The Three Most Costly Medical Conditions in 2019

According to data from the National Council on Compensation Insurance (NCCI), the average workers’ compensation claim comes at a cost of $39,424. At first blush, it might be easy to assume that these numbers are slightly inflated because of claims related to catastrophic injuries or opioid overdoses. But when you take a closer look at the NCCI’s data, you’ll find that the most expensive conditions are also some of the most common.

As rising medical costs continue to be one of the top concerns among carrier executive leaders, it’s important to understand which workplace injuries come with the largest financial burdens. Based on the NCCI’s findings and additional research, here are the three most costly medical conditions in 2019—and what you can do to protect yourself from the growing expenses.

Amputations

By far, the most costly workers’ compensation claims were due to amputations, with the total claim coming in at $95,204. Medical costs average just over $66,000 and indemnity comes in at slightly more than $28,000. 

It’s important to note that indemnity costs for amputations vary wildly on a state-by-state basis. A 2015 report by ProPublica found that while the average compensation for a lost arm is $169,878, workers in Nevada received $859,634. On the lower end, workers in Alabama received $48,400 for similar injuries, which is still well above the NCCI’s average cost of a workers’ compensation claim.

The rising costs and incidents of amputations have also caught the attention of the government. As recently as February of 2019, the U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) released a strongly-worded statement about the uptick in amputation injuries suffered by Nebraska workers. This sent shockwaves throughout the workers’ compensation industry. Not only did this reinforce the costs associated with amputation injuries, but it also served as a harsh reminder that all employers are required by law to provide safe working conditions and training programs. 

Fractures and Dislocations

Although the overall costs of a fracture or dislocation are dwarfed by the typical amputation, the NCCI still found that they’re costly for employers. Medical costs for these injuries come in at $34,846, and indemnity payments average over $22,000. 

Indemnity costs for a fracture or dislocation are just $6,000 less than for an amputation injury, but the associated medical costs are just one-third of the typical amputation. This shouldn’t come as a huge surprise. An amputation is a potentially life-changing (and career-ending) event for an employee, whereas a minor fracture might not even prohibit a worker from doing his or her job in some cases. 

But in a recent report, the Workers Compensation Research Institute (WCRI) also found that the time for initial treatment tends to be faster for objective injuries such as fractures. This is consistent with what we’ve seen in the marketplace, as some of the most proactive companies have increased their investments in on-site first aid teams and training programs. As the costs of workers’ compensation claims related to fractures or dislocations continue to climb, the upfront expense of on-site first aid training often proves to be worth the price of admission.

Burns

The NCCI reports that workers’ compensation injuries leading to burns cost employers just north of $50,000. Over $38,000 of those expenses are for medical care and indemnity payouts for a burn come in at $12,295.

Some of the more obvious causes of workplace burns involve industrial kitchen equipment, exposure to radiation, or contact with chemicals. But what makes burns a unique challenge in workers’ compensation are the unpredictable risks to employees. This past April, the Rhode Island Supreme Court ruled that an employee could not sue his co-worker for playing a practical joke that led to a serious burn. Although there was sufficient evidence to prove that the injury was caused by the fellow employee, the victim had already collected workers’ compensation benefits, which prevented him from filing further lawsuits. 

The ruling might have been good news for the person responsible for the practical joke, but it also meant the workers’ compensation bill fell squarely on the employer. Cases like this might be unusual, but they also reinforce the importance of providing regular training (and re-training) to highlight the dangers of being careless on the job.

Processing claims related to these costly and complex medical conditions can be overwhelming. At Viscardi, we’ve developed a set of best practices for complex and catastrophic injuries. These best practices ensure every stakeholder understands the situation and the plan for treatment - and claimants receive the care they need, when they need it.