The Impact of Claimant Age on Late-Term Medical Costs

Posted Date: October 20, 2014

Industry InformationResearch

Recent NCCI research found that for workers compensation medical payments made between 20 and 30 years after an injury, the average annual payments for claimants younger than age 60 at the time of treatment are greater than the average annual payments for claimants older than age 60.

This study examines this difference by looking at the claims characteristics for injured workers in these age groups:

  • Number of medical services and overall average prices paid for medical services
  • Injury mix
  • Prescription drug use

For this study, late-term medical care consists of all medical services provided during 2011 and 2012, for claims that occurred 20 to 30 years ago.

Key Findings

  • The average annual late-term medical cost per claim generally decreases gradually with increasing claimant age.
  • The number of services per claim is a larger contributor to age-related annual late-term medical cost differences than is cost per service.
  • Average annual late-term medical costs per claim are about 60% higher for claimants born after 1950 than for older claimants. About 80% of this difference is explained by:
    • The mix of injuries being treated and, in particular, differences in the share of quadriplegic and paraplegic claims. This explains approximately 60% of the difference.
    • Use of prescription drugs and, in particular, differences in the use of narcotics. This explains approximately 20% of the difference.