Costs Growing for Late-Term Care from Workplace Injuries

A growing percentage of medical costs for workplace injuries is for services provided more than 20 years after an injury occurs, a new report says.

The study, “Medical Services for Claims 20 or More Years Old,” released by the National  Council on Compensation Insurance (NCCI), says, “It is likely that more than 10 percent of the cost of medical benefits for the workplace injuries that occur this year will be for services provided more than two decades into the future,” and adds that the percentage has been growing and may continue to grow. 

NCCI notes that drug treatments account for 38 percent of services provided from 20-30 years after an injury. That is a jump from 9 percent of services provided within 20 years of an injury. 

At the other end of the spectrum, surgery drops from 22 percent of services provided within 20 years of an injury to 7 percent of services provided from 20-30 years afterward.

NCCI says the types of drugs prescribed suggest that the focus of treatments shifts in late-term treatments to relieving pain rather than treating the loss of function. “Because drugs account for a large proportion of late-term-care costs, prescription data can suggest the nature of late-term care,” the report explains. 

It reports that OxyContin jumps from 6 percent of workers’ comp medication costs overall (as of 2009) to 11 percent for late-term care. Opioid chronic-pain medication prescriptions overall are “generally higher within late-term care than within all medication costs for 2009,” NCCI says, suggesting the shift in treatment focus.

As for the types of medical conditions typically treated 20 years after an injury, the report says disease cases and cases with complications from a medical procedure account for more than three-fourths of late-term payments. Treatments for traumatic conditions other than complications accounts for less than one-fifth of the cost of late-term care.

Patients under 60 account for more than half, 53 percent, of the cost of late-term care, NCCI says, even though such patients account for less than half, 48 percent, of late-term services used. “It follows that the average cost-per-service for a patient younger than age 60 was about 20 percent greater than for an older patient,” NCCI says.

Males dominate the late-term care landscape, accounting for 71 percent of such claimants. “This is much higher than the corresponding percentage for men in the workforce, which dropped from 57 percent in 1980 to 55 percent in 1990,” the study says.

For its study, NCCI used its new source of workers’ comp medical data: Medical Data Call (MDC). NCCI says, “The MDC captures transaction-level detail on the medical bills processed on or after July 1, 2010, including dates of service, charges, payments, procedure codes, and diagnoses codes.”

About the Author
Phil Gusman,

Phil Gusman,

Phil Gusman is Managing Editor of Prior to joining National Underwriter in 2008, he was Editor of Insurance Advocate. Gusman has also served as Associate Editor of Crackdown!, an insurance fraud publication, and Assistant Editor of Empire State Report, which covers New York politics. He graduated in 2002 from Plattsburgh State University in New York. Gusman may be reached at Follow him on Twitter: pgusman and PC360_Markets


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