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Thursday, December 12, 2013

Wah, Wah, Wah

Occupational disease claims present difficulty in the delivery of medical care. Today's post was shared by WorkCompCentral and comes from

At least that's the message that I got out of the latest study from researchers at National Institute for Occupational Safety and Health in their study just published by the Journal of Occupational and Environmental Medicine.

According to them, accepted workers' compensation claims that do not result in medical payments could be costing group health insurers at least $212 million a year because folks who don't get their treatment through work comp for their work injuries or illnesses do so through their group health provider.

Claims that do not result in medical payments through work comp are referred to as "zero-cost claims" in the study.

The researchers' analysis of more than 12,000 claims from 2002 through 2005 revealed that 15.9% of the claims were zero-cost claims. Claimants with zero-cost claims were more likely to use group health insurance services and incur more group health costs.

"In the three months before an occupational injury, 53.9% of workers with positive-cost workers' compensation medical claims and 61.6% of workers with zero-cost workers' compensation medical claims used the outpatient group health insurance at least once," the study says. "Within three months after an occupational injury, group health insurance utilization for outpatient services increased to 61.2% and 74.1% for workers with positive- and zero-cost workers' compensation medical claims, respectively."

In addition, one of the study's most significant findings...
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