Do Higher Deductibles in Group Health Plans Increase Injured Workers’ Propensity to File for Workers’ Compensation?

By Olesya Fomenko, Jonathan Gruber

February 19, 2019 Related Topics: Comparing Group Health and Workers’ Compensation, System Overview

This study examines whether employees injured at work are more likely to file under workers’ compensation instead of group health insurance when their group health plan has a higher deductible. The study has great relevance since the number of workers in health insurance plans with high deductibles is growing.

In years past, workers may have chosen to have a work injury covered within their group health plan. But, the increasing cost of deductibles may cause them to consider having the injury covered ─ where it potentially belongs ─ in the workers’ compensation system, where there are no deductibles or copayments for the medical care they receive.

The study also estimated the increase in workers’ compensation volume from the growth in high deductible group health policies. The increase partially offsets the overall decline in workers’ compensation claims seen over the past decade.

Do Higher Deductibles in Group Health Plans Increase Injured Workers’ Propensity to File for Workers’ Compensation? Olesya Fomenko and Jonathan Gruber. February 2019. WC-19-19.

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Research Questions:

  • What impact do higher group health deductibles have on the likelihood that a worker would file for workers’ compensation coverage vs. group health insurance?
  • Are workers with soft tissue conditions more likely to file for workers’ compensation coverage in response to higher deductibles?
  • Are workers more likely to file for workers’ compensation coverage in states where employees can choose their initial provider?

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