experiences of workers’ compensation systems, and that this experience is similar across the different systems. This review also identified a clear need for future research on workers’ compensation systems in order to promote evidence-based approaches to best support the occupational rehabilitation of injured workers. What are the implications for practitioners? Evidence suggests a more holistic, biopsychosocial approach is required by practitioners when facilitating an injured worker’s recovery and return to work. This approach is also vital when considering legislative reforms, such as workers’ compensation systems, processes and practices.

What are physicians told about their role in return to work and workers’ compensation systems? An analysis of Canadian resources

2018 ◽  
Vol 17 (1) ◽  
pp. 78-89 ◽  
Author(s):  
Agnieszka Kosny ◽  
Marni Lifshen ◽  
Ellen MacEachen ◽  
Andrea Furlan ◽  
Mieke Koehoorn ◽  
...  
Keyword(s):  
Return To Work ◽  
Workers Compensation ◽  
Compensation Systems

scholarly journals Quality evaluation of workers’ compensation hospital in Korea

2014 ◽  
Vol 9 ◽  
Author(s):  
Jong-Uk Won
Keyword(s):  
Health Care ◽  
Occupational Health ◽  
Return To Work ◽  
Hospital Stay ◽  
Evaluation Method ◽  
Length Of Hospital Stay ◽  
Work Rate ◽  
Injured Workers ◽  
Workers Compensation ◽  
Occupational Health Care

Background: The length of hospital stay among occupationally injured workers was too long comparing to national health insurance patients in Korea. Also return-to-work rate was low comparing to other countries. The Korea Workers’ Compensation & Welfare (COMWEL) has tried to upgrade the quality of care workers’ compensation contract hospitals since several years. One of the tries was to evaluate the workers’ compensation contract hospitals. However, many hospitals argued the appropriateness of the hospital evaluation.Objectives: This study was performed to evaluate the appropriateness of the workers’ compensation contract hospital evaluation.Methods: The total number of 500 hospitals was selected to evaluate among about 5,500 contracts hospitals according to their size or the number of occupationally injured patients. The main evaluation items were hospital facilities and equipment, health personnel, including doctors, record keeping, appropriateness of hospital care, outcomes, including return-to-work, length of hospital stay, satisfaction, etc. Multiple logistic regression was performed to evaluate the appropriateness of the results of this hospital evaluation. The dependent variables were return-to-work rate and length of hospital stay and independent variables were severity of injured workers, disability rate, company size, etc.Results: The hospitals were classified three categories according to the evaluation score; high, middle, and low quality. The return-to-work rate of high-quality hospitals was significantly higher (odds ratio 1.81; CI 1.27 – 2.58) than others. However, the length of hospital stay was not different among them.Conclusion: Return-to-work rate is one of the useful indicators for evaluating the occupational health care. Even though these are preliminary results, this evaluation method for the occupational health care hospitals would be appropriate for the purpose. The more specific analysis should be needed.

scholarly journals Data linkage to build detailed return-to-work trajectories for work disability research

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Esther Maas ◽  
Wei Zhang ◽  
Mieke Koehoorn ◽  
Chris McLeod
Keyword(s):  
Health Services ◽  
Return To Work ◽  
Work Disability ◽  
Population Based ◽  
Economic Benefits ◽  
Injured Workers ◽  
Workers Compensation ◽  
Prescription Data ◽  
Cost Benefits ◽  
The Cost

IntroductionMusculoskeletal disorders (MSDs) are the most prevalent chronic condition in Canada, and account for the highest disability costs. Gradual-return-to-work (GRTW) can improve health and labour market outcomes in an aging workforce at risk of MSDs. Linked longitudinal data enables us to generate evidence of GRTW to inform policy needs. Objectives and ApproachThe objective of this study was to investigate the effectiveness and cost-benefits of GRTW for workers with a work-acquired MSD in British Columbia, Canada. We linked workers’ compensation data, health services data, and prescription data from three governing bodies to 1) identify injured workers with an accepted MSD lost-time injury between 2010 and 2015; 2) identify trajectories of RTW states (injury, sickness absence, GRTW, RTW, and non-RTW) and the probability of transitioning between states; and 3) assess the association between workers characteristics and RTW trajectories, and analyze the cost-benefits of GRTW. ResultsFinal results are expected early 2019. To our knowledge, this will be the first study linking workers’ compensation data (in particular detailed RTW data), health services data and prescription data from three different governing bodies for a comprehensive, population-based investigation of work disability experiences over a longitudinal time period and within the Canadian context. Also, using this data for the purpose of assessing the cost-benefits is new, and will help to prioritize prevention resources and strategies to limit the health and economic impact of work-related MSDs on employers, workers’ compensation boards and society. Conclusion/ImplicationsEvaluating the effects of GRTW on work disability is essential to maximize the health and economic benefits for injured workers. The innovation of this project is that is links three population-based databases to capture multiple indicators of health and work status to build RTW trajectories over time.

scholarly journals Medical Care Spending and Labor Market Outcomes: Evidence from Workers’ Compensation Reforms

2018 ◽  
Vol 108 (10) ◽  
pp. 2995-3027 ◽  
Author(s):  
David Powell ◽  
Seth Seabury
Keyword(s):  
Medical Care ◽  
Injured Workers ◽  
Administrative Claims ◽  
Workers Compensation ◽  
Low Back ◽  
Post Injury ◽  
Market Outcomes ◽  
Back Injuries ◽  
Low Back Injuries ◽  
Labor Outcomes

Medical care represents an important component of workers’ compensation benefits with the potential to improve health and post-injury labor outcomes, but little is known about the relationship between medical care spending and the labor outcomes of injured workers. We exploit the 2003–2004 California workers’ compensation reforms which reduced medical spending disproportionately for workers incurring low back injuries. We link administrative claims data to earnings records for injured workers and their uninjured coworkers. We find that workers with low back injuries experienced a 7.6 percent post-reform decline in medical care, and an 8.1 percent drop in post-injury earnings relative to other injured workers. (JEL I11, I12, I13, J24, J28, J31)

Injured workers and their return to work

2016 ◽  
Vol 4 (1) ◽  
pp. 2-29 ◽  
Author(s):  
Monica Galizzi ◽  
Roberto Leombruni ◽  
Lia Pacelli ◽  
Antonella Bena
Keyword(s):  
Return To Work ◽  
Job Security ◽  
Injured Workers ◽  
Reduced Form ◽  
Institutional Setting ◽  
Workers Compensation ◽  
High Wage ◽  
Data Set ◽  
Content Type ◽  
Ex Post

Purpose – The purpose of this paper is to study the factors affecting the return to work (RTW) of injured workers in an institutional setting where workers’ earnings are fully compensated during the disability period. Design/methodology/approach – The authors use a unique data set matching employer-employee panel data with Italian workers’ compensation records. The authors estimate survival models accounting for workers’ unobserved heterogeneity. Findings – Workers with higher wage growth, higher relative wages and from firms with better histories of stable employment, RTW sooner. More vulnerable workers – immigrants, females, members of smaller firms – also tend to return sooner. But even when we control for such measures of commitment, status, and job security, high-wage workers RTW sooner. Research limitations/implications – The authors use proxies as measures of commitment and status. The authors study blue-collar workers without finer job qualifications. The authors estimate a reduced form model. Practical implications – In an institutional environment where the immediate cost of workers’ compensation benefits falls largely on firms, employers seem to pressure those workers whose time off is more costly, i.e., high-wage workers. The lack of evidence of ex post moral hazard behavior also demands for a better understanding of the relationship between benefits and RTW. Social implications – Workers who are induced to RTW before full recovery jeopardize their long- term health and employability. Firms that put such pressure on employees might generate social costs that can be particularity high in the case of high productivity workers. Originality/value – The paper offers the first quantitative analysis of an institutional setting where injured workers face 100 percent benefits replacement rate and have job security. This allows focus on other workers’ or employers’ reasons to speed RTW. It is one of very few economics studies on this topic in the European context, providing implications for human resource managers, state regulators, and unions.

scholarly journals Return to work rate rises in the Sunshine State (Queensland, Australia)

2014 ◽  
Vol 9 ◽  
Author(s):  
Sharon Stratford
Keyword(s):  
Return To Work ◽  
Work Rate ◽  
Injured Workers ◽  
Work Outcomes ◽  
Workers Compensation ◽  
Annual Survey ◽  
Work Outcome ◽  
State Records

Measuring return to work outcomes after injury is in itself a challenge for most workers’ compensation schemes. Increasing return to work rates is even more difficult. In Australia, the national return to work measure obtained via an annual survey of injured workers has not risen since its introduction in 1997/98. However, unlike most other Australian jurisdictions, Queensland, Australia's ‘sunshine state’, records return to work outcomes at the end of every time lost claim. More than this, Queensland has increased its overall return to work outcome in recent years from 90% to over 95%. A number of specific strategies were introduced to improve these return to work results. The presentation will outline these strategies which other jurisdictions and countries can hopefully learn from. In addition, WorkCover Queensland, the state's monopoly insurer outside self-insurers, has introduced further return to work measures it successfully uses both internally and externally.

Sign in / Sign up

Export Citation Format

Share Document