Back Pain Accounts for Largest Share of New York Worker's Comp Claims

As part of its analysis of medical treatment guidelines, the New York Insurance Department asked what medical conditions occur most frequently and account for the largest share of medical expenditures in worker's compensation. To address this, the Cambridge, Mass.-based Workers Compensation Research Institute analyzed data from private insurers and self-insurers from claims with an average of three years' experience through March 2005.

WCRI found that nearly one-fifth of medical costs were paid to treat workers with back problems involving disc conditions or radicular symptoms (e.g., radiating pain into the limbs). Expenditure on the typical such case was nearly $10,000 at the time. Nonspecific low back pain constituted nearly one in seven cases and 10 percent of medical payments while conditions involving the cervical spine (neck) represented nearly five percent of cases and 10 percent of medical payments.

Shoulder and arm problems--both inflammatory conditions and sprains/strains--also accounted for a significant share of medical costs and cases, with the inflammatory conditions being twice as costly as the sprains/strains. Knee derangements occurred in two percent of cases but accounted for nearly 6 percent of medical costs, averaging more than $7,000 per case. Carpal tunnel conditions were diagnosed in about two percent of cases, as well, but represented only about three percent of costs. For the complete report, visit www.wcrinet.org.

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