Austin, TX – The Texas Department of Insurance’s Workers’ Compensation Research and Evaluation Group (REG) recently released a new report that sought to investigate how common multiple injury claims are in the Texas workers’ compensation system, to estimate reinjury rates by demographic and injury characteristics, and to examine risk factors of multiple injury by comparing injured employees of single injury with those of multiple injuries.
Key findings from the report included:
- About 40 percent of new claims in each year were claims by those individuals who had at least one previous injury and claim. Among the new claims without a past injury, about 30 percent of them would have a second injury in 10 years.
- Considering all available medical and claims data from 1998 to 2017, 53 percent of all claims and 51 percent of medical costs were associated with multiple injuries.
- The reinjury rate was significantly higher for those in public administration and health care industries. The reinjury rate was also notably higher among medical-only claims, and those with shoulder injury.
- The injury rate was slightly higher among males, younger employees, and pre-formulary claims.
- Medical and income benefit costs associated with the first injury of multiple injury cases were significantly lower than the similar costs of single injury employees.
- However, sum costs of first and second injuries for multiple injury employees were significantly higher than those of the single injury cases.
- After the pharmacy closed formulary, the usage of status “N” drugs decreased significantly among both single injury and multiple injury claims.
- Comparing first injuries, utilization of central nervous systems (CNS) drugs and opioids was slightly higher among single injury claims than multiple injury claims, in part because single injury claims were more likely to have severe injuries. Utilization of NSAIDs and musculoskeletal drugs was higher among multiple injury claims.
- Total morphine milligram equivalent (MME) dosage of opioids was higher among single injury claims than multiple injury claims. While average daily doses were similar in both claim groups, single injury claims received opioids for a longer period. The percentage of high dosage (90+ MMEs) prescriptions was about the same for both claim groups. This opioid utilization pattern appears to be affected mostly by the fact that the single injury group had a higher share of more severe, lost time claims than the multiple injury group.
- Logistic regression analyses showed that odds of having a second injury was higher for male gender, younger age, shoulder injury type, and pre-formulary claims.
- Employees working in the Public Administration industry sector had 2.13 times greater odds of reporting a second injury than those in all other industries.
The REG concluded by noting that currently available data showed that multiple injuries are quite common and costly, that many injured employees suffer from repeated injuries, and that further research should assess whether and how repeated injuries could be reduced. Evaluating the cause and effect and the exact process by which some factors affect reinjury would also require more detailed studies with improved data, as current claim-centered data is extensive in medical costs, but data on income benefits and disability duration is often incomplete. In addition, the REG noted that employee data regarding demographic, employer, and industry characteristics are partial and limited, so results in the report should be viewed within the data limitations.
To view the full report, click here: TDI Workers’ Comp REG: Injured Employees with Multiple Injuries and Claims in the Texas Workers’ Compensation System (PDF)