Length of Disability and Medical Costs in Low Back Pain: Do State Workers' Compensation Policies Make a Difference?
OBJECTIVE
The aim of the study was to examine the impact of state workers' compensation (WC) policies regarding wage replacement and medical benefits on medical costs and length of disability (LOD) in workers with low back pain (LBP).


METHODS
Retrospective cohort analysis of LBP claims from 49 states (n = 59,360) filed between 2002 and 2008, extracted from a large WC administrative database.


RESULTS
Longer retroactive periods and state WC laws allowing treating provider choice were associated with higher medical costs and longer LOD. Limiting the option to change providers and having a fee schedule were associated with longer LOD, except that allowing a one-time treating provider change was associated with lower medical costs and shorter LOD.


CONCLUSIONS
WC policies about wage replacement and medical treatment appear to be associated with WC LBP outcomes, and might represent opportunities to improve LOD and reduce medical costs in occupational LBP.
Center for Disability Research (Dr Shraim, Ms Willetts, Dr Pransky), Liberty Mutual Research Institute for Safety, Hopkinton; Work Environment Department (Dr Shraim), University of Massachusetts Lowell; Research and Evaluation Unit (Dr Cifuentes), Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury; Center for Injury Epidemiology (Ms Willetts, Dr Marucci-Wellman), Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts; and An-Najah National University (Dr Shraim), Nablus, Palestine.
Mujahed
M
Shraim
Manuel
M
Cifuentes
Joanna L
JL
Willetts
Helen R
HR
Marucci-Wellman
Glenn
G
Pransky
D000293:Adolescent; D000328:Adult; D000368:Aged; D016208:Databases, Factual; D004185:Disability Evaluation; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D017116:Low Back Pain / Q000191:economics / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000191:economics / Q000534:rehabilitation*; D012189:Retrospective Studies; D062707:Return to Work / Q000191:economics / Q000706:statistics & numerical data*; D014481:United States; D014942:Workers' Compensation / Q000191:economics*; D055815:Young Adult