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Digital EditionWCRI Update: No Delay in Workers’ Comp Medical Treatment During Height of Pandemic
A new study from the Workers Compensation Research Institute, entitled “The Early Impact of COVID-19 on Medical Treatment for Workers Compensation Non-COVID-19 Claims,” has found almost no delays in treatment during the first two quarters of the pandemic.
The report sought to “investigate patterns of medical care access and utilization that are specific to workers’ compensation during the first quarters of 2020.”
Chief among the report’s major findings, is that “claims with injury dates in the first two quarters of 2020 did not experience any noticeable delay in medical treatment as compared with the waiting time for claims with injuries in the first two quarters of 2019.”
In fact, the study found slightly shorter waiting times for several service types in treatment of lost time claims with injuries, including emergency room services, physical medicine, major surgery, and neurological/neuromuscular testing, as well as shorter waiting times from injury to emergency care services for lost time claims with injury dates in 2020 Q1 relative to 2019 Q1 claims.
“The main takeaway of this report is that workers sustaining injuries in the first two quarters of 2020 [did] not experience any noticeable delays in medical treatment as compared to the first two quarters of 2019,” said study author Dr. Olesya Fomenko.
Dr. Olesya Fomenko, economist, WCRI
Fomenko added, “Our key findings are potentially surprising, given that over the timeframe of our study, the decline in medical care used by the general public was substantial and universal.”
The report cites other studies showing that by the end of the second quarter of 2020, approximately 41% of U.S. adults had delayed or avoided emergency and routine care.
“Several recent studies uncovered during the first half of 2020 evidence of substantial delays, avoidance or reduction of medical care among individuals with group insurance,” said Fomenko.
“It is therefore likely that the general public expected to see similar trends for workers’ compensation patients.”
Reasons for a Lack of Delays
One possible cause for the lack of delays was a reduction in volume of claims.
“In a previous WCRI report, we show that the volume of non-COVID-19 workers’ compensation claims decreased substantially in the second quarter of 2020,” Fomenko said.
“The majority of states experienced a decrease of at least 30%, and as much as 50% in Massachusetts. Factors including a sharp reduction in employment, a substantial shift to remote work, and the decision not to seek care for less severe injuries, most likely decreased injury rates and claiming behaviors, and thus the overall demand for health care services of non-COVID-19 workers’ compensation patients.”
While it was outside the scope of the report, Fomenko also pointed out that, “On the other hand, stay-at-home orders could have led to increases in waiting times.”
Other possible factors include a reduction in demand from non-workers’ comp health care consumers, as well.
The report states that, “During the first half of 2020, delays and avoidance of medical care were common among the general public, as noted by a CDC study — by June 30, 2020, an estimated 41% of U.S. adults had delayed or avoided medical care, including urgent or emergency care (12%) and routine care (32%), because of concerns about COVID-19.
“Also, and the first months of the pandemic, with the adoption of stay-at-home orders, visits to doctor offices decreased by 70 to 80% … In the first months of the pandemic, the decreases in medical services used by the general public were substantial and universal.”
Such reluctance may have caused workers’ comp patients with less serious injuries to defer treatment, so that, of those who did seek treatment, a disproportionate number had injuries that were more serious and more urgent.
“In our previous study on the early impact of COVID-19 on the composition of workers’ compensation claims, we reported an increase in the share of lost-time claims among non-COVID-19 claims,” Fomenko said.
“This could be indicative of patients who on average have a higher severity and a more urgent need for medical treatment.”
What Injuries Were Most Common?
The study does point out, however, that the types of injuries remained consistent across 10 categories: fractures, hand lacerations, inflammation, knee derangements, lacerations and contusions, neurological pain, spine sprain/strains, other sprain/strains, skin, and other.
“Even though the pandemic had a sizable effect on the volume of WC non-COVID-19 claims for most study states, the injury composition remains largely not impacted by the outbreak,” the study said.
The study found similar stability in the types of services being utilized by workers’ comp patients.
“For lost time claims with injury dates in the first two quarters of 2020, the share of claims with eight types of services remained largely stable as compared with the patterns of care for the first two quarters of 2019.”
The services examined were: “evaluation and management, emergency care, physical medicine, neurological and neuromuscular testing, pain management injections, major surgery, major radiology, and minor radiology.”
Exceptions to this include a 4% drop in the share of claims with emergency room services, which the report noted “is consistent with the expectation that people would want to avoid going to the emergency room because of fear of virus contraction.”
In the first quarter of 2020 compared to the first quarter of 2019, there was also a 3% decrease in claims with major surgery, and 2% decreases in both claims with pain management and claims with major radiology.
The study also looked at the number of visits to medical providers by workers’ comp patients.
“We also examined the impact of the pandemic on the number of unique visits for evaluation and management, physical medicine, and minor radiology — the only service types with non-negligible frequencies of multiple visits,” it said. “Across all analyzed subgroups of WC claims, we found no change in the average number of visits for these three types of services.”
The study examined 27 states, representing 68% of workers’ comp benefits paid in the U.S. Learn more about the study or download a copy here. &
