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The Costs of Occupational Injuries to Workers and their Families

The Costs of Occupational Injuries to Workers and their Families. Presentation to: New York State Workers’ Compensation Board September 16, 2008 Les Boden Boston University School of Public Health.

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The Costs of Occupational Injuries to Workers and their Families

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  1. The Costs of Occupational Injuriesto Workers and their Families Presentation to: New York State Workers’ Compensation Board September 16, 2008 Les Boden Boston University School of Public Health Research supported by the National Institute for Occupational Safety and Health, the California Commission on Health, Safety, and Workers’ Compensation, and the State of New Mexico

  2. Workplace Injuries & Illnesses: An Important Pathway to Disability Share of the disabled reporting that disability was caused by work 49% 50% 40% 36% 30% 24% 21% 20% 10% 0% White Men White Women Black Men Black Women Source: Health & Retirement Survey Wave I, Reville and Schoeni (2001)

  3. Lost Earnings 7000 6000 Lost earnings 5000 4000 Earnings/quarter$ Earnings 3000 2000 Earnings 1000 0 Injured Uninjured Uninjured Earnings = $6000 Injured Earnings = $4000 Lost earnings = $2000

  4. Lost Earnings: Temporary Disability Uninjured Injured Wages Time Return Injury to Work

  5. Lost Earnings: Permanent Disability Uninjured Injured Wages Time Return Injury to Work

  6. PD Workers’ Wages Drop After Injury 8000 Comparison Workers 6000 Losses Wages/quarter 1997 $ PDWorkers 4000 2000 0 -4 -3 -2 -1 0 1 2 3 4 Years from injury - 1994 California PPD cases

  7. Relative Earnings: Workers with PPD / Controls

  8. Losses Continue for Many Years Years from injury – 1992-3 Oregon PPD cases

  9. Losses Continue for Many Years Years from injury – 1990 Wisconsin PPD cases

  10. Losses are Between $44,000 and $75,000 Ten-year earnings losses: PD cases 70,000 60,000 50,000 2007 $ 40,000 30,000 20,000 10,000 0 NM WA CA WI OR

  11. Benefits are Much Less than Losses Ten-year earnings losses: PD cases 70,000 60,000 50,000 2007 $ 40,000 Lifetime cash benefits 30,000 20,000 10,000 0 CA NM WA WI OR

  12. Causes of Lost Earnings Impairment does not equalDisability Source: Robert E. Bonner, MD, 5/20/08

  13. Zero % Impairment

  14. 100 % Impairment

  15. Causes of Lost Earnings Poor health reduces productivity: • Makes workers less attractive to employ • Makes employers less willing to offer jobs • Causes employers offer lower wages Time off work recovering can lead to: • Depreciation of work skills and knowledge • Missed wage increases • Loss of at-injury job • Reduced attractiveness to future employers

  16. Losses in Long TTD Cases Persist

  17. Losses in Long TTD Cases Persist

  18. Lost Earnings and Replacement 7000 6000 Uncompensated lost earnings Lost earnings 5000 Benefits 4000 Earnings/quarter$ Earnings 3000 2000 Earnings Earnings 1000 0 Uninjured Injured Replacement Uninjured Earnings = $6000 Injured Earnings = $4000 Lost earnings = $2000 Proportional Lost Earnings = 1/3 Replacement Rate = 2/5

  19. Adequacystandard Replacement Rate Varies from 32-41% 70 60 50 Percent of 10-year losses 40 30 20 10 0 CA NM WA WI OR

  20. CA: AMA Guides Reduced Ratings by 40% Source: Neuhauser 2007

  21. AMA Guides Increased Zero Ratings Source: Brigham, 2005

  22. CA: AMA Guides Cut PPD Benefits in Half Source: Neuhauser 2007

  23. Personal and Family Problems Reported as Caused by CTS Source: Keogh et al. 2000

  24. Personal Costs of Upper Extremity MSD: Connecticut Source: Morse et al. 1998

  25. Source: Strunin & Boden (2000)

  26. Caregiving Hours Before MSD Onset 35 28.6 30 25 17.6 20 Hours per week 15 10 5 0 Men Women Source: Franche et al. 2006

  27. Caregiving Hours After MSD Onset 35 30 -29% 25 20 Hours per week 20.4 -17% 15 14.6 10 5 0 Men Women Source: Franche et al. 2006

  28. Workers’ Compensation: Often Part of the ProblemNot Part of the Solution Source: Fang et al. 2007

  29. Workers’ Compensation: Demeaning Experience • “When you first go into the doctor for the very first time…you’re automatically lying. I mean, they don’t even look at you to see if you’re lying or not. You’re automatically lying because people on Workers’ Comp lie.” (Florida) • “They, they treat you like you're not human. That's about the best way I can put it.” (Wisconsin) Source: Strunin & Boden (2004)

  30. Additional Issues: WC Information System

  31. Underreporting Estimates: 7 States

  32. CA: Delayed Reporting • 2003 claims, in WCIS on 3/15/06 • New data run on 4/22/08 • 43,000+ new cases reported in the 2 years after 3/15/06

  33. CA: Very Few Payment Reports (2003 AY)

  34. CA: EIN Reporting Very Inaccurate • Many missing or invalid EINs in CA WC data system • 38% in 2003 • Many potential uses of the WCIS may require identifying the employer

  35. Woman Welding Dorothea Lange

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