Occupational disease and workers' compensation: coverage, costs, and consequences

Area of Science:

• Occupational Health
• Public Health Policy
• Epidemiology

Background:

• Workers' compensation systems often fail to cover the full economic burden of occupational diseases.
• Significant costs associated with workplace illnesses are shifted to individuals, families, and public healthcare systems.

Purpose of the Study:

• To estimate the total deaths and costs of occupational diseases in 1999.
• To compare these estimates with data from workers' compensation claims.
• To quantify the extent of undercoverage and cost shifting in workers' compensation.

Main Methods:

• Utilized epidemiological studies to estimate all occupational disease deaths and costs in 1999.
• Analyzed workers' compensation data from 16 states for cases, costs, and deaths in 1999.
• Compared findings from epidemiological studies with workers' compensation data.

Main Results:

• Epidemiological estimates identified job-related cancer, chronic respiratory disease, and circulatory disease as major contributors to occupational disease burden.
• Workers' compensation data highlighted nonfatal conditions like tendonitis and hernia.
• Workers' compensation likely missed 46,000-93,000 deaths and $8-$23 billion in medical costs in 1999.

Conclusions:

• Workers' compensation significantly underreports the true burden of occupational diseases.
• Substantial cost shifting occurs from workers' compensation to individuals, private insurance, and taxpayers.
• Developing policies to address this inefficiency and cost shifting presents a significant challenge.