Virus-related delays lead to expensive soft-tissue claims

The pandemic negatively affected both medical costs and indemnity for workers with soft tissue injuries, according to a study released Thursday by the Workers Compensation Insurance Rating Bureau of California.

Researchers from Oakland, California-based WCIRB analyzed indemnity claims for work-related injuries between 2013 and 2017, looking at categories of soft tissue claims, low back pain, dislocation and sprain, fracture and minor wounds.

The study revealed that workers with soft-tissue injuries had higher medical costs, and that their claims were more likely to stay open longer, have longer duration of disability and permanent disability.

When the shutdown occurred, year-over-year medical payments per claim and medical services per claim in the state declined significantly, with medical payments dropping 6% between March 15 and March 31 and 18% in April compared with the same time period the previous year, before beginning to rebound in June. Medical services dropped 7% during the same March timeframe and 10% in April before rising again in June.

The researchers found that workers with soft tissues injuries during the pandemic who had delays in their first medical service had medical costs as much as 32% higher at 54 months after policy inception than those who received prompt care during non-pandemic periods.

Indemnity benefits also rose as much as 28% for workers with soft tissue injuries who had delayed medical service versus those who had early care, and they were also more likely to receive permanent disability payments, with those 71% of those claims from workers who received late treatment to involve permanent disability compared with 58% of those who were treated early.

This article was first published by Business Insurance.

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