Occupational differences in workers' compensation indemnity claims among direct care workers in Minnesota nursing homes, 2005‐2016

Abstract

BackgroundNursing assistants have one of the highest injury rates in the U.S., but few population‐based studies assess differential injury risk by occupation in nursing homes. This statewide study assessed differences in musculoskeletal disorders (MSDs) and patient handling injuries among direct care workers in Minnesota nursing homes.MethodsIndemnity claims from the Minnesota workers' compensation database were matched to time at risk from the Minnesota Nursing Home Report Card to estimate 2005 to 2016 injury and illness claim rates for certified nursing assistants (CNAs), licensed practical nurses (LPNs), and registered nurses (RNs). Associations between occupation and claim characteristics were assessed using multivariable regression modeling.ResultsIndemnity claim rates were 3.68, 1.38, and 0.69 per 100 full‐time equivalent workers for CNAs, LPNs, and RNs, respectively. Patient handling injuries comprised 62% of claims. Compared to RNs, CNAs had higher odds of an indemnity claim resulting from an MSD (odds ratio [OR] = 1.67; 95% confidence interval [CI], 1.31‐2.14) or patient handling injury (OR = 1.89; 95% CI, 1.47‐2.45) as opposed to another type of injury or illness. CNAs had lower odds of receiving temporary and permanent partial disability benefits and higher odds of receiving a stipulation settlement.ConclusionsCNAs in Minnesota nursing homes are at heightened risk for lost time MSDs and patient handling injuries. Claims filed by CNAs are more frequently settled outside the regular workers' compensation benefit structure, an indication that the workers' compensation system is not providing adequate and timely benefits to these workers.

Relationship Analysis of Injured Workers’ Average Weekly Wages and Workers’ Compensation Indemnity Claims in Maine, US: 1998 to 2017

“…23 However, oversimplifications about the association between a quick return of injured workers to their jobs with lower claims' related expenses should be avoided, especially when employees are either temporary or permanent/direct hire employees and/or the employees have different incomes. 6,8,9,24 Further examination is needed to understand, in addition to the injured workers' income, what specific groups, elements and/or exposures within the industries reviewed derived the results reflected in this study. In addition, it should not be assumed that the estimated relative risk ratios obtained for each industry group are the same for every subgroup within that group.…”

“…Generally, those states where the National Council of Compensation Insurance (NCCI) calculates businesses’ experience modification factors, only 30% of the costs related to medical-only claims are incorporated while 100% of the expenses are included for indemnity claims in the calculation of the factor 23 . However, oversimplifications about the association between a quick return of injured workers to their jobs with lower claims’ related expenses should be avoided, especially when employees are either temporary or permanent/direct hire employees and/or the employees have different incomes 6,8,9,24 …”