Report: Calif. Head and Spine Injuries Cost $500M in 10 years

Head and spinal injuries cost California’s workers’ compensation insurers more than $500 million over 10 years, according to the California Workers’ Compensation Institute’s “Injury Score Card.”

The report reflects data on California work injury claims for head and spinal injuries without spinal cord involvement.

Such cases represent only a small fraction of all workers’ comp cases, but a disproportionate share of the costs because they include catastrophic cases considered to be among the most expensive in the system, the report states.

Several statistics stand out in the score card, which uses data from open and closed claims from accident years 2001 through the middle of 2011, including notable changes in injuries by industry sector, as well as workers’ comp payments by county. Also notable is the ever-increasing cost of workers’ comp in California.

“Since the recession, the types of injuries by industry has changed,” said John Ireland, an associate research director at CWCI. “It says a lot about the state of economy, but also about the nature of types of injuries.”

The construction sector went from 15 percent of all workers’ comp claims in California in the early part of decade to 8 percent last year. Manufacturing has also seen a sizable decrease, while the professional and clerical services sector rose the most, from 15.8 percent in the period from 2001 to 2007 to 21.8 percent in the period between 2008 and 2011, according to the report.

Since 2008 construction and manufacturing also dropped percentage points for head and spine workers’ comp claims, while professional and clerical services rose for head and spine claims, the report shows.

The latest score card also features a profile of head and spine injury by claimant county of residence.

Los Angeles County topped the list with 23 percent of all the state’s head and spine payments from 2001 to 2010, and L.A.’s average of $67,002 per claim was second only to Kern County, which tops the list for average per paid claim at $67,714.

Other than the possibility that a high number of agricultural operations yielded such a high average in Kern, Ireland was at a loss as to why that rural county’s average was so high.

As for L.A.? “That’s the $67,000 question,” he said.

“We really don’t’ know why it’s so high in L.A.,” he said.

But he did have some thoughts on the matter.

It may also be why L.A.’s $17,087 average for all workers’ comp claims tops the list of counties.

“We do know that there are higher attorney rates in Los Angeles,” he said. “The whole workers’ comp system in L.A. tends to be a little bit more contentious than it is in the rest of the state.”

L.A.’s average per paid claim is nearly 40 percent above the state average of $47,746.

According to the study, head and spinal injuries accounted for one out of 200 job injury claims in California. However, due to the high average cost of these claims, they consumed 1.7 percent of paid losses, the study shows.

The study shows that strains, contusions and lacerations lead the “nature of injury” categories for head and spine injuries, comprising nearly half of the claims.

A high proportion of head and spine claims involve fractures, concussions, multiple physical injuries and other cumulative injuries which are often expensive to treat and result in delayed return to work and high indemnity costs, the report shows.

More than 9 percent of head and spine injuries are fractures, 7.4 percent are concussions and 5.8 percent are considered multiple physical injuries, the report shows.

Unlike other types of injury claims, average paid losses payments on head and spine injury claims never declined following the 2004 workers’ compensation reforms, with the most recent data for accident years 2007 through 2009 showing that average paid losses on head and spine claims at one, two and three years are three- to four-times higher than the average for all California workers’ compensation claims, according to the report.

For example, among 2007-2009 lost-time cases, average benefit payments at 36 months post injury for head and spine injury claims averaged $96,980 — that’s adding an average $67,325 for medical plus $29,655 indemnity — compared with an average of $29,211, $15,646 medical plus $13,565 indemnity, for all California workers’ compensation lost time claims in 2001, the report states.

These numbers reflect the continued escalation in workers’ comp costs, particularly in the cost of healthcare.

“The cost of healthcare has been in an inflationary spiral for many, many years,” Ireland said.

One driver of those costs may be prescription drugs.

Hydrocodone, or Vicodin, was No. 1 in percentage of prescriptions written (12.4 percent) for head and spine injuries in workers’ comp cases in California in 2010. Omeprazole, or Prilosec, followed at 6 percent, and Gabapentin (Neurontin) and Naproxen (Naprosyn) were at 2.7 percent.

“There definitely is an association with the prescription of opioid analgesics and costs,” Ireland said.