‘Most significant’ problem facing workers comp: Can you guess?

‘Most significant’ problem facing workers comp: Can you guess?

‘Most significant’ problem facing workers comp: Can you guess?

Workers compensation costs have skyrocketed, creating a mass of affordability problems for employers and insurance professionals, and producing a profit just once in the past 15 years. According to workers compensation and managed care expert Joe Paduda, one thing is fueling those issues more than any other: opioid abuse.

“I believe that opioids are the most significant problem facing work comp today,” Paduda said during a Tuesday webinar hosted by CID Management. “It’s not the hard market, it’s not the economy, it is—in fact—opioids.”

Paduda said the increase in opioid use to treat work-related injuries has been “stunning,” with the number of prescriptions growing 41% from 2003 to 2011, and “directly affect[ing] claims costs.”

Claims managers and others working directly with workers comp seem to agree.

In a survey conducted by Health Strategy Associates, Paduda’s own firm, 33% of front-line case managers said opioid use led to an increase in costs and claims. However, 30% of employers responding to the survey said they were unable to identify opioid-related claims that would benefit from interventions.

That’s where an educated producer comes in, said Mike Tolland, an insurance veteran who spent 35 years working both in claims management and as a producer in workers comp.

“[Employers] are going to be pretty reliant on the broker to serve as an advocate and spokesperson. That ranges from key ways to submit underwriting data to intervening in claims situation,” Tolland said. “The most common way in which a broker would intervene is to make sure a claim is properly investigated.”

Producers can also hold educational seminars, distribute newsletters, and pass along helpful hints on workers comp to avoid claims situations involving improper opioid use, Tolland said.

That message may be timely, as less than 24% of employers said they are currently working with insurance professionals to address opioid issues. Another 30% of senior management believes managing opioids is “not a priority.”

This is troubling to Paduda, who wants to see all parties involved in educating employers and helping them manage opioid use, which would help control claims costs.

“We have to make sure programs put in place are conceived by senior folks, that they deliver what they should deliver,” he said. “Reporting and evaluating that is going to be critical going forward.”