• 28
  • November
    2011

A new study from the National Council on Compensation Insurance is shedding some light on how workers' compensation benefits are spent.

The study found that overall health care costs have gone up 43 percent between 2001 and 2010. In-office doctor's visits cost 33 percent more than they did 10 years ago, while hospital costs have gone up by an astounding 82 percent. Prescription drug prices have increased by 34 percent over the last decade.

As many New Haven workers' compensation attorneys know, insurance companies can sometimes be slow to pay out the most expensive claims. The study confirmed this observation. It found that while insurers usually pay for office visits and emergency care relatively quickly, they often dragged their feet when covering the cost of hospital care. Insurers are also often slow to reimburse for prescription drug expenses.

Different Injuries Need Different Providers

Interestingly, the study found that injured workers utilize different mixes of medical treatment depending on the severity of their injuries.

In claims of less than $5,000, most of the insurance dollars are spent on office visits and emergency services. For mid-range claims costing between $5,000 and $100,000, surgery and anesthesia represent the largest share of medical services obtained. In claims over $100,000, hospital services and prescription drugs account for over 40 percent of the overall claim cost.

Overall, nearly 60 percent of workers compensation dollars are used pay medical benefits. This is up from around 40 percent in the early 1980s.

As the cost of medical care rises, workers need to be careful to make sure they are not taken advantage of by their insurers. If you've been injured in a workplace accident, contact an experienced workers' compensation attorney who can defend your rights.

Source: Insurance Journal, "NCCI Study Examines Medical Services in Workers' Comp Claims," 4 November 2011