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

Abstract

ObjectivesTo determine the impact of legislative changes to the New South Wales (NSW) workers’ compensation scheme on injured workers access to benefits, insurer claim processing and work disability duration.MethodsPopulation-based interrupted time series study of workers’ compensation claims made in NSW 2 years before and after legislative amendment in June 2012. Outcomes included incidence of accepted claims per 100 000 workers, the median and 75th percentile insurer decision time in days, and the median and 75th percentile of work disability duration in weeks. Effects were assessed relative to a comparator of seven other Australian workers’ compensation jurisdictions.Resultsn=1 069 231 accepted workers’ compensation claims were analysed. Claiming in NSW fell 15.3% following legislative reform, equivalent to 46.6 fewer claims per 100 000 covered workers per month. This effect was greater in time loss claims (17.3%) than medical-only claims (10.3%). Across models, there were consistent trend increases in insurer decision time. Median work disability duration increased following the legislative reform.ConclusionsThe observed reduction in access to benefits was consistent with the policy objective of improving the financial sustainability of the compensation scheme. However, this was accompanied by changes in other markers of performance that were unintended, and are suggestive of adverse health consequences of the reform. This study demonstrates the need for care in reform of workers’ compensation scheme policy.

Collider Bias in Administrative Workers’ Compensation Claims Data: A Challenge for Cross-Jurisdictional Research

“…Legislative change may also introduce a collider if it alters compensability thresholds. For instance, we previously found that when New South Wales restricted eligibility to its compensation system in 2012, the claim rate decreased while disability duration increased (49). Such an outcome would be consistent with both a change in the cohort towards more severe and complex injuries and a system that has increased the stressfulness of compensation.…”

impact of workers’ compensation benefit cessation on welfare and health service use

“…Our recent evaluation of these reforms concluded that they had their intended effect: the number of accepted claims fell by 15%. However the reforms also had unintended effects as insurer claim processing time increased by 20% and the median disability duration by 29% [ 31 ].…”

“…Further, injured workers with longer claims that were unaffected by Section 39 would generally be historical claims. Given the substantial effect of the 2012 legislation (of which Section 39 was a part) [ 31 ], such historical claims would likely differ systematically from those affected by Section 39. However, we will use sensitivity analyses to estimate the effects of such biases (described in Sensitivity Analysis ).…”

Injured worker outcomes after compensation system overhaul: an interrupted time series study

“…We previously observed that workers’ compensation system reform was followed by an increase in claim processing time, 5,6 which is predictive of delayed return to work. 7–9 Longer insurer decision times are also an obstacle to early intervention, which is associated with better outcomes and shorter disability durations.…”