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Cost Drivers of Workers' Compensation Low Back Injury Claims in an Academic Health System, 2015-2024
Akbar Sharip1, Kimberly Kinney, Cesar Reis
1From the Department of Preventive Medicine, Loma Linda University School of Medicine, Loma Linda, California (A.S., C.M.M.); Department of Risk Management, Loma Linda University Shared Services, Loma Linda, California (K.K.); Department of Administrative Medicine, Veterans Affairs, Loma Linda, California (C.R., A.G.); and California Division of Occupational Safety and Health, Long Beach, California (P.P.).
Objective:
Quantify costs, durations, incidence trends, and risk factors for WC lower-back injury claims in an academic health system.
Methods:
Observational review of 797 closed claims (2015-2024) evaluating demographics, occupation, mechanism, tenure, days away from work, and temporal trends.
Results:
Mean cost $10,973 (median $3294); mean duration 197 days (median 74). Top 5% of claims averaged $114,548 and 1819 days, accounting for 52.1% of total costs. Nurses and patient-care assistants were most affected; lifting and pushing/pulling were the leading mechanisms. Higher costs were associated with longer duration, occupation, male sex, older age, and shorter tenure. Incidence declined 8.4% annually. Occupational medicine-managed claims had lower mean costs than externally managed claims ($9701 vs. $19,880).
Conclusions:
Lower-back WC claims show a substantial but declining burden; integrated occupational medicine management was associated with lower costs.
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