This study 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. 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).

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.

Patterns and Trends of High-Cost Claims Involving Back and Shoulder Injuries. Dongchun Wang, Kathryn L. Mueller, and Randall D. Lea. August 2025. WC-25-42.

Video: