WCRI Study Shows No Treatment Delays Caused by COVID, but Some Care Avoided

COVID-19 did not delay medical treatment for workers’ compensation claimants, but did decrease the amount of emergency care and other services provided to injured workers, a study released Thursday by the Workers’ Compensation Institute concludes.

Research by WCRI economist Olesya Fomenko found that there were no noticeable delays in medical treatment for injured workers when the first two quarters of 2019 are compared to the same period in 2020. In fact, there were slightly shorter waiting times for some types of services, including emergency room, physical medicine, major surgery, and neurological/neuromuscular testing.

On the other hand, WCRI did observe some decreases in the share of patients receiving particular types of services when comparing the first half of 2019 to the first half of 2020. In particular, the states hit hardest by COVID — Connecticut, Massachusetts and New Jersey — saw the share of lost-time claims with emergency services drop to 23% from 31%.

“This is consistent with the expectation that people would want to avoid going to the emergency room because of fear of virus contraction,” the report says.

Fomenko examined data from 27 state workers’ compensation systems to track changes in medical utilization. Her findings are similar to the conclusions of previous studies conducted by the National Council on Compensation Insurance and the California Workers’ Compensation Institute.

In general health, the coronavirus pandemic greatly reduced the use of health care services in the United States. The Centers for Disease Control and Prevention estimated that 41% of adults delayed or avoided medical care because of concerns about COVID-19, the WCRI study notes.

“In contrast, our results for WC show that medical treatment for injuries covered by WC did not experience any delays and actually had shorter duration for some types of services,” the report says. “This can potentially be explained by injuries filed with WC being more severe than general health medical conditions on average.”

The study found ample evidence that workers’ compensation did avoid medical services in the hard-hit states. In Connecticut, Massachusetts and New Jersey, the share of claims with physical medicine dropped by 4.7 percentage points and pain management by 2.4 percentage points.

The study showed that the decrease in the share of patients using particular medical services as most pronounced in the hard-hit states. For example, nationally the share of injured workers who used emergency rooms declined by 4 percentage points, compared to 8% for Connecticut, Massachusetts and New Jersey.

Among all 27 states, the share of claims with major surgery dropped three percentage points, to 17% during the 1st quarter of 2020 from 20% during the same period of 2019. The share of claims with pain management injections dropped to 7% from 9%.

By comparison, the share of patients in the hard-hit states that received major surgery dropped six percentage points. The share of patients who had pain management injections dropped by two points in all 27 states and in the hard-hit states.

The conclusion that workers’ compensation medical care was not delayed defies commonly held beliefs about the impact of the virus.

Last December, MedRisk reported that injured workers were being impacted by the deferral of hospital treatments and physical therapy due to COVID-19. Some researchers predicted it would take 45 weeks to catch up with the backlog of surgeries and other medical procedures, Medrisk Chief Operating Officer Mary O’Donoghue said in a company blog post.

In April 2020, Jeff Rush, workers’ comp program manager for the California Joint Powers Authority, wrote in the insurance pool’s newsletter that “employees with existing claims are experiencing delays in treatment, especially if they need to undergo surgery.”

In contract to those observations, NCCI reported last December that the impact of COVID on emergency room visits was only minor. NCCI said that the average time between the date of injury and the first ER encounter increased from 1.2 days in 2019 to 1.4 days in 2020.

The same report concluded that the wait time for major surgeries decreased slightly during the COVID pandemic, from 20 days in the second quarter of 2019 to 19.8 days in the second quarter of 2020.

“The measure indicates that, in general, WC injured workers did not experience significant delays in major surgeries during this period based on claims that had a surgery,” the report says.

Alan Pierce, a Salem, Massachusetts claimants’ attorney who hosts a regular podcast on workers’ compensation issues, said the he is “pleasantly surprised” by WCRI’s findings.

“I can think of a couple of clients right now that would have had surgery in the past year, but for COVID,” he said by telephone. “I can think of some who did not get MRIs and their PT was canceled.”

Pierce said he would be interested to see a comparison of temporary disability duration pre- and post-pandemic. He said an increase in the amount of time injured that workers remain on TD would indicate that many delayed care and therefore recovered more slowly.