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Ankle Sprains in the Workers' Compensation System: Trends, Costs, and Predictors of High-Expense Claims: A 9-Year
Xuguang Grant Tao1, Nicholas F Tsourmas, Marcos Iglesias
1From the Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland. (X.T., N.F.T., N.K., N.L., N.L., E.J.B.); From AF Group, Lansing, Michigan (M.I.); General Electric, Norwalk, Connecticut (N.K.); Texas Mutual Workers' Compensation Insurance, Austin, Texas (N.F.T.); University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (J.G.M.).
Objectives:
To evaluate trends, costs, and predictors of high-cost ankle sprain claims in the workers' compensation system.
Methods:
Among 26,773 ankle injury claims (2016-2024), 18,991 sprains were identified and analyzed using descriptive and analytical multivariate methods.
Results:
Sprains comprised about 70% of all ankle injuries, with increasing proportions among medical-only claims during the 9 years. Litigation, some comorbidities (diabetes and thyroid conditions), and coexisting injuries were strongly associated with high-cost claims (≥$50,000). Sprains without coexisting injuries represented 82.2% of medical-only and 65.1% of lost-time cases, with average costs of $1331 and $25,593, respectively, whereas those with coexisting injuries averaged $2451 and $53,942.
Conclusions:
Ankle sprains impose a substantial and underrecognized workers' compensation burden among ankle injuries. Litigation, some comorbidities, and injury complications are key predictors of high-cost outcomes.
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