Effectiveness of employer financial incentives in reducing time to report worker injury: an interrupted time series study of two Australian workers’ compensation jurisdictions

Abstract

BackgroundEarly intervention following occupational injury can improve health outcomes and reduce the duration and cost of workers’ compensation claims. Financial early reporting incentives (ERIs) for employers may shorten the time between injury and access to compensation benefits and services. We examined ERI effect on time spent in the claim lodgement process in two Australian states: South Australia (SA), which introduced them in January 2009, and Tasmania (TAS), which introduced them in July 2010.MethodsUsing administrative records of 1.47 million claims lodged between July 2006 and June 2012, we conducted an interrupted time series study of ERI impact on monthly median days in the claim lodgement process. Time periods included claim reporting, insurer decision, and total time. The 18-month gap in implementation between the states allowed for a multiple baseline design. In SA, we analysed periods within claim reporting: worker and employer reporting times (similar data were not available in TAS). To account for external threats to validity, we examined impact in reference to a comparator of other Australian workers’ compensation jurisdictions.ResultsTotal time in the process did not immediately change, though trend significantly decreased in both jurisdictions (SA: −0.36 days per month, 95% CI −0.63 to −0.09; TAS: 0.35, −0.50 to −0.20). Claim reporting time also decreased in both (SA: −1.6 days, −2.4 to −0.8; TAS: -5.4, −7.4 to −3.3). In TAS, there was a significant increase in insurer decision time (4.6, 3.9 to 5.4) and a similar but non-significant pattern in SA. In SA, worker reporting time significantly decreased (−4.7, −5.8 to −3.5), but employer reporting time did not (−0.3, −0.8 to 0.2).ConclusionsThe results suggest that ERIs reduced claim lodgement time and, in the long-term, reduced total time in the claim lodgement process. However, only worker reporting time significantly decreased in SA, indicating that ERIs may not have shortened the process through the intended target of employer reporting time. Lack of similar data in Tasmania limited our ability to determine whether this was a result of ERIs or another component of the legislative changes. Further, increases in insurer decision time highlight possible unintended negative effects.Electronic supplementary materialThe online version of this article (10.1186/s12889-017-4998-9) contains supplementary material, which is available to authorized users.

Characterising the Burden of Work-Related Injuries in South Australia: A 15-Year Data Analysis

“…ERIs were introduced as a policy in 2009 in South Australia, encouraging employers to report worker injuries in a timely fashion. Employers who lodged a compensation claim within two working days of becoming aware of an injury were given a rebate on their insurance excess [15]. Results for the regression models were expressed as rate ratios (RR) with 95% confidence intervals (CIs) by exponentiating the coefficients and interpreting them as a percentage change in compensation expenditure or working days lost with change of age.…”

“…In the process of deindustrialisation, a gradual decline in work-related morbidity and mortality has also been observed in other developed countries such as USA [22] and Canada [23]; and (3) the tightening eligibility for compensation benefits overtime. Evidence has shown that the level of compensation benefits was positively associated with claim rate [15,24]. In addition, the trend might be confounded by the introduction of ERIs in 2009, although there is limited research to investigate its impact on injury claims.…”

Impact of legislative reform on benefit access and disability duration in workers’ compensation: an interrupted time series study

“…Consistent with the policy objectives of the reforms, we hypothesise a reduction in the number of workers accessing the NSW workers’ compensation scheme in the period after reform. Based on prior studies that have demonstrated increases in the time taken by insurers to adjudicate claims following legislative reform,17 and the adverse impacts of slower decision making on return to work,4 5 we hypothesise that the reforms increased insurer decision time and the duration of disability among workers with accepted claims. Finally, we hypothesise that workers with occupational disease and mental health conditions will be disproportionately affected by the reforms.…”

Evaluating the success of legislative amendments designed to reduce work disability

“…The introduction of penalties for late workplace injury reports was implemented because of both recommendations set out in Clayton's report and research that indicates long lag times are associated with poorer RTW outcomes and higher costs to the WC system (Workers Rehabilitation and Compensation Amendment Bill, Tasmanian Government 2009). In an earlier study, we found that whilst claim reporting time significantly dropped in Tasmania, insurer decision time increased (attributed to administrative burden of implementing a whole suite of amendments), which offset the gains, leading to no change in the time between injury and acceptance of claim (Lane et al 2018). This shows that there can be unintended consequences of changing legislation, in this case possibly because the system could not handle claims in the same manner as before the change.…”