Texas DWC: 40% of Workers’ Comp Claimants Have Previous Injuries

There are about 200,000 new claims each year in the Texas workers’ compensation system, representing about 2 percent of covered Texas employees. About 40 percent of those new claims involve claimants who have had at least one previous work injury, according to a report released in May by the Texas Department of Insurance, Division of Workers’ Compensation.

The Division’s Research and Evaluation Group (REG) looked at characteristics of injured employees who had single injuries and compared them to those who had multiple injuries. Findings of the report, Injured Employees with Multiple Injuries and Claims in the Texas Workers’ Compensation System, include:

• About 40 percent of new claims between 2006-2012, were claims by individuals who had at least one previous injury and claim.
• Reinjury rates were slightly higher among males and younger employees.
• The reinjury rate was significantly higher among those in public administration and health care industries.
• Among the new claims without a past injury, about 30 percent of them would have a second injury in 10 years.
• Considering all available medical and claims data from 1998 to 2017, 53 percent of all claims and 51 percent of medical costs were associated with multiple injuries.
• Medical and income benefit costs associated with the first injury of multiple injury cases were significantly lower than the similar costs of single injury employees.
• Sum costs of first and second injuries for multiple injury employees were significantly higher than those of the single injury cases.
• After the pharmacy closed formulary, the usage of status “N” drugs decreased significantly among both single injury and multiple injury claims.
• Comparing first injuries, utilization of central nervous systems (CNS) drugs and opioids was slightly higher among single injury claims than multiple injury claims, in part because single injury claims were more likely to have severe injuries.
• Utilization of NSAIDs and musculoskeletal drugs was higher among multiple injury claims.

The report used medical billing and claims data from Injury Year 1998 to 2017.

It concludes that currently available data show that multiple injuries are quite common and costly, and that many injured employees suffer from repeated injuries. Further research should assess whether and how repeated injuries could be reduced, the report states.