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Member, Beacon International Group, Ltd.
Turns out that "zero-cost" workers compensation claims actually have some costs after all, and actually cost group health plans more than $200 million a year, according to a report published this month in the Journal of Occupational & Environmental Medicine.
A study by the National Institute for Occupational Safety and Health found that claims with no workers comp-related medical expenses often result in medical costs being paid by Medicare, Medicaid and group health insurers. This is partly because injured workers are reluctant to file workers comp claims "because of fear of disciplinary action, stigmatization, harassment, or denial of other benefits," the report said.
In a review of more than 12,000 workers comp claims between 2002 and 2005, NIOSH found that workers comp claimants with zero-cost claims were 20.3% more likely to use their group health insurance for outpatient medical services and 400% more likely to use group health plans for inpatient services within three months after a work injury.
That increase is estimated to add $212 million in medical bills to the group health system each year, NIOSH said.
"This is likely an underestimate if we assume that the Bureau of Labor Statistics system undercounts the number of nonfatal occupational injuries," the report reads.
The NIOSH report echoes another study published last year in the Journal of Occupational & Environmental Medicine. Researchers at the University of California found that nearly 80% of direct and indirect costs that could be covered by workers comp are being paid by private health plans, government insurance programs or from workers' own pockets.
You can read the full report online here.