Program > Saturday > 11:15 > Session 12. Épisodes d’incapacité de longue durée

Paper: Long duration claims – what is driving increases in duration and locked-in claims in Ontario?
Author(s) and Affiliation(s):
Sheilah Hogg-Johnson, Institute for Work & Health
David Tolusso, Institute for Work & Health
Cynthia Chen, Institute for Work & Health
Emile Tompa, Institute for Work & Health
Benjamin Amick III, Institute for Work & Health
Session : 12. Épisodes d’incapacité de longue durée
Day/Time: Saturday at 11:15
Room: St. Patrick Room, 3rd Floor
Objectives:

Over the last decade in Ontario, there has been a dramatic increase in the number of total compensated days per lost time Workplace Safety & Insurance Board (WSIB) claim. Our objective is to determine whether these increases are concurrent with the policy changes of January 1998 under Bill 99 or whether changes in worker demographics, injury characteristics and workplace characteristics account for the observed changes in claim duration over time.

Methods:

Claimants to the Ontario WSIB with an allowed lost-time work-injury claim with date of accident between January 1, 1990 and December 31, 2001 were eligible for inclusion. Fatalities, serious injuries and occupational diseases were excluded. Inclusion ended at 2001 to allow complete follow-up for locked-in status for all claims. A stratified random sample of 10% of claims from each accident year was drawn and used for analysis. Two outcome measures were considered: total compensated days on 100% benefits and whether the claimant is “locked in” to receive benefits until age 65 years. Baseline covariates included: year of accident, age, sex, occupation, pre-injury wage, region, previous claim, part of body injured, nature of injury, firm size, industrial sector. Descriptive statistics of all variables under study were examined by year of accident. Logistic regression (locked in status) and log-normal models (cumulative duration) were used to analyse the relationship between covariates and outcomes.

Results:

There were 126,709 claims in our sample. The percentage of claims locking in was 3.7% for 1990 claims, gradually reducing to 1.5% for 1997, and increasing to 3.0% for 2001. Locking in was more likely for older workers, females, concussions, inflammations and herniated discs, backs and necks and for workers from smaller firms. There were similar covariate findings for cumulative duration. Adjusting for covariates did not alter odds ratios for locking in or rate ratios for cumulative duration e.g., OR of locking in for 2001 compared to 1997 is 2.06 (1.66, 2.54) without adjustment and 1.98 (1.58, 2.48) with adjustment.

Conclusions:

We see changes in claims outcomes coincidental with introduction of Bill 99. Reaching locked-in status for 2001 claimants was approximately twice as likely as for 1997 claims and this could not be explained by changes in worker age, injury type or workplace characteristics. Trends for duration were similar. These findings point to changes in claims management arising out of the policy change. Continuing work will examine claims management milestones (timeliness of adjudicative decisions, use of WSIB funded services, Second Injury Enhancement Fund) as possible explanations for increasing durations.