Workers' compensation insurance : a primer for public health
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Workers' compensation insurance : a primer for public health

Filetype[PDF-1.04 MB]

  • English

  • Details:

    • Journal Article:
      DHHS publication ; no. (NIOSH)
    • Description:
      The purpose of this document is to help public health researchers and practitioners, particularly those in occupational safety and health, to broaden their understanding of workers’ compensation insurance, relevant aspects of the insurance industry records, and the potential uses of that information for public health purposes. Workers’ compensation insurance has been established in all states to provide income protection, medical treatment, and rehabilitation for employees who are injured or become ill as a result of work. Workers’ compensation claims and medical treatment records along with other information resources have been used to conduct occupational safety and health research and surveillance and to identify intervention needs.

      Several government agencies and private organizations sponsored two workshops in September 2009 and June 2012 on the use of workers’ compensation data for occupational safety and health purposes. The workshops featured discussions of opportunities for collaboration in the analysis of workers’ compensation data in order to help reduce the risks of occupational injuries and illnesses. Participants included representatives from private insurance carriers, insurance associations, self-insured corporations, academic institutions and government agencies.

      At the end of the second workshop, some com- mented that the public health and the insurance communities may have different interpretations of terms in common usage and overcoming that barrier might be facilitated by a summary of the workers’ compensation industry and a crosswalk of terminology used by each group. A team began work on this document as a result.

      Following the background and brief history of the workers’ compensation programs in the U.S., this primer describes: (1) benefits and premiums; (2) the relationship between premiums and safety incentives; (3) roles of insurers, state agencies and third party administrators; (4) types of policies; (5) claims and other workers’ compensation insurance information on medical treatments, costs and disability status; (6) limitations of current industry data standards; (7) loss prevention programs; and (8) public health research, surveillance and regulations. A glossary of workers’ compensation terms begins on page 35 and a guide for prospective research and surveillance projects follows on page 41.

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