Proportion of Workers Who Were Work-Injured and Payment by Workers' Compensation Systems --- 10 States, 2007

Proportion of Workers Who Were Work-Injured and Payment by Workers' Compensation Systems --- 10 States, 2007
Weekly
July 30, 2010 / 59(29);897-900


Work-related injuries are a major cause of morbidity in the United States, with approximately 4 million employer-reported nonfatal injuries and illnesses in 2007 (1). Currently, few population-based state-level estimates of nonfatal occupational injury rates exist. In the few extant studies, self-reported, nonfatal occupational injury rates exceed estimates based on employer reports or state workers' compensation systems (2,3). To estimate the proportion of workers who were work-injured during the preceding 12 months and the proportion of those injured for whom workers' compensation insurance programs paid for medical care, 10 states added a module to their 2007 Behavioral Risk Factor Surveillance System (BRFSS) survey. This report summarizes the results of that survey, which found that the proportion of workers who were work-injured during the preceding 12 months ranged from 4.0 to 6.9 work-injured persons per 100 employed persons (Kentucky and New York, respectively). The proportion of self-reported work-injured persons for whom medical treatment was paid by workers' compensation insurance ranged from 47% in Texas to 77% in Kentucky. This study shows the feasibility of complementing existing occupational injury surveillance through the use of population-based surveys. States that wish to enhance existing occupational injury surveillance should consider similar studies. Additional research is needed to understand the reasons for nonpayment of worker-reported occupational injuries by workers' compensation insurance programs.

BRFSS is a state-based, random digit--dialed, landline telephone survey of the noninstitutionalized U.S. civilian population aged ≥18 years that collects data on health conditions and behaviors. For the 2007 BRFSS, a module developed by the 10 participating states* was administered to determine whether respondents employed for wages during the preceding 12 months had a work-related injury requiring medical care or medical advice and, if so, whether workers' compensation insurance paid for the treatment or advice. For this report, respondents were considered to be employed for wages during the preceding 12 months if they responded affirmatively to questions regarding being currently "employed for wages" or "out of work for less than 1 year." Respondents who were currently "students," "retired," "unable to work," or "homemakers" were screened further regarding any employment during the preceding 12 months with the following question: "During the past 12 months, have you been employed for any period of time, either part-time, full-time, or self-employed?" An affirmative response led to inclusion in subsequent data collection.

Those who acknowledged employment during the preceding 12 months were asked, "During the past 12 months were you injured seriously enough while performing your job that you got medical advice or treatment?" Those who answered affirmatively were asked, "For your most recent work-related injury, who paid for your treatment?" Respondents answering that 1) their treatment had been paid using a state or federal workers' compensation system or military insurance,† or 2) they had initiated a workers' compensation claim were assumed to have had payment within a workers' compensation insurance system. Response and cooperation rates for each state were calculated using Council of American Survey and Research Organizations (CASRO) guidelines. Response rates ranged from 26.9% (New Jersey) to 60.1% (Kentucky) (median: 39.0%), and cooperation rates ranged from 49.6% (New Jersey) to 77.2% (Kentucky) (median: 64.6%) (4).

The proportion of workers who were work-injured during the preceding 12 months was calculated by dividing the total number of employed respondents with a work-related injury during the preceding 12 months by all employed respondents. The proportion of work-injured persons for whom the self-reported work injury was paid for by workers' compensation was determined by dividing those with a self-reported injury paid by workers' compensation by those reporting having been injured during the preceding 12 months. Because self-employed workers usually are not required to have workers' compensation insurance, data collected for self-employed workers were excluded from all analyses. The number of work injuries to the respondents during the preceding 12 months was not included as part of the BRFSS module; therefore, an injury rate could not be calculated.

BRFSS is administered monthly during a calendar year. However, injured persons data were collected for the preceding 12-month period; therefore, work injuries for the population surveyed might have occurred during January 2006--December 2007, but each respondent had, at a maximum, a 12-month exposure period. All data were weighted to population-based estimates according to age-, race-, and sex-specific state population estimates and the respondent's probability of selection.

The proportion of workers who were work-injured during the preceding 12 months ranged from 4.0 (Kentucky) to 6.9 work-injured persons per 100 employed persons (New York) (median: 5.9 work-injured persons per 100 employed persons) (Table). The proportion of self-reported work-injured persons for whom medical treatment was paid by workers' compensation insurance ranged from 47% in Texas to 77% in Kentucky (median: 61%).

Reported by
DK Bonauto, MD, JZ Fan, PhD, Washington State Dept of Labor and Industries. TW Largo, MPH, Michigan Dept of Community Health; KD Rosenman, MD, Michigan State Univ. MK Green, MPH, JK Walters, MPH, Oregon Dept of Human Svcs. BL Materna, PhD, J Flattery, MPH, California Dept of Public Health. T St. Louis, MSPH, Connecticut Dept of Public Health. L Yu, PhD, Univ of Kentucky. S Fang, ScD, Harvard School of Public Health, Boston; LK Davis, ScD, Massachusetts Dept of Public Health. DJ Valiante, MPH, New Jersey Dept of Health and Senior Svcs. KR Cummings, MPH, New York State Dept of Health. JJ Hellsten, PhD, SL Prosperie, MS, Texas Dept of State Health Svcs.

open here to see the full-text:
Proportion of Workers Who Were Work-Injured and Payment by Workers' Compensation Systems --- 10 States, 2007