‘Zero Cost’ Workers’ Compensation Claims Aren’t Zero Cost

According to Claims Journal, employee insurances pick up the cost for most work-related compensation injuries.

Nationwide, “zero-cost” workers comp claims are costing group health insurance plans more than $200 million per year, according to the study by Abay Asfaw, PhD and colleagues of the National Institute for Occupational Safety and Health.

Asfaw and his team analyzed data on more than 12,000 injured workers who filed for WC insurance from 2002 through 2005. They found that only 16 percent of the claims really were “zero cost” claims, which resulted in no worker’s comp payments.

Employees using worker’s compensation and the payments made from their group health insurance increased after claims made, for both zero-cost claims and those resulting in payments.

Zero cost claims were associated with significantly greater increases in costs to group health insurance, after adjustment for other factors was put in place. The increase for deductibles was highest in the area of outpatient care, with an estimated increase of $400 per claim.

The researchers wrote: “Our national estimated showed that zero-cost workers compensation claims added $212 million in medical bills to group health insurance across the United States per year.” They also suggest that their data may miss some occupational injuries, as they believe that the true economic impact on zero cost claims.

The study helps validate previous evidence that suggested non-WC insurance, not only employee health plans but also public insurance, cover at least part of the costs for work-related injuries and illnesses.

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