The impact of workers’ compensation accidents and claims on employers can be profound. Employees’ health and well-being are at risk, as are the organization’s reputation and financial health.

During this week’s University Risk Management and Insurance Association (URMIA) Conference in Boston, we shared the highlights from PMA Companies’ 2019 Integrated Claims Study. We examined one of the most problematic trends in workers’ compensation: the impact of employee comorbidities, that is, pre-existing conditions, such as obesity, smoking, and diabetes on workers’ compensation claims results.

Research Findings

PMA’s study examined over 60,000 lost time workers’ compensation claims from over 1,900 accounts, screening for 14 comorbidities and nine psychosocial risk factors. The research revealed:

• 58% of lost time claims had one or more comorbidity risk factors
• 68% of lost time total incurred costs can be attributed to claims with comorbidities
• Average cost of lost time claims with comorbidities was 40% higher than those claims with no comorbidities
• Top five comorbidity risk factors significantly impacting lost time workers’ compensation claims (in descending order): Obesity, Hypertension, Smoking, Diabetes, Cholesterol

Three Action Steps

These findings underscore the need for employers to address comorbidity risks.

According to the National Institute for Occupational Safety & Health, the most effective programs and policies for preventing disease and promoting health & safety address both the work environment and an individual’s personal health risks.

With that in mind, we recommend three key actions steps to enhance your workforce’s health and well-being and decrease your workers’ compensation risks:

1. Conduct a formal needs assessment. Determine if your insurer/TPA collects workers’ compensation comorbidity data and is examining how pre-existing conditions contribute to claims frequency and severity.
   Based on that data, identify health and workers’ compensation issues impacting your organization, share the findings and collaborate on integrated education and initiatives for your institution.
2. Break down the silos between risk management and human resources to successfully integrate safety and employee wellness. Communication among teams is the key!
3. Find solutions that fit your organization, targeting both individual behaviors and worksite environment/practices. Environmental interventions could include establishing guidelines for healthy meetings, creating walking maps and allowing employees flex time to use them, holding challenges for wellness activities and nutrition.

PMA Companies is an industry leader of workers' compensation, casualty insurance, and TPA & Risk Services. Our expertise in workers’ compensation makes us uniquely positioned to help reduce your frequency and severity of claims, including indemnity and medical costs, outstanding reserves, and overall workers’ compensation budget—while providing access to appropriate medical care and improving return-to-work outcomes for injured workers.

For more information, contact your PMA Representative or email us at info@pmagroup.com.