Do Higher Group Insurance Deductibles Mean More Work Comp Claims?

On Behalf of | Mar 6, 2019 | Firm News

Are some injuries not submitted to work comp?: Those of us dealing daily with injured workers have long suspected that many work injuries go unreported for a variety of reasons. Workers with access to health care insurance with a low deductible may choose to file with group health instead of workers’ compensation. Workers with other wage replacement benefits (such as short-term disability) may also choose not to file for workers’ compensation. Employer intimidation through both overt and covert suggestions or directives not to file for workers’ compensation also applies. The stigma and the loss of bonuses or overtime pay is another contributing factor to non-filing for workers’ compensation..

Recent study: In an in-depth study by the Workers’ Compensation Research Institute (WCRI) entitled “Do Higher Deductibles in Group Health Plans Increase Injured Workers’ Propensity to File for Workers’ Compensation,” WCRI economists Olesya Fomenko and Jonathan Gruber continue their exploration into financial incentives about filing for workers’ compensation. Prior studies focused on the providers of services (doctors’ and other medical providers’) incentives to increase revenue under workers’ compensation rather than group health. The new study examines whether injured workers are more likely to file for workers’ compensation instead of group health when their group health plan has a higher deductible.

The authors ask three specific questions.

  1. Do higher group health deductibles increase filings for workers’ compensation?
  2. Given higher deductibles, are soft tissue injuries more likely to be filed as workers’ compensation claims?
  3. Is the impact of higher deductibles greater in states where injured workers are provided the choice of initial medical providers?

Answer: The authors answer a resounding “Yes” to all three of those questions.



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