Employer Paid Sick Leave, Disability, and Workers’ Compensation Trends for Employees With Cancer Conditions in the United States

Abstract

Purpose: Employee benefits in U.S. firms often include medical and prescription insurance and short-and long-term disability (STD and LTD, respectively), workers' compensation (WC), and discretionary sick leave (SL). Employers are intensifying their efforts to understand and manage employee disability and its relationship to important health conditions. This research compares all-cause STD/LTD/WC/SL utilization and changes from baseline for eligible employees with cancer. Methods: Employees incurring cancer medical claims over a 20-year period (ending 12/31/2020) were identified in the Workpartners database. The annual prevalence, direct all-cause medical and prescription costs, absence benefit utilization, mean days of leave, and disability payments were analyzed retrospectively overall, and for specific cancer categories. Annual outcomes were calculated over the 20-year period. Trend line slopes were compared to detect differences from zero and across types of cancer. Results: At baseline (2001), 3.4% of employees had cancer, 58.7% of whom used SL, 16.7% filed STD claims, 0.8% filed LTD claims, and 0.9% filed WC claims. Baseline mean medical and drug costs for employees with cancer were $7,330 and $1,039, respectively. From 2001 to 2020, cancer prevalence rates increased significantly, by 0.75 per 1000 employees per year. While medical costs, drug costs, and sick days per employee increased significantly, the percent of employees using SL, LTD, and WC decreased. Some significant differences in trends among cancer types were seen. Conclusions While medical and drug costs for employees with cancer have increased over 2001-2020, utilization of most absence benefits and disability payments for those absences as a percent of salary have not.