Medical Services for Claims 20 or More Years Old

Posted Date: January 21, 2013

Industry InformationResearch

It is likely that more than 10% of the cost of medical benefits for the workplace injuries that occur this year will be for services provided more than two decades into the future. That percentage has been growing and might continue to grow.

This study looks at workers compensation medical services provided beyond 20 years after the injury, with a view toward anticipating:

  • Which medical service categories will account for the largest shares of costs
  • Future treatment and utilization that will drive those costs

NCCI first looks at the demographics of claimants who are still being treated for job-related injuries that were suffered more than two decades ago. The focus then shifts from patients to their medical care, looking at medical costs by service and diagnosis categories. Some key findings concerning services provided from 20 to 30 years following the date of injury are as follows:

  • Patients are predominantly male, more so than can be explained by historical gender differences in the workforce
  • Deteriorating medical conditions of the more elderly claimants is not a main cost driver; indeed, claimants younger than age 60 cost more per year, per claimant, to treat than those older than age 60
  • Relative to services within the first 20 years after injury, care provided later has a significantly greater portion of cost going for prescription medications, supplies, home health services, and the maintenance of implants, orthotics, and prosthetics.