The correlation between health insurance and work comp claims.

Thursday, November 15, 2007 | 0

By Joe Paduda

I have long assumed individuals working at employers that do not offer health insurance are more likely to file workers comp claims. With the number of employers offering health insurance declining, a logical corollary is more claims will be filed.

Logical, but wrong.

The Rand Corp. published a study way back in early 2005 that examined the relationship between employer-based health insurance and workers comp claims frequency.

It turns out that my assumption is not only wrong, it is backwards - frequency is actually lower at employers that do not provide/offer health insurance.

In fact, among the factors that lead injured workers to file claims, whether or not their employer offers health insurance is the single most important factor. It is even more significant than that worker's health insurance coverage status (if that individual worker has health insurance is less significant than if their employer offers health insurance).

The Rand study is long and rather dense, but should be required reading for anyone puzzled by the decline in frequency. For among its other conclusions is this statement:

"Workers' compensation provides insurance against job-related injuries, but as many as half of injured workers choose not to file."

What does this mean for you?

The oft-cited decline in frequency likely way understates the actual rate of workplace injuries.

But here's the bold-type headline. If health reform does come and includes universal coverage, the frequency rate may well dramatically increase.

Joe Paduda is principal and founder of Health Strategy Associates. His weblog, managedcarematters.com, covers managed care for group health, workers compensation and auto insurance, covering health care cost containment, health policy, health research, and medical news for insurers, employers, and healthcare providers.