Claims involving comorbidities are often associated with higher costs and increased duration, but the latest research from Harbor Health Systems undeniably demonstrates the impact comorbidities have on claims outcomes. Based on this research analyzing more than 7,000 workers’ compensation claims, claims associated with comorbid conditions experienced longer claims duration, higher medical costs, more temporary total disability (TTD) days and increased litigation and surgery rates. These findings were recently presented at the National Workers’ Compensation & Disability Conference (NWCDC), in New Orleans, Louisiana.
The research study evaluated the following seven comorbidities in claims with an injury date between January 1, 2011, and December 31, 2013: obesity, diabetes, hypertension, addiction, mental health, tobacco use and multiple comorbidities.
Impact by the numbers
When evaluating the overall impact of various comorbidities on workers’ compensation claims, the two that have the greatest impact are multiple comorbidities and obesity, followed by addiction, mental health and hypertension, with diabetes and tobacco having the lowest impact.
Links between comorbidities complicate risks
Relationships between comorbidities — such as the link between obesity and diabetes — can exacerbate complications and health risks. The age of the injured worker is another factor that is associated with comorbidities and can complicate the management of a claim.
Given these findings, the workers’ compensation industry needs a more comprehensive, system-wide approach to address the risk associated with comorbidities. Prescriptive solutions ranging from more complete intake data, to a system that incorporates comorbidities into the utilization review process, to factoring in comorbidities in the treatment process should be all be considered.
By keeping these comorbid conditions top of mind in claims management, workers’ compensation professionals can minimize risk while providing more appropriate care to injured workers.