Length of Disability and Medical Costs in Low Back Pain: Do State Workers' Compensation Policies Make a Difference?

J Occup Environ Med. 2015 Dec;57(12):1275-83. doi: 10.1097/JOM.0000000000000593.


Objective: The aim of the study was to examine the impact of state workers' compensation (WC) policies regarding wage replacement and medical benefits on medical costs and length of disability (LOD) in workers with low back pain (LBP).

Methods: Retrospective cohort analysis of LBP claims from 49 states (n = 59,360) filed between 2002 and 2008, extracted from a large WC administrative database.

Results: Longer retroactive periods and state WC laws allowing treating provider choice were associated with higher medical costs and longer LOD. Limiting the option to change providers and having a fee schedule were associated with longer LOD, except that allowing a one-time treating provider change was associated with lower medical costs and shorter LOD.

Conclusions: WC policies about wage replacement and medical treatment appear to be associated with WC LBP outcomes, and might represent opportunities to improve LOD and reduce medical costs in occupational LBP.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Databases, Factual
  • Disability Evaluation
  • Female
  • Health Care Costs / statistics & numerical data*
  • Humans
  • Low Back Pain / economics
  • Low Back Pain / rehabilitation*
  • Male
  • Middle Aged
  • Occupational Diseases / economics
  • Occupational Diseases / rehabilitation*
  • Retrospective Studies
  • Return to Work / economics
  • Return to Work / statistics & numerical data*
  • United States
  • Workers' Compensation / economics*
  • Young Adult