Sociodemographic, Industry and Health Factors Associated with Underutilization of Workers' Compensation Insurance

Details

• Journal Article:
  American Journal of Industrial Medicine
• Personal Author:
  Wuellner, Sara E. ; Bonauto, David K.
• Description:
  Objective: Workers' compensation insurance is an important financial resource for workers, and a key source of occupational injury and illness surveillance and research data. Underutilization of workers compensation is an ongoing concern. Using statewide data for a general working population, we estimated the portion of workers whose work-related injury or illness (WRII) was paid by workers' compensation and assessed workers' compensation utilization by industry, occupation, demographic and health characteristics, and over time. Methods: We combined 5 years of Behavioral Risk Factor Surveillance System telephone survey data (2017-2022, excluding 2020) from Washington State for workers (n = 31,171) and identified respondents with WRII (n = 1463). We estimated the percent of workers who utilized workers' compensation to pay for treatment of their WRII, and calculated adjusted prevalence ratios to estimate underutilization controlling for sociodemographic, work and health factors. Estimates were weighted to be representative of the Washington adult population. Results: Of the 5.1% of Washington workers who experienced a WRII within the past 12 months, just over half (51.3%, 95% CI: 48.1%, 54.5%) reported that their WRII was paid by workers' compensation insurance. Controlling for other sociodemographic, work and health factors, workers' compensation utilization was lower among workers who were younger, male, graduated from college, reported poorer mental health, and could not afford medical care. Workers' compensation utilization was lower among most service-related industries and occupations. Annual estimates of utilization statewide changed little over time. Conclusion: Underutilization of workers' compensation insurance is substantial. Workers' compensation data are more likely to miss younger workers, and workers in service-related industries and occupations.
• Subjects:
  Behavioral Risk Factor Surveillance System Mental Health Occupational Health Occupational Injuries Safety Workers' Compensation
• Keywords:
  Author Keywords: Occupational Injury; Survey; Underreporting; Work Injury; Workers' Compensation Workers Compensation; Surveillance; Behavioral Risk Factor Surveillance System; BRFSS; Young Workers; Mental Health; Service Industries; Demographic Characteristics;
• Source:
  Am J Ind Med 2026 Jan; 69(1):3-13
• ISSN:
  0271-3586
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  Washington ; San Francisco Region [OSHA]
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  11 pdf pages
• Volume:
  69
• NIOSHTIC Number:
  nn:20071201
• Contact Point Address:
  Sara Wuellner, SHARP Program, Washington State Department of Labor & Industries, Olympia, Washington, USA
• Email:
  sara.wuellner@lni.wa.gov
• Federal Fiscal Year:
  2026
• Performing Organization:
  Washington State Department of Labor and Industries
• Peer Reviewed:
  True
• Start Date:
  20050701
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:ac58d06b19e8e216d09585be89df5fe715b43f991ead2652a9a95aaae6ef1f74a26c879a368b8dfc01911fad2d28566f57a270a84df466c51186d28d8912bd86
• Download URL:
  https://stacks.cdc.gov/view/cdc/258680/cdc_258680_DS1.pdf
• File Type:
  [PDF - 402.72 KB ]