Do differences in work disability duration by interjurisdictional claim status vary by industry and jurisdictional context?

2021 ◽  
pp. oemed-2020-106917
Author(s):  
Robert A Macpherson ◽  
Mieke Koehoorn ◽  
Barbara Neis ◽  
Christopher B McLeod
Keyword(s):  
Work Disability ◽  
Oil And Gas ◽  
Healthcare Providers ◽  
Workers Compensation ◽  
Exact Matching ◽  
Work Related ◽  
Compensation Systems ◽  
Long Duration ◽  
Time Work ◽  
Resource Economy

ObjectivesTo examine whether differences in work disability duration between out-of-province and within-province workers differed by industry and jurisdictional context.MethodsWorkers’ compensation data were used to identify comparable lost time, work-related injury and musculoskeletal disorder claims accepted in six Canadian jurisdictions between 2006 and 2015. Out-of-province workers were identified as workers who filed claims in a different provincial jurisdiction to their province of residence. Coarsened exact matching was used to match out-of-province workers with within-province workers based on observable characteristics. Quantile regression models were used to estimate differences in cumulative disability days paid between out-of-province workers and within-province workers at different percentiles in the disability distribution, adjusting for confounders.ResultsCompared with within-province workers, out-of-province workers were paid more disability days even after matching and adjusting on observable characteristics. Differences between the two groups of workers were observed for short-duration, medium-duration and long-duration claims (differences of 1.57, 6.39, 21.42, 46.43 days at the 25th, 50th, 75th and 90th percentiles, respectively). Industry-specific models showed that differences were largest in construction, transportation and warehousing, and mining, quarrying and oil and gas extraction. Jurisdiction-specific models showed that differences were largest in the western provinces where out-of-province workers were concentrated in those sectors.ConclusionsOut-of-province workers are a vulnerable group with respect to risk of longer work disability duration. Workers’ compensation systems, employers and healthcare providers may need to tailor specific interventions for these types of workers, particularly those employed in resource economy-dependent regions that are far from their regions of residence.

scholarly journals Collider bias in administrative workers’ compensation claims data: A challenge for cross-jurisdictional research

2021 ◽  
Author(s):  
Tyler J Lane
Keyword(s):  
Work Disability ◽  
Claims Data ◽  
Occupational Injuries ◽  
Simulated Data ◽  
Workers Compensation ◽  
Compensation Systems ◽  
Compensation Claims ◽  
Analytical Approaches ◽  
Collider Bias ◽  
State Territory

Abstract Purpose Workers’ compensation claims consist of occupational injuries severe enough to meet a compensability threshold. Theoretically, systems with higher thresholds should have fewer claims but greater average severity. For research that relies on claims data, particularly cross-jurisdictional comparisons of compensation systems, this results in collider bias that can lead to spurious associations and confound analyses. In this study, I use real and simulated claims data to demonstrate collider bias and problems with methods used to account for it. Methods Using Australian claims data, I used a linear regression to test the association between claim rate and mean disability durations across Statistical Areas. Analyses were repeated with nesting by state/territory to account for variations in compensability thresholds across compensation systems. Both analyses are repeated on left-censored data. Simulated claims data are analysed with Cox survival analyses to illustrate how left-censoring can reverse effects.Results The claim rate within a Statistical Area was inversely associated with disability duration. However, this reversed when Statistical Areas were nested by state/territory. Left-censoring resulted in an attenuation of the unnested association to non-significance, while the nested association remained significantly positive. Cox regressions on simulated data showed left-censoring can also reverse effects. Conclusions Collider bias can seriously confound work disability research, particularly cross-jurisdictional comparisons. Work disability researchers must grapple with this challenge by using appropriate study designs and analytical approaches, and considering how collider bias affects interpretation of results.

Cumulative Injury or Disease Claims: An Attempt to Define Employers’ Liability for Workers’ Compensation

1980 ◽  
Vol 6 (1) ◽  
pp. 1-28
Author(s):  
Joseph LaDou ◽  
Lawrence E. Mulryan ◽  
Kevin J. McCarthy
Keyword(s):  
Occupational Stress ◽  
Financial Burden ◽  
Causal Link ◽  
Direct Result ◽  
Workers Compensation ◽  
Work Related ◽  
Compensation Systems ◽  
Stress Injuries ◽  
The Cost ◽  
All Diseases

AbstractThe workers’ compensation systems of several states have been expanded in recent years to include injuries and diseases caused by cumulative injury and occupational stress. This expansion has placed a financial burden on the respective systems, on employers, and on consumers, who ultimately must pay the cost of claims through higher priced products or services. This expansion may not be justified from a social perspective, however; extant medical and sociological evidence is not conclusive as to whether occupational-stress injuries or diseases—such as coronary heart disease, hypertension, stroke, and neuropsychiatric illness—are the direct result of stressful work environments. Using the California workers” compensation system as a model, the authors submit that the underlying premises of liability governing the expanded systems should be reassessed based (1) on economic factors, specifically, the increasing costs of workers’ compensation; (2) on the capacity of the system to process an ever-increasing number of claims; and (3) on the principle on which workers’ compensation systems were established, that of equity between the employer and the employee.On the basis of these three factors, the authors evaluate three legislative approaches to restructuring the expanded system: presumption of compensability, apportionment of liability, and threshold of compensability. The first recognizes that although certain health problems are related to the workplace, the degree of causation is difficult to prove; under this approach, therefore, causation is presumed, and injury compensated, for all diseases and injuries that the system defines as work-related. The second holds that where a causal relationship between the work and the injury can be proved, the employer nevertheless should be responsible only for that portion of the disability actually caused by the workplace. The third directs that the injured employee be compensated only when a direct causal link between the job and the injury or disease can be proved. The authors recommend that legislators implement this third alternative. For one reason, it is feasible economically; for a second, it would not burden the system or increase litigation; for a third, it is equitable to both employees and employers.

scholarly journals O2C.2 Does region of residence matter for return-to-work after work-related injury? A comparative analysis of six canadian workers’ compensation jurisdictions

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A16.1-A16
Author(s):  
Robert Macpherson ◽  
Hui Shen ◽  
Mieke Koehoorn ◽  
Benjamin Amick ◽  
Alex Collie ◽  
...  
Keyword(s):  
Return To Work ◽  
Rural Areas ◽  
Urban Areas ◽  
Work Disability ◽  
Injured Workers ◽  
Workers Compensation ◽  
Disability Benefits ◽  
Work Related ◽  
Work Related Injury ◽  
Urban Rural

ObjectivesTo investigate regional differences in return-to-work following work-related injury and whether these differences persist after adjusting for individual characteristics.MethodsWorkers’ compensation claims from six Canadian provinces were used to create comparable cohorts of workers aged 15–80 with a work-related injury resulting in at least one disability day from 2011 to 2015. Workers’ residential postal codes were mapped to Census standard geographic units to categorize workers into six regions representing decreasing urban density and metropolitan influence (ranging from large urban areas of 100,000+people to rural areas of <10 000 people with no metropolitan influence). Cox regression models were used to estimate the effect of urban-rural residence on the likelihood of injured workers transitioning off work disability benefits within one-year post-injury, adjusting for confounders, including provincial compensation jurisdiction. Models were stratified by industry sectors.ResultsThe cohort included 7 46 029 work disability claims, of which the majority resided in large urban areas (69%). Unadjusted models showed that workers residing in smaller urban and rural areas had a lower likelihood of transitioning off work disability benefits compared to those in large urban areas. Urban-rural differences persisted in adjusted models (e.g. HR=0.91 95% CI 0.89, 0.94 for workers in rural areas with no metropolitan influence). Industry-stratified models showed that greater differences existed between urban and rural places of residence for workers in the transportation and construction sectors, and smaller differences for workers in the health care and manufacturing sectors.ConclusionsThe main finding suggests that injured workers in more rural areas face barriers in returning to work and that workers’ compensation resources may need to be allocated to address these regional disparities. Future research will incorporate both individual and regional-level variables in a multilevel model framework to identify the characteristics that are the most important in explaining variability in work disability duration.

The Role of Healthcare Providers in Return to Work

2018 ◽  
Vol 13 ◽  
Author(s):  
Agnieszka Kosny ◽  
Marni Lifshen ◽  
Basak Yanar ◽  
Sabrina Tonima ◽  
Ellen MacEachen ◽  
...  
Keyword(s):  
Return To Work ◽  
Healthcare Providers ◽  
Case Managers ◽  
Compensation System ◽  
Workers Compensation ◽  
Role Clarity ◽  
Compensation Systems ◽  
Inductive Constant ◽  
Meaningful Engagement

International research has generated strong evidence that healthcare providers (HCPs) play a key role in the return to work (RTW) process. However, pressure on consultation time, administrative challenges and limited knowledge about a patient's workplace can thwart meaningful engagement. Aim: Our study sought to understand how HCPs interact with workers compensation boards (WCBs), manage the treatment of workers compensation patients and navigate the RTW process. Method: The study involved in-depth interviews with 97 HCPs in British Columbia, Manitoba, Ontario and Newfoundland and Labrador and interviews with 34 case managers (CMs). An inductive, constant comparative analysis was employed to develop key themes. Findings: Most HCPs did not encounter significant problems with the workers compensation system or the RTW process when they treated patients who had visible, acute, physical injuries, but faced challenges when they encountered patients with multiple injuries, gradual-onset or complex illnesses, chronic pain and mental health conditions. In these circumstances, many experienced the workers compensation system as opaque and confusing. A number of systemic, process and administrative hurdles, disagreements about medical decisions and lack of role clarity impeded the meaningful engagement of HCPs in RTW. In turn, this has resulted in challenges for injured workers (IWs), as well as inefficiencies in the workers compensation system. Conclusion: This study raises questions about the appropriate role of HCPs in the RTW process. We offer suggestions about practices and policies that can clarify the role of HCPs and make workers compensation systems easier to navigate for all stakeholders.

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

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.

Use of the AMA Guides in State Workers' Compensation Systems: 2009 Update

2009 ◽  
Vol 14 (2) ◽  
pp. 13-16
Author(s):  
Christopher R. Brigham ◽  
Jenny Walker
Keyword(s):  
New York ◽  
North Carolina ◽  
South Carolina ◽  
South Dakota ◽  
Rhode Island ◽  
Workers Compensation ◽  
Fourth Edition ◽  
Sixth Edition ◽  
Specific Guideline ◽  
Compensation Systems

Abstract The AMAGuides to the Evaluation of Permanent Impairment (AMA Guides) is the most widely used basis for determining impairment and is used in state workers’ compensation systems, federal systems, automobile casualty, and personal injury, as well as by the majority of state workers’ compensation jurisdictions. Two tables summarize the edition of the AMA Guides used and provide information by state. The fifth edition (2000) is the most commonly used edition: California, Delaware, Georgia, Hawaii, Kentucky, New Hampshire, Idaho, Indiana, Iowa, Kentucky, Massachusetts, Nevada, North Dakota, Ohio, Vermont, and Washington. Eleven states use the sixth edition (2007): Alaska, Arizona, Louisiana, Mississippi, Montana, New Mexico, Oklahoma, Pennsylvania, Rhode Island, Tennessee, and Wyoming. Eight states still commonly make use of the fourth edition (1993): Alabama, Arkansas, Kansas, Maine, Maryland, South Dakota, Texas, and West Virginia. Two states use the Third Edition, Revised (1990): Colorado and Oregon. Connecticut does not stipulate which edition of the AMA Guides to use. Six states use their own state specific guidelines (Florida, Illinois, Minnesota, New York, North Carolina, and Wisconsin), and six states do not specify a specific guideline (Michigan, Missouri, Nebraska, New Jersey, South Carolina, and Virginia). Statutes may or may not specify which edition of the AMA Guides to use. Some states use their own guidelines for specific problems and use the Guides for other issues.

Impairment Tutorial: Rating Facial Disfigurement After an Injury

1998 ◽  
Vol 3 (4) ◽  
pp. 6-6
Author(s):  
Marc T. Taylor
Keyword(s):  
Current Work ◽  
Workers Compensation ◽  
Loss Of Function ◽  
Facial Disfigurement ◽  
Work Related ◽  
Work Related Injury ◽  
Compensation Claim ◽  
Impairment Ratings

Abstract This article discusses two important cases that involve the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). First, in Vargas v Industrial Com’n of Arizona, a claimant had a pre-existing non–work-related injury to his right knee as well as a work-related injury, and the issue was apportionment of the pre-existing injury. The court held that, under Arizona's statute, the impairment from the pre-existing injury should be subtracted from the current work-related impairment. In the second case, Colorado courts addressed the issue of apportionment in a workers’ compensation claim in which the pre-existing injury was asymptomatic at the time of the work-related injury (Askey v Industrial Claim Appeals Office). In this case, the court held that the worker's benefits should not be reduced to account for an asymptomatic pre-existing condition that could not be rated accurately using the AMA Guides. The AMA Guides bases impairment ratings on anatomic or physiologic loss of function, and if an examinee presents with two or more sequential injuries and calculable impairments, the AMA Guides can be used to apportion between pre-existing and subsequent impairments. Courts often use the AMA Guides to decide statutorily determined benefits and are subject to interpretation by courts and administrative bodies whose interpretations may vary from state to state.

Women's healthcare providers: Work factors, personality, and stress

2019 ◽  
Vol 47 (7) ◽  
pp. 1-11
Author(s):  
Victoria A. Farrow ◽  
Anthony Ahrens ◽  
Kathleen C. Gunthert ◽  
Jay Schulkin
Keyword(s):  
Cultural Differences ◽  
Perceived Stress ◽  
Healthcare Providers ◽  
Descriptive Statistics ◽  
Related Factors ◽  
Work Related ◽  
Work Factors ◽  
Physician Stress ◽  
Linear Regressions

We assessed neuroticism, perceived stress, and work-related factors among obstetrician-gynecologists (ob-gyns), and examined the relationships between these variables. Surveys were sent to 500 physician members of the American College of Obstetricians and Gynecologists and we received 287 (57.4%) completed responses. Analyses included descriptive statistics and linear regressions. Ob-gyns reported high levels of perceived stress. After controlling for neuroticism, variables that significantly predicted stress levels included average hours worked, perception of working too many hours, colleague support for work–home balance, isolation due to gender/cultural differences, and perception of workplace control. Because these work-related factors are linked to stress even when controlling for neuroticism, administrators and physicians may consider whether any of these factors are modifiable to mitigate physician stress. This in turn may affect physicians' own health and the quality of care patients receive.

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