Top 10 Workers Compensation Challenges of 2019

Top 10 Workers Compensation Challenges of 2019

March 21, 2019 Uncategorized 0 Comments

Risk and Insurance magazine surveyed attendees at the National Workers’ Compensation and Disability Conference about trends and challenges in 2019. As published online at, these were identified as the top ten:

  1. Rising cost of care – CMS forecasts annual growth of 5.5% between 2017 and 2026, 1% more than GDP. Total healthcare spending is projected to reach $5.7 trillion in 2026.
  2. Comorbidities including excess weight, diabetes, hypertension, sleep apnea and joint pain. HIPAA regulations make it difficult for workers compensation professionals to get information about these conditions. (Privacy rules should have an exception for secure communications between healthcare professionals.)
  3. Opioids – according to the CDC opioids were prescribed in the U.S. at a rate of 61 prescriptions per 100 persons in 2016; injured workers were prescribed at three times that rate. Workers with long-term opioid prescriptions receive temporary disability benefits 251% longer than those who do not. On the positive side, over 43% of claim managers have had success in implementing opioid therapy management.
  4. Mental health – PTSD has been recognized as compensable injury for first responders. Work related stress and anxiety, and post-injury depression also contribute to costs.
  5. Complex claims – 3 to 5% of claims drive 50-60% of costs. In addition to severe injury, prescription abuse, comorbidity, psychological factors or attorney involvement are responsible.
  6. Regulatory and legislative changes – there were 76 new laws and 83 regulation changes in the first half of 2018. More changes are expected in 2019, including updates by CMS and state debates on medical marijuana.
  7. Distracted drivers and auto collisions – auto injuries cost employers $3.2 billion per year. Frequency and severity are increasing.
  8. Claims data breach could violate HIPAA and/or non health-related privacy laws and regulations.
  9. Cumulative trauma claims – 80% are open for more than 18 months and are 15% more expensive than average specific injury claims.
  10. Litigation management issues include dealing with ADA accommodations and whether to prosecute suspected fraud.

If you have anyone of these issues, contact Beacon or your workers compensation insurer for advice and assistance.

P. S. For a more comprehensive list of issues going beyond workers compensation implications,

About the Author

Harry Cylinder

Harry Cylinder, CPCU, ARM has spent nearly fifty years in the insurance industry, the majority of the time as a consultant. He has been employed by The Beacon Group of Companies since 2008, specializing in the review and analysis of property and casualty coverage forms. Mr. Cylinder has been reviewing policy forms as they have evolved over the past decades. In 2008 he published an article in the CPCU Journal which was the first description of cyber insurance coverage for a general insurance audience. Since that time he has regularly written on cyber and other topics for The Beacon Companies’ blog.