WCRI's report on "Patterns and Trends of High-Cost Claims Involving Back and Shoulder Injuries" was reviewed in the Sept. 9 issue of Carrier Chronicles. As the authors observe, "A recent study released by the Workers Compensation Research Institute (WCRI) identifies factors that increase the likelihood of high-cost claims involving back and shoulder injuries. We review their findings, including the specific conditions most at risk."

“High-cost claims do not just happen by chance; they develop over time through a combination of factors, like medical complexity and delayed recovery,” said Lisa Haug, Assistant Vice President of Medical Management at Safety National. “The earlier we recognize these patterns, the better positioned we are to control costs and improve injured worker outcomes.”

Read more about the WCRI study here.

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Waltham, MA, September 4, 2025 ― The Workers Compensation Research Institute (WCRI) will host a free, 45-minute webinar on Thursday, September 25, 2025, at 2 p.m. ET, to discuss the latest editions of CompScope™ Benchmarks for Florida and other recent WCRI research.

“The CompScope™ studies highlight key cost drivers, recent trends, and how Florida’s workers’ compensation system performs compared with other states. Other WCRI research provides valuable information on a variety of issues, such as recent changes in the medical workforce, the impact of comorbid conditions in workers’ compensation, and more. If you are an employer, insurer, policymaker, medical professional, or labor stakeholder in Florida, this webinar is a must-attend,” said Ramona Tanabe, WCRI president and CEO.

Topics Covered:

• The primary cost drivers and recent trends across various performance metrics in Florida’s workers’ compensation system.
• Performance comparisons between Florida and other states on medical payments and utilization, income benefits, and benefit delivery efficiency.
• Findings from WCRI research on the medical workforce, comorbid conditions, and more.

The 18 states in CompScope™ studies represent about 60 percent of all workers’ compensation benefits paid nationwide. Along with Florida, they include Arkansas, California, Delaware, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Texas, Virginia, and Wisconsin.

This is a FREE webinar. Attendance is limited to 500 people, and all attendees receive a free copy of the slides and a recording of the webinar. Click here to register now.

About WCRI:

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in 1983, the Institute does not take positions on the issues it researches. It provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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WCRI’s VP of Research, Sebastian Negrusa, joined attorneys Alan & Jud Pierce on the Workers’ Comp Matters podcast to discuss findings from WCRI's forthcoming study on the impact of excessive heat in the workplace.

As the podcast puts it, "What role does excessive heat in the workplace play in employee injuries? Turns out, it’s a lot. In temperatures of more than 90 degrees, the risk of injury on the job increases by a significant 5%-6%. Excessive heat, the study finds, impairs both cognitive and physical abilities, leaving workers more likely to make mental and physical errors and suffer injuries at work."

🎧Listen here.
A link to the WCRI study, "Impact of Excessive Heat on the Frequency of Work-Related Injuries," will be added here when it's published later this month.

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A recent WCRI report, "Patterns and Trends of High-Cost Claims Involving Back and Shoulder Injuries," was featured in a recent article in Risk & Insurance, "Late Medical Interventions Drive Workers’ Comp Costs as Back, Shoulder Claims Show Wide Cost Variation."

Here's an excerpt: "A comprehensive analysis of workers’ compensation claims reveals that late resource-intensive medical care is the primary driver of high-cost claims across seven common back and shoulder injury categories, with costs varying dramatically by specific injury type, according to a new study by the Workers Compensation Research Institute."

Read more about the WCRI study here.

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Waltham, MA – August 7, 2025 — A new study from the Workers Compensation Research Institute (WCRI) examines the key factors associated with high-cost workers’ compensation claims involving back and shoulder injuries, where medical expenses exceed $65,000 within 36 months of injury.

“In a previous WCRI study, we identified factors that increase the likelihood of high medical payments by looking at all injury types together,” said Sebastian Negrusa, WCRI’s vice president of research. “This new study refines that analysis by focusing on back and shoulder injuries to better understand what contributes to higher claim costs.”

The study looks at four back conditions (neurologic back pain; disc disorders; degenerative back conditions; and sprains, strains, and non-specific pain) and three shoulder injuries (rotator cuff disorders, frozen shoulders, and shoulder osteoarthritis).

Key questions the study explores include the following:

• How prevalent are high-cost claims for these injuries, and how do they compare in terms of medical costs and duration of temporary disability
• What characterizes high-cost claims versus other claims within each injury category?
• What factors are associated with elevated medical payments?
• How do degenerative conditions and comorbidities influence treatment choices and affect costs?

The analysis is based on about 194,000 workers’ compensation claims with more than seven days of lost time, from 32 states. These claims involve injuries that occurred between October 1, 2015, and March 31, 2019, with detailed treatment and billing data tracked for up to 36 months after the injury, through March 31, 2022.

The full report, Patterns and Trends of High-Cost Claims Involving Back and Shoulder Injuries, is authored by Dongchun Wang, Kathryn L. Mueller, and Randall D. Lea. It is available to WCRI members and can be purchased by nonmembers at www.wcrinet.org.

ABOUT WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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Carrier Management reviews WCRI's study "Advanced Practitioners and Workers’ Compensation Claim Outcomes" (Savych and Fomenko, 2025).

As the article notes, this "newly released decade-long study...indicates that claims initiated by nurse practitioners (NPs) and physician assistants (PAs) didn’t lead to negative outcomes and suggested some benefits when compared to those led by primary care physicians (PCPs)."

You can read (or listen to) CM's article here.  For more on WCRI's study, including how to order copies, please visit the page on our website.

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Waltham, MA – July 24, 2025 – As the shortage of primary care physicians grows, more injured workers are receiving initial care from advanced practitioners—nurse practitioners and physician assistants. A new study from the Workers Compensation Research Institute (WCRI) asks a timely question: Does it make a difference?

“There’s growing interest in understanding how provider type influences outcomes,” said Sebastian Negrusa, WCRI’s vice president of research. “Some worry that advanced practitioners may lack the specialized experience to manage certain injuries. This study sheds light on how care provided by nurse practitioners and physician assistants shapes patterns of care and claim outcomes.”

WCRI tested these concerns by comparing claim outcomes when the initial provider was an advanced practitioner versus a physician. Key measures included the following:

• Time to first nonemergency office visit
• Number of medical visits
• Use and timing of specialty care
• MRI use within six weeks
• Medical and indemnity payments
• Duration of temporary disability

The analysis for the study, Advanced Practitioners and Workers’ Compensation Claim Outcomes, draws on detailed claims and medical data from 29 states, covering over 80 percent of workers’ compensation benefits paid in 2022. It includes injuries from October 1, 2012, to September 30, 2022, and tracks outcomes up to 6 or 12 months postinjury.

The full report, authored by Bogdan Savych and Olesya Fomenko, is available to WCRI members and for purchase by nonmembers.

ABOUT WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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Advanced-care practitioners treated injured workers in 37% of nonemergency visits for evaluation and management, more than double the 18% reported in 2013, according to the Workers Compensation Research Institute.

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During the recent period of high inflation in the general economy, states experienced varying rates in growth in workers’ compensation medical prices depending on what methods were used to update workers’ compensation fee schedules, according to a WCRI analysis. The research—which examines how the high inflation period between 2021 and 2023 has affected medical payments in workers’ compensation in 2025—indicates that, since the summer of 2022 through the first quarter of 2025, the general inflation rate has been slowing down, after two years (2021-2022) of substantial growth in prices. 

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Three years ago Jeff Rush of CJPIA, Jill Leonard of LWCC and I presented a session entitled “Rising Temps, Rising Risks: Climate Change & Comp” at National Work Comp. 

Maybe a dozen or so folks attended…

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It may come as no surprise that heat-related worker injury claims rise on hot days, but the magnitude of the increase is an eye-opener.

As temperatures skyrocketed during early summer heat waves across the United States, the Workers Compensation Research Institute put out a webinar digging into the WCRI’S recent report on heat-related illnesses in the workplace.

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The Workers’ Compensation Research Institute (WCRI) published a new study that outlines the key decisions public officials face when establishing or revising physician fee schedules.

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WCRI's Annual Conference is back in 2026! The conference will take place March 3-4, 2026 at the Westin Copley Hotel in Boston, Massachusetts. 

Registration will open up in the coming months. We'll see you there!

In the meantime, check out some of the highlights from our 2025 conference in Phoenix.

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Waltham, MA – July 8, 2025 – A new study by the Workers Compensation Research Institute (WCRI) identifies detailed factors associated with high-cost claims involving rotator cuff disorders, based on an analysis of clinical characteristics and treatment patterns specific to these injuries.

“This study offers a deeper understanding of how various levels of rotator cuff tears and their surgical patterns contribute to elevated medical costs. From a medical and claims management perspective, these are challenging injuries, and the study’s results could inform effective care strategies and resource utilization,” said Sebastian Negrusa, WCRI’s vice president of research.

The study, Patterns and Trends of High-Cost Claims Involving Rotator Cuff Disorders, examined the association between condition-specific factors and the likelihood of a claim becoming high cost (defined as medical payments exceeding $65,000 within 36 months of injury).

The following are among the questions the study addresses:

• What are the specific factors contributing to high medical payments for rotator cuff injuries?  
• Are patterns of medical care consistent with guideline recommendations and expected medical practice regarding timing of surgery and pre- and postoperative nonsurgical treatments?
• To what extent do degenerative conditions and comorbidities influence treatment decisions and contribute to elevated costs?

The analysis is based on nearly 50,000 rotator cuff disorder claims drawn from a dataset of over 930,000 lost-time claims across 32 states. These claims involved injuries occurring between October 2015 and March 2019, with medical billing and treatment data tracked for three years postinjury.

The full report is available to WCRI members and can be purchased by nonmembers at www.wcrinet.org. The report was authored by Dongchun Wang, Randall D. Lea, and Kathryn L. Mueller.

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In this WCRI Member Spotlight, we speak with Nancy Kelly of Averitt Express—a leading transportation and logistics provider with 140 service centers and over 8,000 employees across more than 21 states. Nancy shares how she discovered WCRI, the value she finds in membership, her favorite research, and how she’s applied it in her work.

For the past 15 years, Nancy has served as a risk and nurse case manager at Averitt, overseeing workers’ compensation, disability management, and OSHA reporting. She is a registered nurse with both a bachelor’s and master’s in nursing and holds certifications as an Occupational Health Nurse Specialist and Case Manager.

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Waltham, MA, June 30, 2025 – A new study from the Workers Compensation Research Institute (WCRI) sheds light on how the high-inflation period of 2021–2023 has influenced medical payments in workers’ compensation up to 2025, focusing especially on states that link their medical fee schedules to general economic inflation measures.

“With more data now available, we are better equipped to understand how the high inflation from 2021 to 2023 has affected medical costs in workers’ compensation and how different fee schedule update methods influence these outcomes,” said Sebastian Negrusa, vice president of research at WCRI. “This knowledge is relevant as policymakers and stakeholders address ongoing inflationary pressures.”

The study, Post-Inflation Trends in Medical Payments Through 2025—A WCRI FlashReport, examines how inflation and state fee schedule update methods—from general economic indexes like the Consumer Price Index and wage measures to medical-specific indexes like the Producer Price Index for health care services—have influenced medical cost growth in workers’ compensation since 2020. While general health care prices rose steadily at about 3 percent annually, the study explores why workers’ compensation payments showed greater variation across states.

The following are some of the questions the study addresses:

• How did workers’ compensation medical payments change following the first two years of the COVID-19 pandemic, and what drove those changes?
• Why did prices for nonhospital professional services in workers’ compensation grow faster in most states after 2021?
• What happened to the growth of workers’ compensation fee schedule rates for nonhospital professional services as general inflation slowed between 2023 and 2025?
• What factors contributed to the increase in ambulatory surgery center (ASC) and hospital payments between 2021 and 2023?
• How do fee schedules affect the growth of medical prices in workers’ compensation, particularly for nonhospital and hospital outpatient services?

This report draws on data from multiple sources. General and health care inflation figures come from the U.S. Bureau of Labor Statistics. Workers’ compensation data are based on WCRI’s CompScope™ studies and the Detailed Benchmark/Evaluation database, which includes claims from insurers, state funds, and self-insured employers. Nonhospital price trends are measured using WCRI’s Medical Price Index for Workers’ Compensation, and hospital outpatient trends are based on WCRI’s Hospital Outpatient Payment Index. Information on fee schedules is drawn from WCRI’s 2025 fee schedule study, RefMed® data, and Medicare data. The analysis spans trends from 2012 through 2025.

For more information about this report or to download a copy, visit www.wcrinet.org. The report was authored by Dr. Rebecca Yang and Dr. Olesya Fomenko.

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In this free, 30-minute webinar held on June 26, 2025, author and senior policy analyst Dr. Vennela Thumula discussed WCRI's recent research, Heat-Related Illnesses in the Workplace, on the connection between high temperatures and heat-related illnesses (HRIs) in the workplace.

The webinar addressed the following questions:

• What is the effect of excessive heat on HRIs versus broader heat-related accidents?
• What role does geographic region play in the frequency of HRI claims?
• Are certain age groups, genders, or industries more at risk?
• How does job tenure—particularly two or fewer months on the job—influence the likelihood of HRIs?

The study draws on data from WCRI’s Detailed Benchmark/Evaluation (DBE) database, which includes workers’ compensation claims from various insurers, state funds, and self-insured employers across 31 U.S. states—accounting for approximately 80 percent of national workers’ compensation benefits. Temperature data were used alongside claims data to assess patterns and risk factors associated with excessive heat.

Click here to watch. 

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Waltham, MA, June 25, 2025 — A new study from the Workers Compensation Research Institute (WCRI) examines how stakeholders view the promises and challenges of artificial intelligence (AI) in the workers’ compensation system.

“In recent years, interest in the role of artificial intelligence in workers’ compensation has grown rapidly,” said Sebastian Negrusa, vice president of research at WCRI. “This study is an important step toward understanding how stakeholders are approaching the opportunities and risks associated with these emerging technologies.”

To develop the study, WCRI researchers conducted semi-structured interviews with 34 leaders across 20 organizations—including employers, insurers, medical providers, worker advocates, and regulators—supplemented by informal discussions. They also reviewed literature and regulations on AI developments and applications.

The key questions asked in the interviews included:

• How do you define AI and its role in the economy and the workers’ compensation system?
• Where do you see the value of AI tools for your job, your organization, and the system?
• What challenges and risks do you foresee with broader AI adoption, and how can these be mitigated?

By outlining current and emerging uses of AI in workers’ compensation and identifying risks and potential guardrails, the study, Artificial Intelligence in Workers’ Compensation: An Overview of Promises and Challenges, aims to provide a common language for stakeholders and inform policy discussions to promote responsible AI use that improves injured workers’ recovery and experience.

The authors of the study are Bogdan Savych and Vennela Thumula.

ABOUT WCRI:

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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Waltham, MA, June 20, 2025 – As policymakers seek to implement or revise price controls in their state workers’ compensation systems through medical fee schedules, a new study from the Workers Compensation Research Institute (WCRI) highlights the critical design choices involved in adopting, reforming, and updating them.

“The construction of a medical fee schedule in workers’ compensation involves a delicate balance,” said Sebastian Negrusa, WCRI’s vice president of research. “Setting rates too low may make treating injured workers uneconomical for providers and jeopardize access to care. On the other hand, setting rates too high may limit savings and undermine the fee schedule’s cost-containment goals.”

The study, Designing Workers’ Compensation Medical Fee Schedules, 2025, outlines key decisions public officials face when crafting or updating physician fee schedules. It examines how 44 states and the District of Columbia with fee schedules have addressed these challenges as of March 31, 2025, and discusses substantial changes to professional medical service fee schedules since March 2022, focusing on the spillover effect of the relatively high inflation in the general economy. These decisions include the following:

• How high or low the fee schedule should be set
• How frequently fee schedules should be updated and which update approach to adopt
• Whether to base the fee schedule on relative value units (RVUs) or another metric (e.g., historical charges or usual and customary charges)
• If using RVUs, whether to adopt the relative values developed for the Medicare program or another scale
• What share of medical services are without assigned fee schedule rates and how these services should be reimbursed

The study compares fee schedule levels across states for professional services, which account for about 41 percent of workers’ compensation medical costs. It does not assess appropriate rate levels or explore broader policy impacts, such as access to care or patterns of medical utilization.

Click here for more information about this study or to purchase a copy. The authors of the study are Olesya Fomenko and Te-Chun Liu.

ABOUT WCRI:

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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From stress and burnout to substance use disorders, this Travelers Institute session provided a comprehensive framework for understanding mental health as a continuum. Dr. Jerome M. Adams, the 20th U.S. Surgeon General and Executive Director of Purdue University’s Health Equity Initiatives and Center for Community Health Enhancement and Learning, was joined by Ramona Tanabe, President and CEO of the Workers Compensation Research Institute, and Rich Ives, Senior Vice President, Business Insurance Claims at Travelers. This expert panel shared insights on how organizations can proactively identify and implement the necessary resources to support mental health and effectively connect employees to these resources. Additionally, they discussed the latest trends in workers compensation programs and their role in the broader context of employee well-being. We had an engaging conversation as we discussed how to raise awareness and develop actionable plans to address mental health in your workplace.

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Short-tenure workers with less than two years of experience continue to account for the largest share of workers' compensation claims in New Jersey, according to the Workers Compensation Research Institute.

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Waltham, MA, June 10, 2025 – Short-tenure workers, meaning those with less than two years of job tenure, continued to account for the largest share of workers’ compensation claims in New Jersey, and that share has grown since 2021, according to a recent study from the Workers Compensation Research Institute (WCRI).

“New hires, and shorter-tenure workers more broadly, have grown as a share of the workforce, and of claims, particularly since 2021. Their wages, too, have been growing faster than most other tenure groups, particularly new hires with less than a year on the job, and are a major contributor to the state’s 10 percent annual indemnity growth as of late,” said Sebastian Negrusa, vice president of research for WCRI. “Thus, New Jersey provides an effective microcosm of the national labor market trends post-pandemic.”

The following are some other findings from the study:

• Medical payments per claim in New Jersey increased by over 13 percent in 2023, largely driven by high-cost medical claims of over $100,000.
• Total costs per claim in New Jersey remained typical of study states, with higher-than-typical medical and benefit delivery expenses but lower indemnity benefits despite recent growth.

The CompScope™ Benchmarks for New Jersey, 2025 Edition offers an annual overview of changes in indemnity benefits, medical payments, and benefit delivery expenses per claim. It also compares the New Jersey workers’ compensation system with those in 17 other states across these key metrics. The study covers claims through March 2024, focusing on non-COVID-19 claims and examining the effects of pandemic-related disruptions and labor market shifts from 2019 to 2023.

The report was authored by Evelina Radeva.

ABOUT WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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WCRI is on the ball.

A webinar on Heat-Related Illnesses in the Workplace is scheduled for June 26; register here. Space is limited so don’t get left out in the blazing sun.

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Waltham, MA, June 5, 2025 — With summer approaching, the Workers Compensation Research Institute (WCRI) is hosting a free, 30-minute webinar on Thursday, June 26, 2025, at 2:00 p.m. ET to share recent research on the connection between high temperatures and heat-related illnesses (HRIs) in the workplace.

“With 2024 confirmed as the hottest year on record, these findings are especially timely as cities and states adopt heat safety regulations,” said Sebastian Negrusa, vice president of research at WCRI. “The data also show that excessive heat increases the frequency of other injuries.”

The webinar will cover key findings from WCRI’s recent study, Heat-Related Illnesses in the Workplace, which explores questions such as the following:

• What is the effect of excessive heat on HRIs versus broader heat-related accidents?
• What role does geographic region play in the frequency of HRI claims?
• Are certain age groups, genders, or industries more at risk?
• How does job tenure—particularly two or fewer months on the job—influence the likelihood of HRIs?

The study draws on data from WCRI’s Detailed Benchmark/Evaluation (DBE) database, which includes workers’ compensation claims from various insurers, state funds, and self-insured employers across 31 U.S. states—accounting for approximately 80 percent of national workers’ compensation benefits. Temperature data were used alongside claims data to assess patterns and risk factors associated with excessive heat.

Space is limited to 500 attendees. All registrants will receive a copy of the slides and a recording of the session. Click here to register.

About WCRI:

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in 1983, the Institute does not take positions on the issues it researches. It provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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One of the best free workers' comp info sources on medical pricing nationwide was published in May by the Workers Compensation Research Institute. The authors of the study are Rebecca Yang and Olesya Fomenko.

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Jack Nolish, director of Michigan's Workers Disability Compensation Agency, shares how WCRI’s research supports his work by providing valuable comparative data. He discusses how studies like CompScope and national workers' comp laws help him better understand Michigan’s position, inform discussions on workers' compensation reform, and provide useful insights for policymakers. If you're interested in how WCRI’s research helps stakeholders make informed decisions, this interview offers a great perspective.

To learn more about the benefits of membership, visit https://www.wcrinet.org/member....

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According to the National Safety Council, the Workers Compensation Research Institute found a pattern of heat-related illness incidents across the United States from 2013 to 2020 in worker compensation data.

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Waltham, MA, May 29, 2025 – As policymakers nationwide focus on the rising costs of health care, a new study from the Workers Compensation Research Institute (WCRI) reveals that hospital outpatient payments for workers’ compensation grew faster in states with fee schedules based on a percentage of hospital charges and in states without fee schedules.

“This study provides meaningful state comparisons at a time when many are considering or revising hospital fee regulations,” said Sebastian Negrusa, vice president of research at WCRI. “It offers a clear, evidence-based perspective on how different regulatory approaches influence cost growth and payment levels.”

The report, Hospital Outpatient Payment Index: Interstate Variations and Policy Analysis, 14th Edition, analyzes payments for common outpatient surgeries across 36 states, representing 88 percent of the nation’s workers’ compensation benefits. Covering data from 2005 to 2023, the study also compares workers’ compensation hospital payments to Medicare rates.

The following are among the major findings:

• Faster growth in states with charge-based fee regulations and in non-fee schedule states: From 2011 to 2023, growth in outpatient payments for common surgeries reached 61–81 percent among states with charge-based fee schedules, and 55–88 percent in non-fee schedule states, substantially higher than 24 percent in the median fixed-amount fee schedule state.
• Higher payments in states without fee schedules: Outpatient payments were 63 to 154 percent higher than the median of states with fixed-amount fee schedules. In these states, workers’ compensation paid $7,550 to $22,002 more per surgical episode than Medicare.
• Percent-of-charge states cost more: States like Alabama and Louisiana, using percent-of-charge-based fee schedules, paid 83 to 233 percent more than states with fixed-amount fee schedules.

• Wide variation vs. Medicare: Average workers’ compensation payments for a common group of outpatient surgeries ranged from 40 percent below Medicare in Nevada to 480 percent above in Alabama.

The report also tracks the impact of recent policy reforms. In May 2023, Florida expanded its fixed-amount fee schedule by eliminating charge-based reimbursement for unlisted procedures. This policy change led to a 6 percent decrease in hospital outpatient payments per surgical episode within the same year.

Click here for more information or to download the full report. The study was authored by Dr. Olesya Fomenko and Dr. Rebecca Yang.

ABOUT WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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Waltham, MA, May 29, 2025 – As policymakers nationwide focus on the rising costs of health care, a new study from the Workers Compensation Research Institute (WCRI) reveals that hospital outpatient payments for workers’ compensation grew faster in states with fee schedules based on a percentage of hospital charges and in states without fee schedules.

“This study provides meaningful state comparisons at a time when many are considering or revising hospital fee regulations,” said Sebastian Negrusa, vice president of research at WCRI. “It offers a clear, evidence-based perspective on how different regulatory approaches influence cost growth and payment levels.”

The report, Hospital Outpatient Payment Index: Interstate Variations and Policy Analysis, 14th Edition, analyzes payments for common outpatient surgeries across 36 states, representing 88 percent of the nation’s workers’ compensation benefits. Covering data from 2005 to 2023, the study also compares workers’ compensation hospital payments to Medicare rates.

The following are among the major findings:

• Faster growth in states with charge-based fee regulations and in non-fee schedule states: From 2011 to 2023, growth in outpatient payments for common surgeries reached 61–81 percent among states with charge-based fee schedules, and 55–88 percent in non-fee schedule states, substantially higher than 24 percent in the median fixed-amount fee schedule state.
• Higher payments in states without fee schedules: Outpatient payments were 63 to 154 percent higher than the median of states with fixed-amount fee schedules. In these states, workers’ compensation paid $7,550 to $22,002 more per surgical episode than Medicare.
• Percent-of-charge states cost more: States like Alabama and Louisiana, using percent-of-charge-based fee schedules, paid 83 to 233 percent more than states with fixed-amount fee schedules.

• Wide variation vs. Medicare: Average workers’ compensation payments for a common group of outpatient surgeries ranged from 40 percent below Medicare in Nevada to 480 percent above in Alabama.

The report also tracks the impact of recent policy reforms. In May 2023, Florida expanded its fixed-amount fee schedule by eliminating charge-based reimbursement for unlisted procedures. This policy change led to a 6 percent decrease in hospital outpatient payments per surgical episode within the same year.

Click here for more information or to download the full report. The study was authored by Dr. Olesya Fomenko and Dr. Rebecca Yang.

ABOUT WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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Waltham, MA, May 27, 2025 – A recent study from the Workers Compensation Research Institute (WCRI) found that total costs per workers’ compensation claim in Virginia changed little in recent years and have grown less than the typical state of the 18-state study sample.

“This slow growth in Virginia reflects little change in medical payments per claim after the state implemented a medical fee schedule in 2018,” said Sebastian Negrusa, vice president of research for WCRI. “The other components of costs were growing similarly to what we observe in other study states.”

Key findings from the study include:

• Increases in wages and duration of temporary disability were the main reasons behind increases in Virginia indemnity benefits per claim since 2022.
• All components of benefit delivery expenses contributed to the increases in that category in Virginia in 2023, including medical-legal expenses, medical cost containment expenses, and litigation fees.

CompScope™ Benchmarks for Virginia, 2025 Edition, offers an overview of trends in workers’ compensation indemnity benefits, medical payments, and benefit delivery expenses per claim. It also compares workers’ compensation systems in Virginia and 17 other states across these key metrics. The study covers claims through March 2024, focusing on non-COVID-19 claims and examining the effects of pandemic-related disruptions and labor market shifts from 2019 to 2023.

The report was authored by Bogdan Savych.

ABOUT WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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Waltham, MA, May 22, 2025 – Workers’ compensation costs per claim in Minnesota rose about 10 percent annually from 2021 to 2023, following stability during the first two years of the pandemic, according to a recent report from the Workers Compensation Research Institute (WCRI). Rising wages, longer duration of temporary disability, and increased medical payments per claim were the main drivers of this recent cost growth.

“Minnesota is not alone in seeing growth in overall costs per claim from 2021 to 2023,” said Sebastian Negrusa, vice president of research at WCRI. “Nearly all study states experienced cost growth since 2021, after cost decreases or stability in the prior two years. Changes in the availability of medical services and labor market conditions during the early COVID-19 pandemic and the more recent recovery period were the main factors behind this general trend.”

The following are some other findings from the study:

• Total costs per claim in Minnesota were lower than typical among the study states for claims with more than seven days of lost time and 36 months of experience.
• Benefit delivery expenses per claim increased in 2023, driven by growth in both expenses for managing medical costs and litigation-related expenses.

CompScope™ Benchmarks for Minnesota, 2025 Edition provides a comprehensive analysis of recent trends in indemnity benefits, medical payments, and benefit delivery expenses per claim. It also compares Minnesota’s workers’ compensation system with 17 other states on these key metrics. The study covers claims through March 2024, focusing on non-COVID-19 claims and examining the effects of pandemic-related disruptions and labor market shifts from 2019 to 2023.

The report was authored by Rebecca Yang.

ABOUT WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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Waltham, MA – The Workers Compensation Research Institute (WCRI) recently released the 2025 edition of its annual study, WCRI Medical Price Index for Workers’ Compensation, 17th Edition (MPI-WC). This analysis compares prices paid for workers’ compensation medical services across 36 states and over time, while also showing how rising inflation has affected the system in recent years.

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Waltham, MA, May 20, 2025 —The Workers Compensation Research Institute (WCRI) has released the 2025 edition of its annual study, WCRI Medical Price Index for Workers’ Compensation, 17th Edition (MPI-WC). This analysis compares prices paid for workers’ compensation medical services across 36 states and over time, while also showing how rising inflation has affected the system in recent years.

"This study found that many states experienced faster growth in prices paid for workers’ compensation medical professional services from 2021 to 2024 compared with earlier years," said Ramona Tanabe, WCRI’s president and CEO. “This trend is due to, among other things, higher inflation in the general economy over the last few years. This was especially the case for states that update their fee schedules based on all-price indexes, rather than on medical price indexes.”

The study focuses on comparing prices paid for medical professional services across states, helping policymakers and stakeholders assess whether price growth is a national trend or specific to their state. Services analyzed include evaluation and management, physical medicine, surgery, radiology, neurological testing, pain management injections, and emergency care—typically billed by physicians, physical therapists, and chiropractors. Additionally, the study examines how fee schedules and network participation influence price trends, providing valuable insights into price regulation.

Other key findings from the study include:

• Price Variations Across States: Prices for professional services varied significantly, ranging from 33 percent below the 36-state median in Florida to 172 percent above the median in Wisconsin in 2024.
• Impact of Fee Schedules: States with no fee schedules had prices 35 to 177 percent higher than states with fee schedules in 2024.
• Price Growth Trends: Most states without fee schedules saw faster growth in prices for professional services from 2008 to 2024, with a median growth rate of 40 percent, compared with 15 percent in states with fee schedules.
• Fee Schedule Changes: The study provides insights on price changes following major fee schedule updates, examining both overall price shifts and changes by service type.

This edition expands the growth rate analysis over a 17-year period, from 2008 to 2024, and presents price index comparisons for 2023 and 2024 across the 36 study states. The 2024 results are based on price data collected from the first half of the year, up until June 30, 2024. The 36 states included represent 88 percent of workers' compensation benefits paid in the United States.

To download a free copy of the report, visit WCRI’s website at www.wcrinet.org. The study was authored by Dr. Rebecca Yang and Dr. Olesya Fomenko.

About WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in 1983, the Institute does not take positions on the issues it researches. It provides information obtained through studies and data collection efforts that conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers, insurers, governmental entities, managed care companies, health care providers, insurance regulators, state labor organizations, and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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In this free, 30-minute webinar held on Thursday, June 5, 2025, Evelina Radeva discussed findings from WCRI's CompScope™ Benchmarks for Delaware, 2025 Edition. 

Key Questions Addressed:

• How does Delaware’s workers’ compensation system compare with 17 other states?
• How has the performance of Delaware’s workers’ compensation system changed between 2018 and 2023?

This edition analyzes Delaware workers’ compensation claims from 2018 to 2023 (evaluated as of March 2024), providing both current data and longer-term context. The study also incorporates findings from recent WCRI research and focuses on non-COVID-19 claims to assess the effects of the pandemic on system performance.

Click here to watch.

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Waltham, MA, May 15, 2025 ― The Workers Compensation Research Institute (WCRI) will host a free, 30-minute webinar on Thursday, June 5, 2025, at 2 p.m. ET, focusing on findings from its CompScope™ Benchmarks for Delaware, 2025 Edition. The study’s lead author, Evelina Radeva, will discuss Delaware’s workers’ compensation system and its performance relative to other states.

“The study provides policymakers and other system stakeholders in Delaware with ongoing annual monitoring of changes in indemnity benefits, medical payments, and benefit delivery expenses per claim. It also compares the Delaware workers’ compensation system with 17 other study states on these key metrics,” said Sebastian Negrusa, WCRI’s vice president of research.

Key Questions Addressed:

• How does Delaware’s workers’ compensation system compare with 17 other states?
• How has the performance of Delaware’s workers’ compensation system changed between 2018 and 2023?

This edition analyzes Delaware workers’ compensation claims from 2018 to 2023 (evaluated as of March 2024), providing both current data and longer-term context. The study also incorporates findings from recent WCRI research and focuses on non-COVID-19 claims to assess the effects of the pandemic on system performance.

Attendance is limited to 500 participants. All registrants will receive a copy of the webinar slides and a recording of the session. Click here to register now.

About WCRI:

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in 1983, the Institute does not take positions on the issues it researches. It provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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The Workers Compensation Research Institute said recent changes in overall costs per claim in Florida in 2022 and 2023 were largely the result of wage growth.

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Waltham, MA, May 13, 2025 – The recent changes in overall costs per claim in 2022 and 2023 in Florida were largely due to wage growth, according to a recent study by the Workers Compensation Research Institute (WCRI). In contrast, medical payments per claim were stable from 2020 to 2023 following a decrease in 2020, mainly driven by decreases in utilization of medical services due to pandemic-related factors.

“With stability in medical payments, wage growth in recent years has been the most influential factor on changes in Florida’s total costs per claim,” said Sebastian Negrusa, vice president of research for WCRI. “The state’s experience primarily reflects the tight labor market during the economic recovery from the peak of the COVID-19 pandemic.”

The following are some other findings from the study:

• Florida ranked in the middle of the study states on all components of total costs, namely medical payments, indemnity benefits, and benefit delivery expenses per claim.
• Typical medical payments per claim in Florida mask offsetting components: the lowest prices for nonhospital care and the highest prices for hospital outpatient services of the study states.

CompScope™ Benchmarks for Florida, 2025 Edition provides a comprehensive analysis of recent trends in indemnity benefits, medical payments, and benefit delivery expenses per claim. It also compares Florida’s workers’ compensation system with 17 other states on these key metrics. The study covers claims through March 2024, focusing on non-COVID-19 cases and examining the impact of pandemic-related disruptions and labor market shifts from 2019 to 2023.

The report was authored by Rebecca Yang and is available for download at https://www.wcrinet.org/reports/compscope-benchmarks-for-florida-2025-edition.

ABOUT WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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Waltham, MA, May 6, 2025 – A new study from the Workers Compensation Research Institute (WCRI) finds that total costs per workers’ compensation claim in Delaware remain stable. These costs include three components: indemnity payments for lost wages, medical expenses, and benefit delivery expenses.

“Delaware ranks near the middle of the 18 study states in terms of total costs per claim,” said Sebastian Negrusa, vice president of research at WCRI. “This reflects a mix of lower-than-typical medical payments, typical indemnity benefits, and higher benefit delivery expenses.”

The following are some other findings from the study:

• Higher benefit delivery expenses were primarily driven by more frequent and more costly litigation.
• Total costs per claim increased after 2020, mostly due to increases in duration of temporary disability and workers’ wages.

The CompScope™ Benchmarks for Delaware, 2025 Edition offers an annual overview of changes in indemnity benefits, medical payments, and benefit delivery expenses per claim. It also compares Delaware’s workers’ compensation system with those in 17 other states across these key metrics. The study covers claims through March 2024, focusing on non-COVID-19 claims and examining the effects of pandemic-related disruptions and labor market shifts from 2019 to 2023.

The report was authored by Evelina Radeva and is available for download at https://www.wcrinet.org/reports/compscope-benchmarks-for-delaware-2025-edition.

ABOUT WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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Claim frequency increased by an average of 7.7% in states after the adoption of recreational cannabis laws, according to a new study by the Workers Compensation Research Institute. 

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Today’s issue of WorkCompRecap features the release of the latest edition of WCRI’s CompScope Benchmarks reports, which provide ongoing annual monitoring of how indemnity benefits, medical payments, and benefit delivery expenses in 18 states compare and how they have changed over time.

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Waltham, MA, April 30, 2025 – As more states adopt recreational marijuana laws (RMLs), a new study by the Workers Compensation Research Institute (WCRI) examines changes in workers’ compensation claim frequency and outcomes such as per-claim medical payments, indemnity benefits, temporary disability duration, and prescription drug utilization and costs.

"This research is important as marijuana use continues to rise," said Ramona Tanabe, president and CEO of WCRI. "Our study highlights the complex effects RMLs have on work injury risk and workers' compensation claim costs. This information is relevant for policymakers, insurance carriers, medical providers, labor advocates, and employers as they navigate these evolving challenges."

The study, Impact of Recreational Marijuana Laws on Workers’ Compensation Benefits, answers key questions:

• How did the adoption of RMLs affect overall workers' compensation claim frequency?
• Were the effects different among younger workers, or those in safety-sensitive or physically demanding jobs?
• What impact did RMLs have on medical payments per claim?
• Were there changes in prescription drug use due to RMLs, including opioids?
• Did RMLs affect indemnity benefits and disability duration?
• Did the impact of RMLs on these outcomes change over time?

The study’s findings can inform debates on issues such as marijuana rescheduling, occupational treatment guidelines, state THC (tetrahydrocannabinol) regulations, or marijuana taxes. The analysis covers 31 states, using data from workers' compensation claims filed between October 2012 and March 2022.

Click here for more information or to purchase a copy of the study. It was authored by Vennela Thumula, Johanna Catherine MacLean, David Powell, and Sebastian Negrusa.

ABOUT WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia and New Zealand.

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Recent studies by the Workers’ Compensation Research Institute (WCRI) and the National Council on Compensation Insurance (NCCI) shed light on the significant risks posed by heat-related illnesses (HRIs). These findings underscore the need for comprehensive measures to protect workers from excessive heat and other extreme weather.

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Indemnity benefits and medical costs per workers compensation claim grew in most states since 2021, according to research reports released Monday by the Workers Compensation Research Institute.

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Waltham, MA, April 28, 2025―Total costs per workers’ compensation claim rose between 2 and 14 percent annually from 2021 to 2023 across 18 states, according to a new set of studies from the Workers Compensation Research Institute (WCRI).

“Total cost per claim is a widely used measure for policymakers and system stakeholders to gauge how their system is performing compared to other states. It combines three components—indemnity benefits for lost wages, medical payments, and benefit delivery expenses per claim,” said Sebastian Negrusa, vice president of research at WCRI. “While it’s a key metric, it’s just one of many measures that these studies track to provide a comprehensive view of system performance.”

The increase across the board in total costs per claim reflects changes in access to medical services and labor market conditions since the early pandemic years, particularly the recent rise in short-tenure workers as a share of claims. Although all states showed an upward trend in total costs per claim, the measure masks important nuances:

• Delaware: Total costs per claim increased 7 percent per year in Delaware from 2021 to 2023, primarily driven by rapid growth in wages and temporary disability duration.
• Florida: Wage growth in Florida accelerated in 2022 and then moderated in 2023, cooling the increases in indemnity benefits and resulting in growth of 4.5 percent per year in total costs per claim.
• Minnesota: Total costs per claim in Minnesota grew 10 percent per year from 2021 to 2023, mainly driven by increases in wages, duration of temporary disability, and medical payments per claim.
• New Jersey: Costs per claim in New Jersey increased about 8 percent annually from 2021 to 2023, largely driven by wage growth, especially for new hires and short-tenure workers.
• Virginia: The 7.4 percent average growth in Virginia total costs per claim since 2021 was driven by increasing indemnity benefits and benefit delivery expenses per claim, but partially offset by declining medical payments.

The studies, CompScope™ Benchmarks, 2025 Edition, provide ongoing annual monitoring of how indemnity benefits, medical payments, and benefit delivery expenses in 18 states compare and how they have changed over time. The 18 states in the study are Arkansas, California, Delaware, Florida, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Texas, Virginia, and Wisconsin. Individual reports are available for every state except Arkansas, Iowa, Kentucky, and Texas. The studies cover claims through March 2024, focusing on non-COVID-19 claims, and track how pandemic-related disruptions and labor market shifts affected claims from 2019 to 2023.

For more information on these studies or to download copies, visit www.wcrinet.org.

About WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; government entities; managed care companies; health care providers; insurance regulators; labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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The Workers’ Compensation Research Institute (WCRI) released its 2025 Annual Report. This report highlights WCRI’s studies, which helped guide policy throughout 2024.

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Sebastian Negrusa, vice president of research for the Workers Compensation Research Institute, discusses the latest research studies on injured workers.

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According to a survey by the Workers Compensation Research Institute, more than 75,000 COVID-19-related claims were filed in 2020 alone, accounting for approximately 7% of all workers’ compensation claims that year.

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In this 30-minute recorded webinar held on April 17, 2025, at 2 PM ET, Dr. Vennela Thumula discussed findings from a recent WCRI FlashReport—Overview of Workers’ Compensation Claims Composition, which evaluated shifts in claim characteristics from 2017 to 2022.

The webinar addressed the following questions:

• How did the relative share of work injuries change by industry?
• Did the proportion of women/men among work-related injuries change?
• What was the most frequent injury type, and were there differences in injury distribution by age, gender, and industry?
• Did work-related injuries occur more frequently among younger or older workers?

The data for this study focus on 8.4 million non-COVID-19 claims from injury years 2017 through 2022 across 31 states, which represent about 80 percent of the workers' compensation benefits paid in the United States.

The recorded webinar is free for WCRI members and $25 for non-members.

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The Workers Compensation Research Institute (WCRI) recently announced the release of its 2025 Annual Report. The report highlights WCRI’s studies and how they were used by policymakers and stakeholders throughout 2024.

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Waltham, MA, October 10, 2024 ― A new set of studies from the Workers Compensation Research Institute (WCRI) found that utilization of medical services by workers with injuries declined in the majority of the 17 study states. The study addresses two aspects of utilization: the percentage of claims receiving a particular medical service and the number of services provided.

“We continue to see the effects of the pandemic on 2022 claims with experience through March 2023,” said Sebastian Negrusa, vice president of research for WCRI. “Besides strained hospital capacity and avoided medical care by many people out of fear of COVID-19 in the early months of the pandemic, waves of increased COVID-19 cases and medical provider shortages may have also affected the delivery of medical care. Even in the few cases where utilization in certain states has begun to rebound, we do not see it reaching pre-pandemic levels yet.”

The studies, CompScope™ Medical Benchmarks, 25th Edition, examined medical payments, prices, and utilization overall and by provider and type of service across 17 states and how these metrics of medical payments have changed over time. The following are sample findings for some of the study states:

• California: Utilization of medical services decreased in 2022, particularly in the percentage of claims with inpatient care and facility services (both hospital outpatient departments and ambulatory surgery centers).
• Indiana: Utilization declined in 2022, particularly for major surgery and facility services.
• Minnesota: Unlike most study states, utilization of most services in Minnesota either stayed stable or began to increase in 2022.
• North Carolina: Decreasing utilization was a driver of the state’s decline in medical payments per claim in 2022, in contrast to many study states which experienced growth.
• Pennsylvania: The share of claims with facility services in the state declined more than most study states since 2019.

The analysis results reflect experience on claims through March 2023, including non-COVID-19 claims from the pandemic period (March 2020–September 2022). The studies, therefore, provide a look at how the pandemic impacted non-COVID-19 workers’ compensation claims. The 17 states in the study ― Arkansas, California, Florida, Illinois, Indiana, Iowa, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Tennessee, Texas, Virginia, and Wisconsin ― represent about 60 percent of all workers’ compensation benefit payments nationwide. Individual reports are available for every state except Arkansas, Iowa, and Tennessee. For more information on these studies, visit https://www.wcrinet.org.

About WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Cambridge, MA. Founded in 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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The landscape of workers’ compensation has shifted significantly in recent years, impacted by technology, advances in medical treatments, and a better understanding of how different types of injuries affect employees

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Waltham, MA, March 27, 2025 – A new report from the Workers Compensation Research Institute (WCRI) reveals that claims involving degenerative conditions and comorbidities, such as hypertension or diabetes, incur higher costs and longer temporary disability durations. The report examines claims with and without comorbidities, as well as those with single or multiple comorbid conditions.

"Degenerative and comorbid conditions often coexist with primary work-related injuries, complicating treatment and recovery, which results in increased medical payments and indemnity benefits," said Sebastian Negrusa, WCRI vice president of research. "This study emphasizes the importance of early identification and intervention to mitigate the impact of these conditions on claim costs and outcomes."

The study, Degenerative and Comorbid Conditions in Workers’ Compensation, analyzes data from 32 states and answers the following key questions:

• How common are degenerative comorbidities, such as degenerative disc disease and osteoarthritis, and how do they vary by injury type?
• What is the frequency of other comorbidities, including hypertension, substance use, mental health conditions, diabetes, and obesity, and how often do claims involve multiple comorbidities?
• How do comorbidities impact claim costs and the duration of temporary disability compared to claims without these conditions?

The study examines data from more than 930,000 claims with over seven days of lost time. The report includes measures on medical payments, indemnity benefits, and duration of temporary disability. The report was authored by Dongchun Wang, Randall D. Lea, and Kathryn L. Mueller.

ABOUT WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia and New Zealand.

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Waltham, MA, March 25, 2025 – The Workers Compensation Research Institute (WCRI) is pleased to announce the release of its 2025 Annual Report, now available on its website. The report highlights WCRI’s studies published in 2024 and how they were used by policymakers and stakeholders.

In her message, WCRI President and CEO Ramona Tanabe emphasized the importance of independent, data-driven research as new challenges—such as extreme weather, policy shifts, and changes in health care—affect workers' compensation. “At WCRI, we remain dedicated to providing unbiased, trusted information, funded by stakeholders who support our mission to deliver research free from recommendations or opinions,” she said.

Tanabe highlighted more than 40 studies published in 2024, covering crucial topics like psychosocial factors in outcomes, attorney involvement, and high-cost claims. She also noted the significance of WCRI’s benchmarking studies, which track trends such as medical pricing, drug payments, and cost-containment strategies across states.

A standout study on the effects of excessive heat on work-related injuries gained national attention, with coverage from the Wall Street Journal, New York Times, and Newsweek. This research contributed to the development of a proposed Occupational Safety and Health Administration rule on heat injury prevention, underscoring WCRI’s influence on policy change and worker safety.

Looking ahead, Tanabe outlined WCRI’s research agenda, which will address topics such as recreational marijuana laws, the aging workforce, emerging technologies like AI, and medical workforce shortages.

Tanabe closed by thanking WCRI members for their continued support and urging them to help expand the Institute’s membership. “Expanding our membership allows us to conduct research in more states and explore a wider range of topics, increasing our ability to create a meaningful impact on the workers’ compensation system,” she emphasized.

The Annual Report includes a list of published studies, how the research was applied, key research highlights, corporate social responsibility efforts, member interviews, and a full list of supporters who made WCRI's research possible in 2024. Click here to view the report.

About WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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A huge thank you to our speakers and attendees for making the 2025 WCRI Issues & Research Conference in sunny Phoenix a tremendous success!

We hope all our attendees enjoyed diving into our latest research, hearing from expert keynote speakers and panelists, and networking with our diverse audience. Mark your calendars for next year’s conference, scheduled for March 3–4, 2026, in Boston, MA.

For those who attended, presentation slides are still available through our conference app, and we’d love to hear your thoughts through our post-event survey. As part of our ongoing commitment to giving back, WCRI will donate $3 to Kids' Chance for every completed survey.

Relive key moments from the conference in the photo slideshow below, and read articles written about the event on our website. If you have any questions or feedback, feel free to reach out. We look forward to seeing you in Boston next year!

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Last week, the daisyBill team had the pleasure of attending the Workers Compensation Research Institute (WCRI) Annual Issues & Research Conference in Phoenix.

The event was exceptional.

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At the Workers’ Compensation Research Institute (WCRI) Annual Conference in Phoenix yesterday, researchers presented findings on how changes in the medical workforce are impacting workers’ compensation systems across the United States. The presentation highlighted significant shifts in who provides care to injured workers and what these changes mean for claim outcomes.

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Waltham, MA, February 27, 2025 – A new report from the Workers Compensation Research Institute (WCRI) and the International Association of Accident Boards and Commissions (IAIABC) compares workers’ compensation regulations and benefits across U.S. states and Canadian provinces as of January 1, 2025.

“This study is a must-have for workers’ compensation professionals,” said WCRI President and CEO Ramona Tanabe. “It answers common questions about jurisdictional differences and continues to expand as new rules emerge, such as presumptions for first responders. We also provide tools for deeper research into specific areas of interest.”

In Canada and the United States, workers’ compensation is governed by sub-national legislative bodies and administrative agencies. The differences between jurisdictional laws and regulations can be subtle, and this survey helps professionals understand those differences, such as the following:

• Eligibility requirements for temporary disability benefits
• Employer vs. employee health care provider selection
• Burial allowances and dependent benefits for work-related fatalities
• Compensation differences for injuries like amputations
• Coverage for mental stress, hearing loss, and cumulative trauma
• Availability of rehabilitation benefits
• Attorney fee structures and payment sources

The study, Workers’ Compensation Laws as of January 1, 2025, builds on years of valuable work by the U.S. Department of Labor (USDOL), which pioneered the use of standardized tables to ensure uniformity across states and consistency over time. After USDOL suspended production for budgetary reasons, WCRI and IAIABC partnered to continue publishing this important resource.

For more information or to purchase a copy, visit www.wcrinet.org. The report was authored by Karen Rothkin.

ABOUT WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia and New Zealand.

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The clock is ticking—only one week remains to secure your spot at the 2025 WCRI Issues & Research Conference, taking place March 6–7 in sunny Phoenix, AZ.

Federal changes—those already made and those under consideration—are likely to impact all stakeholders in the system in different ways. This is what makes the WCRI conference a must-attend event. It brings together employers, insurers, policymakers, labor unions, and more.

Many are preparing for changes that could directly or indirectly affect state workers' compensation systems, including potential shifts in Medicare, Medicaid, and OSHA. How will these developments impact safety, physicians, and access to care for injured workers?

Join us for keynote speakers, expert panels, and cutting-edge research to help you navigate these evolving challenges.

Engage with decision-makers from over 150 organizations—a unique opportunity to gather diverse perspectives, exchange ideas, and shape your priorities for the year.

Don’t wait—register today and book your hotel! You can also register at the door. Be sure to watch this video to see why so many attendees return year after year.

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The Workers Compensation Research Institute released a new report exploring variations in medical utilization trends during the COVID-19 pandemic based on the age and tenure of workers. 

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Waltham, MA, February 25, 2025 —The Workers Compensation Research Institute (WCRI) has released a new FlashReport exploring how medical utilization trends during the COVID-19 pandemic varied by workers' age and job tenure.

"Decreases in medical utilization were a key driver of trends in medical payments per claim during the pandemic," said Dr. Sebastian Negrusa, vice president of research at WCRI. "This report offers valuable insights into how these trends differed across workers of various ages and job tenures."

The FlashReport, Trends in Medical Utilization as a Function of Age and Tenure, analyzed data from 17 states spanning 2017 to 2022, with a focus on the pandemic period since 2019. The report answers the following key questions:

• Did COVID-19 impact medical utilization differently for various age or job tenure groups?
• What were the trends in medical utilization during the pandemic for these groups?
• Did changes in age and tenure distributions of injured workers contribute to the overall decrease in medical utilization?

The study examines medical service utilization by age and tenure, focusing on office visits, emergency care, physical medicine, and major surgeries. The report focuses on non-COVID claims and explores the pandemic’s impact on medical care.

For more information or to purchase a copy, visit www.wcrinet.org. The study was authored by Dr. Rebecca Yang, Dr. Karen Rothkin, Evelina Radeva, and Roman Dolinschi.

About WCRI:

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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The clock is ticking—only two weeks remain to secure your spot at the 2025 WCRI Issues & Research Conference, March 6–7 in sunny Phoenix, AZ.

At WCRI, we know conferences are about two key things: cutting-edge content and meaningful networking. We’re proud to deliver both in abundance.

Cutting-Edge Content

Get access to original, data-driven research on the most pressing issues in our field, including:

• The Impact of Comorbid Conditions
• Shifts in the Medical Workforce
• The Growing Influence of Recreational Marijuana
• Key Developments in the California Workers' Compensation System
• The Link Between Pre-Injury and Post-Injury Opioid Use

But that's not all! We’re also excited to feature two powerful keynote speakers covering:

• The influence of the new administration and Congress on healthcare policy
• Emerging threats to healthcare access

Two dynamic interactive panels will dive even deeper into these pivotal topics—and more!

Meaningful Networking

Join decision-makers from over 150 organizations. This is your chance to engage with top professionals, exchange ideas, and build lasting relationships that can propel your career forward.

Don’t wait—secure your spot and book your hotel today. And be sure to watch this video to see why so many attendees return year after year.

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In this WCRI Member Spotlight, we spoke with Fred Yamashita, Secretary-Treasurer and Executive Director of the Arizona AFL-CIO, about the value his organization gains from being a member of the Institute.

Fred has led the Arizona AFL-CIO since November 2017, overseeing an organization that represents approximately 185,000 union members across more than 200 local affiliates statewide. The Arizona AFL-CIO advocates for workers' rights at the state level.

Originally from Detroit, Michigan, Fred began his career as a frontline worker in the grocery industry, where he spent 20 years before transitioning into union leadership. He then spent another two decades with the United Food and Commercial Workers (UFCW) Local 99.

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The 2025 WCRI Issues & Research Conference is almost here—March 6–7 in Phoenix, AZ. With ongoing changes in Washington, now is the perfect time to explore how these shifts could impact the future of workers' compensation.

This year’s event features two renowned thought leaders:

• Dr. Lanhee J. Chen (Stanford University) will open with an engaging discussion on how the new administration and Congress may influence healthcare policy—and the potential impact on workers’ compensation.
• Dr. Mark Holmes (UNC and the Cecil G. Sheps Center) will address healthcare access challenges in rural America, including how changes to Medicare and Medicaid could affect the system.

Alongside these compelling keynotes, our expert-led panels will offer invaluable, on-the-ground knowledge, empowering you to anticipate what lies ahead and take informed action.

You'll also have the chance to connect with senior decision-makers from over 150 organizations, enabling you to discuss what you're learning with industry peers. Watch this video to see why so many attendees return year after year.

⏳Act Now! The hotel room block has been extended until this Friday (2/14). Secure your spot and book your hotel before it’s too late.

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The Workers’ Compensation Research Institute (WCRI) released its Changes in the Medical Workforce and Impact on Claims report. This report highlights the increasing role of nurse practitioners and physician assistants in treating injured workers during their first medical visits, a trend driven by physician shortages. Despite this shift, the report found it had minimal impact on claim costs.

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Waltham, MA, January 30, 2025 — A new report from the Workers Compensation Research Institute (WCRI) revealed a rise in the frequency of lump-sum settlements in New York after the 2007 workers’ compensation reforms. The percentage of indemnity claims settled by lump sum increased from 23% in injury year 2007 to 37% in injury year 2014, before slightly declining after 2015.

“This marked shift represents an important change in settlement behavior in New York,” said Sebastian Negrusa, vice president of research at WCRI. “This FlashReport provides a detailed look at settlement behaviors in New York and explores the policy changes and other factors driving these shifts.”

The study, titled Changing Settlement Behavior in the New York Workers’ Compensation System, also provides answers to key questions, such as the following:

• How have the frequency and costs of lump-sum settlements evolved in New York?
• What impact have policy changes had on settlement trends?
• How has the time from injury to settlement changed?
• What shifts have occurred in the use and costs of schedule loss of use (SLU) versus non-schedule awards?

Settlements of both indemnity and medical benefits are common in New York, especially in cases involving permanent partial disability (PPD) benefits. Understanding these settlements is critical as New York allows both SLU and non-schedule awards, determined by the specific body part affected by the injury.

The report’s findings are based on data from WCRI’s Detailed Benchmark/Evaluation database, which includes claims data from national and regional insurers and claims management organizations. The analysis covers open and closed non-COVID-19 indemnity claims from injury years 2005 to 2022, with claims evaluated from 12 to 60 months of maturity.

For more information or to purchase the full study, visit https://www.wcrinet.org/reports/changing-settlement-behavior-in-the-new-york-workers-compensation-system.

About WCRI:

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI’s diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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A common question we receive about our annual conference is: Who should attend? The answer is simple: anyone interested in learning about the latest research on state workers' compensation systems, gaining valuable knowledge, and connecting with peers.

Even better, take a look at the diverse organizations registered for our 2025 Annual Issues & Research Conference, happening March 6-7 in Phoenix, AZ. Over 150 organizations have signed up, including:

• accuro Solutions
• Advanced Hearing Providers
• AF Group
• AIG
• Albertsons
• Alius Health
• American Medical Association
• Ametros
• AmTrust
• ANS Solutions
• Arbicare
• Arcuity
• Ascellus
• Ascendia Group, LLC
• Association of New Jersey Chiropractors
• Athens Administrators
• Athletico Physical Therapy
• Averitt Express
• AVO T&L
• Best In Class, MD
• Cadence Rx
• California Physical Therapy Association
• California Workers’ Compensation Institute
• Capehart & Scatchard
• Carisk Partners
• Centre for Neuro Skills
• CNA Insurance
• Colorado Department of Health Care Policy & Financing
• Colorado Division of Workers’ Compensation
• Comp-X Medical
• Concentra
• Constellation Energy
• Construction Industry Service Organization (CISCO)
• Corvel Corporation
• Crest Insurance Group
• CutCompCosts.com
• daisyBill
• Definiti Comp Solutions
• Duke University
• DW Advisors, LLC
• Eastern Alliance Insurance Group
• EK Health
• Emperion
• Enlyte
• ESIS
• Ethos Risk
• Everest Insurance
• FAIR Health, Inc.
• FIGUR8
• FreedomlinkRx
• From Bob’s Cluttered Desk
• Gallagher Bassett
• Gallagher Re
• General Mills
• Gradient AI
• Hanna, Brophy, MacLean, McAleer & Jensen, LLP
• Hanover Insurance Group
• Hartford Insurance Group
• HeadUp Healthcare
• Healthesystems
• Horizon Casualty Services
• Horizon Health Care Consultants
• ICW Group
• IIABA
• IMPAXX
• Indiana Compensation Rating Bureau
• Industrial Commission of Arizona
• Injury Guard Solutions
• Institutes of Health
• Intercare
• ION PT Network
• ISYS Solutions Inc.
• JAG Source IPA, LLC
• Kentucky Employers Mutual Insurance
• Leidos
• Liberty Mutual
• Lockton
• Majoris Health Systems
• Marriott International
• Marsh
• MedRisk
• Milliman
• Missouri Employers Mutual
• Missoula County
• Montana Department of Labor & Industry
• Morrison Mahoney
• MTI America
• Multiplan
• MWCIA
• MyMatrixx by Evernorth
• Nationwide Insurance
• NCCI
• Neuro RehabCare
• New Jersey Compensation and Inspection Bureau
• New Mexico Mutual
• New York State Workers’ Compensation Board
• NJM Insurance Group
• North Carolina Rural Health Research and Policy Analysis Center
• New York State Workers Compensation Board
• ODG by MCG
• One Call
• Optum
• Oregon Department of Consumer and Business Services
• Paradigm
• Penn National Insurance
• Pennsylvania Department of Labor and Industry
• Pennsylvania Compensation Rating Bureau
• Perspecta
• PhysNet
• Plethy, Inc.
• PMA Companies
• Political Subdivision Workers’ Compensation Alliance
• Prime Health Services
• Publix Supermarkets
• RefMed
• Reliant Health Partners
• Rising Medical Solutions
• RoyOMartin
• RxBridge
• S1 Medical
• Safety National
• Sanderson Firm, PLLC
• Secura Insurance
• Sedgwick
• Select Medical
• Selective Insurance
• Sentry Insurance
• SFM Mutual Insurance Company
• Shearwater Health
• Shirley Ryan AbilityLab
• SMS National
• Sompo
• Stanford University
• State California Insurance Fund
• State of Maine
• Stephens Insurance
• Stream
• Streamline
• Tennessee AFL-CIO
• Tennessee General Assembly
• Texas Mutual Insurance Group
• The IMA Group
• TIRR Memorial Hermann
• Towers MSA Partners
• Transcom Solutions
• Travelers Insurance
• Trean
• United Steelworkers Local 1155L
• University of Washington
• Upstream Rehabilitation
• VGM Homelink
• Walmart
• Walt Disney Parks and Resorts
• Washington Self Insurers Association
• WCRIB California
• WCRA
• WellRithms
• WILG
• Wisconsin Department of Workforce Development
• WorkersCompensation.com
• XcelABLE
• Zelis
• Zetroz
• Zurich North America

Don’t miss this chance to elevate your career, expand your expertise, and connect with your peers. Click here to learn more about the agenda or to register for the conference.

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A common question we receive about our annual conference is: Who should attend? The answer is simple: anyone interested in learning about the latest research on state workers' compensation systems, gaining valuable knowledge, and connecting with peers.

Even better, take a look at the diverse organizations registered for our 2025 Annual Issues & Research Conference, happening March 6-7 in Phoenix, AZ. Over 150 organizations have signed up, including:

• accuro Solutions
• Advanced Hearing Providers
• AF Group
• AIG
• Albertsons
• Alius Health
• American Medical Association
• Ametros
• AmTrust
• ANS Solutions
• Arbicare
• Arcuity
• Ascellus
• Ascendia Group, LLC
• Association of New Jersey Chiropractors
• Athens Administrators
• Athletico Physical Therapy
• Averitt Express
• AVO T&L
• Best In Class, MD
• Cadence Rx
• California Physical Therapy Association
• California Workers’ Compensation Institute
• Capehart & Scatchard
• Carisk Partners
• Centre for Neuro Skills
• CNA Insurance
• Colorado Department of Health Care Policy & Financing
• Colorado Division of Workers’ Compensation
• Comp-X Medical
• Concentra
• Constellation Energy
• Construction Industry Service Organization (CISCO)
• Corvel Corporation
• Crest Insurance Group
• CutCompCosts.com
• daisyBill
• Definiti Comp Solutions
• Duke University
• DW Advisors, LLC
• Eastern Alliance Insurance Group
• EK Health
• Emperion
• Enlyte
• ESIS
• Ethos Risk
• Everest Insurance
• FAIR Health, Inc.
• FIGUR8
• FreedomlinkRx
• From Bob’s Cluttered Desk
• Gallagher Bassett
• Gallagher Re
• General Mills
• Gradient AI
• Hanna, Brophy, MacLean, McAleer & Jensen, LLP
• Hanover Insurance Group
• Hartford Insurance Group
• HeadUp Healthcare
• Healthesystems
• Horizon Casualty Services
• Horizon Health Care Consultants
• ICW Group
• IIABA
• IMPAXX
• Indiana Compensation Rating Bureau
• Industrial Commission of Arizona
• Injury Guard Solutions
• Institutes of Health
• Intercare
• ION PT Network
• ISYS Solutions Inc.
• JAG Source IPA, LLC
• Kentucky Employers Mutual Insurance
• Leidos
• Liberty Mutual
• Lockton
• Majoris Health Systems
• Marriott International
• Marsh
• MedRisk
• Milliman
• Missouri Employers Mutual
• Missoula County
• Montana Department of Labor & Industry
• Morrison Mahoney
• MTI America
• Multiplan
• MWCIA
• MyMatrixx by Evernorth
• Nationwide Insurance
• NCCI
• Neuro RehabCare
• New Jersey Compensation and Inspection Bureau
• New Mexico Mutual
• New York State Workers’ Compensation Board
• NJM Insurance Group
• North Carolina Rural Health Research and Policy Analysis Center
• New York State Workers Compensation Board
• ODG by MCG
• One Call
• Optum
• Oregon Department of Consumer and Business Services
• Paradigm
• Penn National Insurance
• Pennsylvania Department of Labor and Industry
• Pennsylvania Compensation Rating Bureau
• Perspecta
• PhysNet
• Plethy, Inc.
• PMA Companies
• Political Subdivision Workers’ Compensation Alliance
• Prime Health Services
• Publix Supermarkets
• RefMed
• Reliant Health Partners
• Rising Medical Solutions
• RoyOMartin
• RxBridge
• S1 Medical
• Safety National
• Sanderson Firm, PLLC
• Secura Insurance
• Sedgwick
• Select Medical
• Selective Insurance
• Sentry Insurance
• SFM Mutual Insurance Company
• Shearwater Health
• Shirley Ryan AbilityLab
• SMS National
• Sompo
• Stanford University
• State California Insurance Fund
• State of Maine
• Stephens Insurance
• Stream
• Streamline
• Tennessee AFL-CIO
• Tennessee General Assembly
• Texas Mutual Insurance Group
• The IMA Group
• TIRR Memorial Hermann
• Towers MSA Partners
• Transcom Solutions
• Travelers Insurance
• Trean
• United Steelworkers Local 1155L
• University of Washington
• Upstream Rehabilitation
• VGM Homelink
• Walmart
• Walt Disney Parks and Resorts
• Washington Self Insurers Association
• WCRIB California
• WCRA
• WellRithms
• WILG
• Wisconsin Department of Workforce Development
• WorkersCompensation.com
• XcelABLE
• Zelis
• Zetroz
• Zurich North America

Don’t miss this chance to elevate your career, expand your expertise, and connect with your peers. Click here to learn more about the agenda or to register for the conference.

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Waltham, MA, January 28, 2025 — The Workers Compensation Research Institute (WCRI) will host two key panel discussions at its 2025 Issues & Research Conference, March 6-7 in Phoenix, AZ.

“These panels feature professionals with extensive, firsthand experience in state workers’ compensation systems. Their varied perspectives will provide attendees with expert guidance on understanding and addressing complexities of the workers’ compensation systems and emerging topics like AI and labor shortages,” said Ramona Tanabe, president and CEO of WCRI.

The first panel, “Regulatory Panel: Responding to Today’s Challenges,” will feature U.S. regulators discussing the dynamics of state workers' compensation systems and future challenges. Panelists include:

• Clarissa Rodriguez, Chair & Commissioner, New York State Workers' Compensation Board
• Marianne Saylor, Director, Pennsylvania Bureau of Workers' Compensation
• Gaetano Testini, Esq., Director, Industrial Commission of Arizona

The second panel, “Perspectives on COMPlex Topics,” will address issues such as AI, labor shortages, long COVID, marijuana, medical inflation, and mental health, with contributions from stakeholders, including:

• Melissa Zaparanick, Head of Workers Compensation - Middle and Large Commercial, The Hartford Insurance Group
• Billy Dycus, President, Tennessee AFL-CIO
• Randall Lea, Retired Orthopedic Surgeon, Hospital Consultant, and WCRI Fellow
• Nancy Kelly, Risk and Nurse Case Manager, Averitt Express

The two-day WCRI Issues & Research Conference is a leading public policy forum for workers' compensation professionals, featuring original research, compelling keynotes, and expert-led panel discussions. Attendees will also have opportunities to network with senior decision-makers and engage with emerging industry trends. Early registrants can save $100 by signing up before February 6. For more information on the conference agenda or to register, please visit here.

About WCRI:

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Cambridge, MA. Organized in 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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The workers compensation industry has seen a steady rise in the number of nurse practitioners and physician assistants tending to injured workers during first medical visits — a shift researchers say was spurred by physician shortages but that has had little impact on claims costs, according to a Workers Compensation Research Institute report released Thursday.

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The Workers Compensation Research Institute on Thursday released a new study offering an in-depth look at the lifecycle of a work comp claim in New York.

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The Workers Compensation Research Institute on Thursday released a new study offering an in-depth look at the lifecycle of a work comp claim in New York.

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Waltham, MA, January 23, 2025 — A new study from the Workers Compensation Research Institute (WCRI) analyzes recent changes in the composition of the medical workforce. These changes, including medical provider shortages and an increase in the demand for health care, may affect care for injured workers.

“Timely access to care is important for workers recovering from injuries,” said Sebastian Negrusa, vice president of research at WCRI. “Provider shortages can cause delays in treatment, longer recovery times, and higher workers’ compensation costs. These challenges were particularly noticeable during the pandemic and continue to be a concern.”

The study, Changes in the Medical Workforce and Impact on Claims, reviewed workers’ compensation data from 2013 to 2022 and addressed questions such as the following:

• How has workers’ access to primary care physicians, as opposed to nurse practitioners or physician assistants, changed since 2013, including during the pandemic?
• Did the use of advanced practitioners (nurse practitioners and physician assistants) instead of physicians vary across states and between urban and rural areas?
• How did the increases in the number of advanced practitioners impact claim costs, disability duration, and types of care provided?

The study uses data from the WCRI Detailed Benchmark/Evaluation (DBE) database, which includes information on workers’ compensation claims, medical care payments, income benefits, and detailed billing data from insurers, state funds, and self-insured employers.

For more information or to purchase the study, visit www.wcrinet.org. The report was authored by Drs. Bogdan Savych and Olesya Fomenko.

About WCRI:

The Workers Compensation Research Institute (WCRI) is an independent, non-profit research organization based in Waltham, MA. Established in 1983, WCRI remains neutral on the issues it investigates, providing objective information from studies and data collection efforts that adhere to recognized scientific methods. Rigorous, impartial peer review procedures further ensure objectivity. WCRI’s diverse membership includes employers, insurers, government entities, managed care organizations, health care providers, insurance regulators, state labor groups, and state administrative agencies across the U.S., Canada, Australia, and New Zealand.

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Waltham, MA, January 22, 2025 — The Workers Compensation Research Institute (WCRI) is excited to announce that University of North Carolina (UNC) Professor Mark Holmes, PhD, will deliver the day-two keynote address at the 2025 WCRI Issues and Research Conference, to be held March 6–7 in Phoenix, Arizona. Dr. Holmes will present a compelling discussion titled “Threats to Healthcare Access in Rural America.”

“We are honored to have Dr. Holmes as our day-two keynote speaker,” said Ramona Tanabe, president and CEO of WCRI. “His deep expertise in rural health policy will shed light on the critical challenges of healthcare access in rural areas and their implications for workers’ compensation stakeholders.”

Dr. Holmes is a professor in the Department of Health Policy and Management at the University of North Carolina (UNC) Gillings School of Global Public Health. He is also the director of the Cecil G. Sheps Center for Health Services Research at UNC, where he leads the North Carolina Rural Health Research and Policy Analysis Center and co-directs the Program on Health Care Economics and Finance.

In his keynote, Prof. Holmes will discuss the unique healthcare challenges in rural areas and their impact on workers' compensation. He will highlight disparities in healthcare access, such as provider shortages and hospital closures, which lead to higher preventable admissions and trauma-related deaths. The focus will also cover barriers like limited telehealth and market forces, including mergers and private equity, emphasizing the need for innovative strategies to ensure timely, quality care for injured rural workers.

The WCRI Issues & Research Conference is a leading public policy forum for workers' compensation professionals. This two-day program highlights the Institute’s latest research findings, drawing upon the diverse perspectives of respected experts and policymakers from across the country. It also provides ample opportunities to network with a high-level group of senior stakeholders. Early registrants can save $100 by signing up before February 6. Click here to learn more about the conference agenda or to register.

About WCRI:

The Workers Compensation Research Institute (WCRI) is an independent, non-profit research organization based in Waltham, MA. Established in 1983, WCRI remains neutral on the issues it investigates, providing objective information from studies and data collection efforts that adhere to recognized scientific methods. Rigorous, impartial peer review procedures further ensure objectivity. WCRI’s diverse membership includes employers, insurers, government entities, managed care organizations, healthcare providers, insurance regulators, state labor groups, and state administrative agencies across the U.S., Canada, Australia, and New Zealand.

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A new WCRI study offers an in-depth look at workers' compensation claims in New York, focusing on the prevalence and costs of various claim types. Learn more at https://buff.ly/42gcn1O.

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Waltham, MA, January 16, 2025 — A new study from the Workers Compensation Research Institute (WCRI) offers an in-depth look at workers' compensation claims in New York, focusing on the prevalence and costs of various claim types.

"The results of this research provide a valuable overview of the types of claims that occur in the New York workers’ compensation system, the costs associated with them, and the timing of key payments, including lump-sum settlements," said Sebastian Negrusa, vice president of research at WCRI. "This information is useful for stakeholders to gain a more detailed perspective of the system and provides a helpful basis for evaluating future policy decisions."

The report, Life Cycle of a New York Workers’ Compensation Claim, analyzes workers’ compensation claims at a snapshot of time, claims from 2018 evaluated in 2023 (60 months after injury). It provides a thorough examination of overall claim costs, timing of key indemnity payments, and other essential system performance indicators. The study explores several important research questions, including the following:

• What percentage of claims and associated costs pertain to each type of claim?
• For indemnity claims, when do key payments, such as the first indemnity or lump-sum payment, typically occur?
• What is the average total cost per claim, and how are costs distributed across categories (indemnity benefits, medical expenses, and benefit delivery costs)?
• What percentage of claims remain open at the time of evaluation?

The data used to evaluate the frequency, costs, and timing of New York claims by claim type come from WCRI’s Detailed Benchmark/Evaluation (DBE) database. This information was collected from national and regional insurance providers and claims management organizations. The data underlying this report come from 15 companies representing a mix in terms of premium volume and claim share, as well as insured and self-insured employers.

For more information or to purchase a copy of the study, visit www.wcrinet.org. The report was authored by William Monnin-Browder and Carol A. Telles.

About WCRI:

The Workers Compensation Research Institute (WCRI) is an independent, non-profit research organization based in Waltham, MA. Established in 1983, WCRI remains neutral on the issues it investigates; instead, it provides objective information drawn from studies and data collection efforts that adhere to recognized scientific methods. Rigorous, impartial peer review procedures further ensure objectivity. WCRI’s diverse membership includes employers, insurers, government entities, managed care organizations, healthcare providers, insurance regulators, state labor groups, and state administrative agencies across the U.S., Canada, Australia, and New Zealand.

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As the year comes to a close, we pause to reflect on the past year with gratitude. The progress we’ve made and the meaningful relationships we’ve built with individuals like you have been invaluable to our mission of providing credible, high-quality, and independent research to the public and policymakers—research that leads to more informed decision-making.

In lieu of sending holiday cards this year, WCRI has chosen to support Kids' Chance, an incredible organization that provides educational opportunities to children whose parents have been seriously injured or killed on the job. We are honored to contribute to their life-changing work.

We deeply value our connection with you and look forward to continuing our collaboration in the year ahead. On behalf of everyone at WCRI, I wish you and your loved ones a joyful holiday season and a New Year filled with health, happiness, and prosperity.

Warm regards,

Ramona Tanabe
President and CEO

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As the number of heat-related illnesses (HRIs) like heat exhaustion and heat stroke continues to rise, a new WCRI FlashReport reveals that HRIs increase by at least sevenfold on days when temperatures exceed 90°F, compared to days with temperatures between 75°F and 80°F. Learn more: https://buff.ly/4gIR7Wv.

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Waltham, MA, Dec. 18, 2024―As the number of heat-related illnesses (HRIs), such as heat exhaustion and heat stroke, continues to rise, a new FlashReport from the Workers Compensation Research Institute (WCRI) finds that HRIs increase by at least sevenfold on days when temperatures exceed 90°F compared with days with temperatures between 75°F and 80°F.

“These findings are especially significant amid ongoing policy debates on heat standards at the state and federal levels,” said Sebastian Negrusa, vice president of research at WCRI. “They also suggest that the broader impact of excessive heat on workplace safety extends beyond HRIs, contributing to an increase in other injuries such as falls and cuts.”

The study, Heat-Related Illnesses in the Workplace, builds on prior WCRI research to better understand HRIs in the workplace and distinguish the effects of excessive heat on HRIs versus heat-related accidents. Among the other questions the study addresses are the following:

• What role does geographic region play in the frequency of HRI claims?
• Are certain age groups, genders, or industries more at risk for HRIs?
• How does job tenure, particularly two or fewer months on the job, influence the likelihood of HRIs?

This study utilizes data from the WCRI Detailed Benchmark/Evaluation (DBE) database, encompassing workers' compensation claims from various insurers, state funds, and self-insured employers across 31 U.S. states. These states account for approximately 80 percent of U.S. workers’ compensation benefits. The DBE database provides comprehensive claims data, including injury dates and locations, while temperature data were used to assess temperature-related patterns and factors in the study.

Click here for more information about the study or to purchase a copy. The study was authored by Drs. Vennela Thumula and Olesya Fomenko.

About WCRI:

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI’s diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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Waltham, MA, Nov. 14, 2024 – A recently released study from the Workers Compensation Research Institute (WCRI) found that utilization of hospital services in the treatment of workers injured in Pennsylvania is declining for many key services to a greater extent than most of the other 16 study states.

“Most states have seen decreasing utilization of medical services, especially hospital services, since the onset of the pandemic,” said Sebastian Negrusa, WCRI’s vice president of research. “Pennsylvania’s decreases are larger than most, particularly in major surgery and hospital outpatient services.”

The study, CompScope™ Medical Benchmarks for Pennsylvania, 25th Edition, examines medical payments, prices, and utilization in Pennsylvania compared with 16 other states. The report also examines how these metrics have changed over time. Some key findings include the following:

• Medical payments per claim, which have decreased 2-3 percent per year since 2019, changed little in 2022.
• Payments per claim for nonhospital services grew moderately in 2022, driven by growth in prices paid for professional services.
• Increases in prices paid for professional services reflected, in part, fee schedule updates that were larger than in previous years.
• Overall medical payments per claim in Pennsylvania were typical of the study states.

This report analyzes claims data through March 2023, offering insights into the pandemic's impact on non-COVID-19 workers’ compensation claims during its first three years. The interstate comparison data cover 17 states, accounting for 60 percent of all workers’ compensation benefits paid nationwide.

For more information or to download a copy of the report, visit https://www.wcrinet.org/reports/compscope-medical-benchmarks-for-pennsylvania-25th-edition. The report was authored by William Monnin-Browder.

ABOUT WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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Waltham, MA, Nov. 7, 2024 – A recent study from the Workers Compensation Research Institute (WCRI) found that medical payments per claim for the treatment of injured workers under workers’ compensation in North Carolina decreased in 2022. In contrast, medical payments grew in many study states in that year.

“North Carolina has lower payments for hospital and nonhospital services than the typical study state, and payments have been largely stable since 2017,” said Sebastian Negrusa, WCRI’s vice president of research. “However, those findings mask offsetting trends, including a 4 percent decrease in payments from 2021 to 2022.”

The study, CompScope™ Medical Benchmarks for North Carolina, 25th Edition, examines medical payments, prices, and utilization in North Carolina compared with 16 other states. The report also examines how these metrics have changed over time. Some sample findings include the following:

• Utilization of nonhospital and hospital services declined from 2021 to 2022 in North Carolina, contributing to the decrease in medical payments per claim.
• North Carolina saw a 5 percent decrease in the use of networks from 2017 to 2022, as measured by the share of claims with payments for care in networks; however, changes varied within the period and by provider.
• Payments per inpatient episode in North Carolina were found to be 21 percent lower than in the typical study state.

This report analyzes claims data through March 2023, providing insights into the pandemic's impact on non-COVID-19 workers’ compensation claims over its first three years. The interstate comparison data cover states that account for 60 percent of all workers’ compensation benefits paid nationwide.

Click here for more information or to download a copy of the report. The report was authored by Carol Telles.

ABOUT WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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Our latest WCRI Member Spotlight features Neil DeBlock, Vice President and Head of Workers' Compensation at Zurich North America, a proud WCRI member since 1990. In his interview, Neil highlights the critical importance of WCRI's data and studies—especially in areas such as opioid use and state benchmarking—in helping Zurich make informed and impactful policy decisions that improve outcomes for injured workers and their employers. He also emphasizes the value of industry collaboration through WCRI. This collaboration allows Zurich and other members to work together to tackle challenges and influence future research priorities. As Neil puts it, "The things you gain from being part of the organization, to me, you can't put a price on."

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Waltham, MA, October 31, 2024 – A recent study from the Workers Compensation Research Institute (WCRI) found that the delivery of medical care to workers injured in Minnesota may be starting to increase after pandemic-related disruptions. Factors suggesting this trend include increasing medical payments per claim and a stable or modest rise in the utilization of most services.

“The main drivers of medical growth in the Minnesota workers’ compensation system in 2022 were increases in ambulatory surgery center facility payments and hospital inpatient payments,” said Sebastian Negrusa, WCRI’s vice president of research. “In addition, utilization remained stable or began to increase for most types of providers and services after decreases during the first two years of the pandemic. This might indicate that the delivery of medical care in Minnesota has started to rebound from the disruptions since the onset of the pandemic.”

The study, CompScope™ Medical Benchmarks for Minnesota, 25th Edition, examines medical payments, prices, and utilization in Minnesota compared with 16 other states. The report also monitors how these metrics have changed over time. Some other sample findings include the following:

• Medical payments per claim in Minnesota were lower than in many study states; most key components in Minnesota were lower or typical of the study states.
• The share of claims that received nonhospital and hospital outpatient care in Minnesota started to increase or were stable in 2022 for most types of services, after the widespread decreases between 2019 and 2021.

This report analyzes claims data through March 2023, offering insights into the pandemic's impact on non-COVID-19 workers’ compensation claims. The interstate comparison data cover states that account for 60 percent of all workers’ compensation benefits paid nationwide. The report was authored by Rebecca Yang.

ABOUT WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Founded in 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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Waltham, MA, October 24, 2024 – A recent study from the Workers Compensation Research Institute (WCRI) found that medical payments per claim for the treatment of workers injured in Indiana were higher than typical for all claims with experience through March 2023. This was driven mostly by high prices paid for professional (nonhospital) services and ambulatory surgery centers (ASCs).

“Indiana has no fee schedule for professional services like it does for hospitals, which means the state does not regulate prices for professional services or ASCs,” said Sebastian Negrusa, WCRI’s vice president of research. “The state did recently implement a fee schedule for ASCs, effective January 2023. Time will tell what effect that will have.”

The study, CompScope™ Medical Benchmarks for Indiana, 25th Edition, is meant to examine medical payments, prices, and utilization in Indiana compared with 16 other states. The report also examines how these metrics have changed over time. Some sample findings include the following:

• Prices paid for professional services remained stable in contrast to most other non-fee schedule study states and were largely in the middle of that group (Indiana, Iowa, New Hampshire, New Jersey, Missouri, and Wisconsin).
• While the share of physician payments in networks decreased in most study states, there was little change in Indiana.
• From 2005 to 2022, Indiana had a long-term decrease in the share of hospital outpatient claims. This was a 4 percent decrease in utilization from 2005 to 2019, and a 6 percent decrease from 2019 to 2023. During this time, however, payments per claim for those services increased.

The study is based on claims data from 2017 through 2022, with claims experience through March 2023. It therefore provides insights into how the pandemic impacted non-COVID-19 workers’ compensation claims during the first three years (March 2020–September 2022). The report, authored by Evelina Radeva, can be downloaded from WCRI’s website at www.wcrinet.org.

ABOUT WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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Waltham, MA, October 17, 2024—A new study from the Workers Compensation Research Institute (WCRI) found that workers’ compensation medical payments per claim in California were 10 percent below the median state of the 17-state study sample for claims with experience through March 2023.

“California’s ranking among states on medical payments per all paid claims reflects offsetting factors,” said Sebastian Negrusa, WCRI’s Vice President of Research. “California has a much bigger share of claims where workers with injuries miss more than seven days of work than the average state, which are naturally more expensive than claims with less lost time. But medical payments for those specific claims are some of the lowest of the study states. Those two phenomena strike a balance that lands California’s payments per all paid claims a bit below the median.”

The study, CompScope™ Medical Benchmarks for California, 25th Edition, is meant to examine medical payments, prices, and utilization in California compared with 16 other states. The report also examines how these metrics have changed over time. Some sample findings Include the following:

• California saw little change in payments per claim for most key professional services 2017–2022, with the exception of recent growth in evaluation & management (office visits) payments.
• Prices paid for professional services increased 2020–2022 in California, but that growth was largely offset by utilization decreases.
• The decrease in utilization of medical services primarily included major surgery, facility services, and inpatient care.

The report analyzes claims data through March 2023, offering insights into the pandemic's impact on non-COVID-19 workers’ compensation claims during its first three years. The interstate comparison data cover 17 states accounting for 60 percent of all workers’ compensation benefits paid nationwide.

Click here for more information about this study or to download a copy. The report was authored by William Monnin-Browder.

ABOUT WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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Waltham, MA, October 10, 2024 ― A new set of studies from the Workers Compensation Research Institute (WCRI) found that utilization of medical services by workers with injuries declined in the majority of the 17 study states. The studies address two aspects of utilization: the percentage of claims receiving a particular medical service, and the number of services provided.

“We continue to see the effects of the pandemic on 2022 claims with experience through March 2023,” said Sebastian Negrusa, vice president of research for WCRI. “Besides strained hospital capacity and avoided medical care by many people out of fear of COVID-19 in the early months of the pandemic, waves of increased COVID-19 cases and medical provider shortages may have also affected the delivery of medical care. Even in the few cases where utilization in certain states has begun to rebound, we do not see it reaching pre-pandemic levels yet.”

The studies, CompScope™ Medical Benchmarks, 25th Edition, examined medical payments, prices, and utilization overall and by provider and type of service across 17 states and how these metrics of medical payments have changed over time. The following are sample findings for some of the study states:

• California: Utilization of medical services decreased in 2022, particularly in the percentage of claims with inpatient care and facility services (both hospital outpatient departments and ambulatory surgery centers).
• Indiana: Utilization declined in 2022, particularly for major surgery and facility services.
• Minnesota: Unlike most study states, utilization of most services in Minnesota either stayed stable or began to increase in 2022.
• North Carolina: Decreasing utilization was a driver of the state’s decline in medical payments per claim in 2022, in contrast to many study states which experienced growth.
• Pennsylvania: The share of claims with facility services in the state declined more than most study states since 2019.

The analysis results reflect experience on claims through March 2023, including non-COVID-19 claims from the pandemic period (March 2020–September 2022). The studies, therefore, provide a look at how the pandemic impacted non-COVID-19 workers’ compensation claims. The 17 study states ― Arkansas, California, Florida, Illinois, Indiana, Iowa, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Tennessee, Texas, Virginia, and Wisconsin ― represent about 60 percent of all workers’ compensation benefit payments nationwide. Individual reports are available for every state except Arkansas, Iowa, and Tennessee. 

Click here for more information on these studies.

About WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Cambridge, MA. Founded in 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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Attorney involvement in workers’ compensation claims substantially increases total indemnity benefits paid to workers, a new study of nearly 1 million claims shows.

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Waltham, MA, Sept. 30, 2024 — A new study from the Workers Compensation Research Institute (WCRI) shows that the average cost of workers' compensation claims in Delaware, for cases with more than seven days of lost work, went up by 3 percent per year between 2019 and 2022.

“In the years following the onset of the COVID-19 pandemic, there were important changes in the labor market as well as shifts in the availability of medical services. These changes were likely important drivers of the trends in total costs per claim in Delaware," said Ramona Tanabe, president and CEO of WCRI.

The study, Trends in the Delaware Workers' Compensation System, 2017–2022, examines key metrics such as total claim costs, medical payments, indemnity benefits, disability duration, and benefit delivery expenses. It provides a detailed look at how these factors have evolved from 2017 to 2022, based on payments made through March 2023.

Key findings include the following:

• Temporary disability duration and wages for injured workers have both increased since 2019, driven by pandemic-related economic changes.
• Medical payments per claim remained relatively stable, with reduced utilization balancing stable prices for professional services.
• Benefit delivery expenses per claim increased after 2019, following a decline in previous years.

The report excludes COVID-19 claims and includes findings from other WCRI studies for a broader context. Click here to learn more or to download a copy of the study. This report was authored by Evelina Radeva.

About WCRI:

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Established in 1983, WCRI is committed to providing objective, data-driven insights through rigorous research and unbiased peer review. The Institute’s diverse membership includes employers, insurers, governmental entities, managed care companies, healthcare providers, insurance regulators, and labor organizations across the U.S., Canada, Australia, and New Zealand.

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Waltham, MA, Sept. 25, 2024―A new study from the Workers Compensation Research Institute (WCRI) examines the effect of attorney involvement on the indemnity payments that workers receive following work-related injuries to help them cover their loss of income.

“While the workers’ compensation system was envisioned as an administrative and predictable system for dealing with the consequences of work-related injuries, disputes that lead to attorney involvement in the system remain common,” said Sebastian Negrusa, vice president of research at WCRI. “High rates of attorney involvement in the system have contributed to the debate about the impact of attorney involvement on the benefits delivered to workers with injuries.”

The study, Impact of Attorney Representation on Workers’ Compensation Payments, uses an empirical approach that reveals the causal effect of the legal representation of workers by accounting for unobserved factors such as attorneys being more likely to get involved in cases with more severe injuries, or other issues that can lead to disputes. These typically unobservable factors have been the main obstacle precluding causal estimates in the past.

The following are some questions the study addresses:

• What is the impact of attorney involvement on the amount of indemnity payments that workers receive after their injuries?
• What impact does attorney involvement have across different injury types, such as fractures, lacerations, contusions, low back pain cases, inflammations, and non-back sprains and strains?

The analysis sample includes information for workers injured between October 1, 2012, and September 30, 2019, in the 31 states covered by the WCRI Detailed Benchmark/Evaluation (DBE) database and evaluated through March 2022. These states represent over 80 percent of the benefits paid in 2017.

Click here to learn more about this study or to purchase a copy. The authors of this study are Bogdan Savych and David Neumark.

About WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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Waltham, MA, Sept. 24, 2024 — The Workers Compensation Research Institute (WCRI) is pleased to announce that registration is now open for its 2025 Annual WCRI Issues & Research Conference, scheduled for March 6-7, 2025, at the Renaissance Phoenix Downtown Hotel in Phoenix, AZ.

“Our two-day conference concentrates on our original research on timely issues impacting state workers' compensation systems,” said Ramona Tanabe, president and CEO of WCRI. “This focus attracts senior-level decision makers from across the workers' compensation industry and provides ample opportunities to network as well as discuss what you are learning with like-minded colleagues.”

The conference will feature valuable findings from the latest research from WCRI, along with expert observations from leading professionals and policymakers across the country. The conference will explore various topics impacting workers’ compensation systems, including the following:

• Shifts in the medical workforce
• Comorbidities and degenerative diseases
• Heat policies
• High-cost claims
• Recreational marijuana

As a leading workers’ compensation forum, the WCRI conference attracts policymakers, employers, labor advocates, insurance executives, health care organizations, claims managers, researchers, and more. Attendees will gain fresh perspectives, make valuable connections, and deepen their understanding of critical issues in today’s competitive landscape. Take advantage of the early-bird discount and special hotel rates available for a limited time. Click here to learn more or register.

About WCRI:

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Established in 1983, WCRI is committed to providing objective, data-driven insights through rigorous research and unbiased peer review. The Institute’s diverse membership includes employers, insurers, governmental entities, managed care companies, healthcare providers, insurance regulators, and labor organizations across the U.S., Canada, Australia, and New Zealand.

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Waltham, MA, Sept. 10, 2024 ― The Workers Compensation Research Institute (WCRI) will hold a free, one-hour webinar on Wednesday, October 2, 2024, at 2 p.m. ET. The webinar will cover key findings from the latest editions of the CompScope™ Benchmarks and Medical Benchmarks for Pennsylvania, as well as the Institute’s recent drug trends study.

“This research provides valuable insights for policymakers and stakeholders in the Pennsylvania workers’ compensation system. It highlights key cost drivers, trends, and the system's performance over time, as well as comparisons with other states,” said Sebastian Negrusa, Vice President of Research at WCRI.

Topics Covered:

• The primary cost drivers in Pennsylvania’s workers’ compensation system.
• Performance comparisons between Pennsylvania and other states.
• Trends across various performance metrics in Pennsylvania’s system.
• Pennsylvania’s prescription drug payments, overall and by drug group, compared with other states.

The CompScope™ Benchmarks and Medical Benchmarks studies include data from states representing 60 percent of all workers’ compensation benefits paid nationwide, including Arkansas, California, Florida, Illinois, Indiana, Iowa, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Tennessee, Texas, Virginia, and Wisconsin. The most recent results are based on claims data through March 2023, including non-COVID-19 claims from the pandemic period (March 2020–September 2022). The studies, therefore, provide a look at how the pandemic impacted non-COVID-19 workers’ compensation claims over the first three years of the pandemic.

Attendance is limited to 500 participants. All attendees will receive a copy of the slides and a recording of the webinar. Click here to register now.

About WCRI:

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in 1983, the Institute does not take positions on the issues it researches. It provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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Waltham, MA, Aug. 8, 2024―Many studies have shown that health care costs are concentrated among a small percentage of individuals with diverse needs. A new study from the Workers Compensation Research Institute (WCRI) identifies the factors linked to high-cost claims in workers’ compensation.

“Our findings highlight the importance of monitoring claims with late occurring resource-intensive care to keep treatment on track as planned and prevent unnecessary delays in recovery,” said Ramona Tanabe, WCRI president and CEO. “Early identification of complex claims with comorbidities and degenerative conditions can also help better address workers’ needs; and a higher level of care coordination likely helps to reduce the probability of a claim becoming a high-cost claim.”

The study, Factors Associated with High-Cost Claims, defines high-cost claims as claims in the top 5 percent of medical payments at 36 months of injury, and identifies key factors that likely contribute to a higher or lower probability of claims becoming high-cost claims. The study explores the following questions:

• What is the impact of high-cost claims on costs and disability duration?
• What are the characteristics of high-cost claims?
• What are the key factors associated with an increased or decreased likelihood of high costs?
• What modifiable factors can improve care management and reduce costs?

The data for this study come from the WCRI Detailed Benchmark/Evaluation (DBE) database. The study analyzed more than 720,000 open and closed claims with more than seven days of lost time from 32 states. These claims had injuries from October 1, 2015, to March 31, 2019, with 36 months of experience observed from the date of injury, up to March 31, 2022. The DBE database covers approximately 38–77 percent of all workers' compensation claims, varying by state, and the 32 states represent over 80 percent of the workers' compensation benefits in the United States during the study period.

To learn more about this study or to purchase a copy, visit https://www.wcrinet.org/reports/factors-associated-with-high-cost-claims. The authors of this study are Dongchun Wang, Kathryn L. Mueller, and Randall D. Lea.

About WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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We had the pleasure of interviewing Stacy Kohlnhofer, the Division Chair at the Mayo Clinic, a longstanding member of WCRI. The Mayo Clinic, a renowned nonprofit American academic medical center, is celebrated for its innovative treatments, research, and commitment to patient care. It boasts a workforce of over 7,300 physicians and scientists and 66,000 administrative and allied health staff across its campuses in Rochester, Minnesota; Jacksonville, Florida; and Phoenix/Scottsdale, Arizona. In her role, Stacy oversees self-insured liabilities, including workers' compensation, short-term disability, FMLA, and other employee disability programs.

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As heat increases, so does risk for some workers. The probability of work-related accidents grows by 5% to 6% when maximum daily temperatures rise above 90 degrees Fahrenheit, compared with a day when temperatures range from 65 to 70 degrees, according to an analysis of claims data by the Workers Compensation Research Institute.

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The worker’s compensation program covers medical expenses and lost wages for employees injured on the job. The independent, nonprofit Workers Compensation Research Institute ranks Wisconsin tied with Iowa as the lowest of 17 states studied for the time employees spend away from work after an injury, thanks to strong health care networks and return-to-work programs that support a smooth transition back to the workplace.

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Waltham, MA, July 30, 2024―A new study from the Workers Compensation Research Institute (WCRI) examines the prevalence and use of behavioral health support services in the New York workers’ compensation system. It follows regulatory actions that created a system for compensating a wide range of providers offering these services to injured workers.

“The specific section on behavioral health services in the state’s medical fee schedule, and the implementation of the state’s Expanded Provider Law in 2020, provide opportunities to review the coding and billing patterns associated with providing behavioral health support services to workers with injuries,” said Ramona Tanabe, WCRI president and CEO.

The study, Use of Behavioral Health Support Services in the New York Workers’ Compensation System, expands on earlier WCRI research by providing detailed insights into the billing of behavioral health support services in New York. It addresses several key research questions:

• How frequently are specific codes for behavioral health support services used in New York?
• What types of behavioral health services are provided most often?
• Does the provision of behavioral health services vary by type of injury and industry?
• How soon after the injury are behavioral health services provided?
• What types of providers bill for behavioral health services most often?
• Does the provision of behavioral health services vary within the state?

The data used to identify the prevalence and costs of behavioral health services among injured workers in this study come from WCRI’s Detailed Benchmark/Evaluation (DBE) database. The analysis focused on non-COVID-19 claims with more than seven days of lost time (indemnity claims in New York), primarily for 2020 claims with 24 months of experience. These claims reflect the full range of medical services provided in workers’ compensation cases.

To learn more about this study or to purchase a copy, visit www.wcrinet.org. The authors of this study are William Monnin-Browder and Carol A. Telles.

About WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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The proportion of work-related injuries among newly hired workers increased from 2017 to 2022, with workers under 25 reporting more frequent injuries than those 55 and older, according to a report released Thursday by the Workers Compensation Research Institute.

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Waltham, MA, July 18, 2024 ― A new FlashReport from the Workers Compensation Research Institute (WCRI) found that the proportion of injuries among newly hired workers increased over the study period of 2017 to 2022. The upward trend started pre-pandemic and accelerated during the pandemic years.

“This report provides comprehensive information for system stakeholders to evaluate shifts in claim characteristics during a period of notable economic and workforce disruptions in the U.S.,” said Ramona Tanabe, WCRI president and CEO. “The detailed tables and graphs present a clear overview of these changes, helping to pinpoint emerging trends.”

The study, Overview of Workers’ Compensation Claims Composition—A WCRI FlashReport, provides a series of tables and graphs that characterize claims in terms of age, gender, and tenure at the time of injury, as well as the distribution of injuries by industry and injury type. The following are among the questions the study addresses:

• How did the relative share of work injuries change by industry?
• Did the proportion of women with work-related injuries increase?
• What was the most frequent injury type, and were there differences in injury distribution by age, gender, and industry?
• Did work-related injuries occur more frequently among younger or older workers?

The data for this study focus on 8.4 million non-COVID-19 claims from injury years 2017 through 2022 across 31 states, which represents about 80 percent of the workers' compensation benefits paid in the United States. These states include Alabama, Arizona, Arkansas, California, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nevada, New Jersey, New Mexico, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin.

Click here to learn more about this study, or to purchase a copy, visit www.wcrinet.org. The authors of this study are Dr. Vennela Thumula and Dr. Olesya Fomenko.

About WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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For employers and insurers, the effects of rising heat-related illnesses and claims are a growing concern. California’s insurance department reports that in the past decade, extreme heat waves have cost the state at least $7.7 billion in lost labor productivity, costs related to power outages, infrastructure repairs and premature deaths. In the workplace, the probability of work-related accidents increases by 5% to 6% when the temperature rises above 90 degrees compared with 65 to 70 degrees, according to the Workers Compensation Research Institute. The effect of workplace heat is stronger in the southern U.S. and on workers in the construction industry, WCRI found.

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Waltham, MA, July 10, 2024 ― The Workers Compensation Research Institute (WCRI) will host a 30-minute webinar on Thursday, August 1, 2024, at 2 p.m. ET on its study, Interstate Variation and Trends in Workers’ Compensation Drug Payments, 5th Edition. Dr. Vennela Thumula will discuss the study's key findings and take audience questions.

“This study provides an overview of the trends in prescription drug payments in workers’ compensation across 28 states. By analyzing prescription drug payments by group (dermatological agents, NSAIDs, opioids, compounds, etc.), the study provides insights into which drug groups went up or down in their share of prescription payments in recent years,” said Ramona Tanabe, president and CEO of WCRI.

Questions Addressed:

• Which drug groups make up higher shares of prescription payments under workers’ compensation?
• How do states compare on prescription drug payments overall and by drug group?
• Did the prescription payments increase or decrease?
• Are increases in prescription drug payments for any drug groups in any state being driven by physician dispensing?

The 28 states in the study are Arkansas, California, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Jersey, New Mexico, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin. In each quarter, prescriptions that were dispensed for non-COVID-19 claims with injuries occurring within three years of the prescription fill date and paid under workers’ compensation were included.

Webinars are $50 for non-members and free for WCRI members, members of the press, and legislators. Attendance is limited to 500 people, and all attendees receive a copy of the slides and a recording of the webinar. Click here to register now.

About WCRI:

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Waltham, MA. Organized in 1983, the Institute does not take positions on the issues it researches. It provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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Yet, Constible said, "the research has kept piling up that heat is not only potentially deadly to workers, but also drastically affects their productivity – billions of work hours lost in the U.S. and around the world because it's too darn hot."

The probability of work-related accidents rises by nearly 6% when temperatures pass 90 degrees Fahrenheit (32 degrees Celsius), according to research from the Workers Compensation Research Institute published in May.

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