The cost of 1989 workers' compensation low back pain claims

Spine (Phila Pa 1976). 1994 May 15;19(10):1111-5; discussion 1116. doi: 10.1097/00007632-199405001-00001.

Abstract

Study design: Cost data were gathered from computerized records of the Liberty Mutual Insurance Company for low back pain workers' compensation claims (N = 119,107) and for all claims (N = 731,087) initiated from 45 jurisdictions (states) during 1989.

Objective: This study provided more current, accurate, and additional information to estimate the costs and incidence associated with compensable low back pain compared with all compensation claims.

Methods: The first group of data included all compensable low back claims selected by specific codes: body part codes consisted of low back area, sacrum and coccyx, disc, and multiple trunk; injury codes consisted of strain, sprain, inflammation, rupture, hernia, fracture, and contusion. The second sample included all compensable claims, including both occupational injuries and illnesses.

Results: Low back pain cases represented 16% of all claims but 33% of all claims costs; 55.4% of the low back pain cases received medical payments only (i.e., did not receive indemnity payments for lost time). The mean cost per case for low back pain was $8321; median cost per case was $396. Medical costs represented 32.4% of the total costs; indemnity costs (i.e., payment for lost time) represented 65.8%.

Conclusions: Since indemnity costs represent the greatest percentage of workers' compensation expenditure, the primary goal of low back pain management should be the prevention or reduction of prolonged disability.

MeSH terms

  • Costs and Cost Analysis
  • Humans
  • Insurance Claim Review
  • Low Back Pain / economics*
  • Low Back Pain / epidemiology
  • United States / epidemiology
  • Workers' Compensation / economics*
  • Workers' Compensation / statistics & numerical data