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• A large fraction of lost-time claims are repeat claims

• Risk of second claim varies by industry, occupation as for first claims • Risk of second claim varies little by nature of injury

• A large fraction of repeat claims are with the same employer

• A large fraction of repeat claims are for a different nature of injury • Risk of repeat claim depends on age & duration of previous claim

• The pattern of repeat claims in Ontario, Victoria and Alberta are similar • Long-duration claims have lower re-injury risk

• Long-duration claims followed by re-injury had lower wage replacement and medical costs

(3)

• WC claims often assumed independent events • Alberta

• Claim = LT + NLT, injury + disease

• 54.0% of men filed second claim within 0-10 years • 37.9% of women filed second claim within 0-10 years

• 67.6% of 1995 claimants filed second claim by end of 2004 • 241,000 second claims (not re-opens)

• Victoria

• First claim = LT (>10 days) + NLT (>$500), injury only • 40.5% of men filed second claim within 9-14 years • 31.3% of women filed second claim within 9-14 years • 63,000 second claims (often re-opens)

(4)

Risk of second claim by industry at first claim (Alberta)

Number of first claims

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1.0 1.1 1.2 1.3 1.4 Agriculture/forestryMining/petroleum Manufacturing Construction Transportation Wholesale/retail Municipal/educ/health

Provincial gov Business/personal/prof services

(5)

Risk of second claim by industry at first claim (Victoria)

Number of first claims

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0.20 0.25 0.30 0.35 0.40 0.45 0.50 Agr/Forestry/Fishing Mining Manufacturing Utilities Construction Wholesale Retail Accommodation/food Transport/postal Media/telecomm Financial Rental/real estate Professional Administrative Public administration Education

Heatlh care/social assistance Arts/recreation

Other

Missing

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Risk of second claim by occupation at first claim (Alberta)

Number of first claims

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1.0 1.5 2.0 2.5 Man ager s Nat ural sci ence Soc ial s cien ces Teac hing Med icin e/he alth Arti stic lite rary Cle rical Sal es Ser vice s Farm ing Fore stry /logg ing M inin g Pro cess ing Fo od/b ever age Mac hini ng Fabr icat ion Con stru ctio n Tran spor t Mat eria l han dlin g Cra fts/e quip men t 0 10000 20000 30000 40000 50000

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Risk of second claim by occupation at first claim (Victoria)

Number of first claims

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0.25 0.30 0.35 0.40 Managers Professionals Technicians Community service Clerical Sales Machinery Labourers Missing 10000 20000 30000 40000 50000

(8)

Risk of second claim by injury type of first claim (Alberta)

Number of first claims

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0.2 0.4 0.6 0.8 1.0 Sprains/strains/tears Surface wounds Fractures/dislocations Open wounds Burns Traumatic Systemic disesase Infectious Neoplasms Symptoms Multiple Other 0 50000 100000 150000

(9)

Risk of second claim by affliction at first claim (Victoria)

Number of first claims

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0.28 0.30 0.32 0.34 0.36 0.38 0.40 Intra cran ial Frac ture s Wou nds Bur ns Ner ves Trau mat ic s oft t issu e Oth er 0 20000 40000 60000 80000

(10)

Risk of second claim by accident type of first claim (Alberta)

Number of first claims

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0.6 0.7 0.8 0.9 1.0 Contact (object/equipment) Bodily reaction/exertion Falls Substances Transportation Assaults/violence Fires/explosions 0 20000 40000 60000 80000 100000 120000 140000

(11)

Risk of second claim by age at first claim (Alberta)

Number of first claims

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1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 18-24 25-34 35-44 45-54 55-65 40000 60000 80000 100000 120000

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• Different affliction + different bodily location: 45.5% • Same industry: 74.8%

• Same occupation: 45.6% • Same employer: 65.6%

• Dates of changes unknown

(13)

Claim costs and duration (Victoria)

Impact Single First Second

Mean Std Mean Std Mean Std Total cost $16,731 $87,011 $8,813 $50,938 $13,147 $65,100 Total wage replacement $5,249 $30,877 $2,631 $18,501 $4,875 $27,204 Total medical $3,447 $29,128 $2,034 $9,996 $2,886 $13,025 Days lost 67 278 42 196 66 244

• Why are the durations and costs so much less for the first claims of repeat claimants?

(14)

• All lost-time claims 2000-01-01 through 2009-12-31 • Injury + disease

• Design 1:

• 5 year inception cohort 2000-2004, 5 year follow-up from first accident date

• Similar to Victoria study: Ruseckaite & Collie (2011) • 23.6% of men filed second claim within 5 years

• 21.0% of women filed second claim within 5 years • 96,000 second claims (mostly not re-opens)

• Mostly trivial difference between post-accident date and post-benefit definition of 5 year follow-up

(15)

Risk of second claim by industry at first claim (Ontario)

Number of first claims

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0.15 0.20 0.25 0.30 Agriculture Fishing/Trapping Logging/Forestry Mining Manufacturing Construction Transportation/Storage Communication/Utility Wholesale Trade Retail Trade Finance/Insurance Real Estate Business Government Educational Health/Social Service Accomm/Food/Beverage Other Service Missing (Schedule 2) 0 20000 40000 60000 80000 100000 120000

(16)

Risk of second claim by occupation at first claim (Ontario)

Number of first claims

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0.10 0.15 0.20 0.25 0.30 M an ag em ent B us/F in/Ad m in N atu ra l/A pplie d S ci H ea lth S ocia l S ci/E du c/G ov/R elig A rt/C ulture /R ec/S po rt S ale s, S erv ice Tra de s/T ra ns p/O pe rato rs P rim ary In du stry P ro ce ss ing /M an uf/U tilitie s 0 20000 40000 60000 80000 100000 120000 140000

(17)

Risk of second claim by affliction at first claim (Ontario)

Number of first claims

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0.16 0.18 0.20 0.22 0.24 Fracture Wounds Burns

Traumatic soft tissue Musculoskeletal dis

Other

Missing

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• Dates of changes unknown • Ontario: 5 year follow-up • Victoria: 9-14 year follow-up

First and second claims of repeat claimants (Ontario)

Ontario Victoria

Different nature + different bodily location 47.1% 45.5%

Same industry 83.9% 74.8%

Same occupation 69.7% 45.6%

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Test Chi-square DF p Independence 4095 36 < 0.0001 Quasi-independence 285 29 < 0.0001 Symmetry 241 21 < 0.0001 Quasi-symmetry 34 15 0.003 Marginal homogeneity 207 6 < 0.0001

Measures of agreement between Part of Body codes on

first and second claims (Ontario)

(21)

Test Chi-square DF P Independence 3825 25 < 0.0001 Quasi-independence 313 19 < 0.0001 Symmetry 523 15 < 0.0001 Quasi-symmetry 34 10 0.0002 Marginal homogeneity 489 5 < 0.0001

Measures of agreement between Nature of Injury codes

on first and second claims (Ontario)

(22)

Claim costs and duration (Ontario)

Impact Years* Single First Second

Mean Std Mean Std Mean Std

Wage replacement ($) 5 8,523 26,401 2,641 9,821 7,499 23,628 1 3,164 6,373 1,770 3,794 3,127 6,352 Medical benefits ($) 5 2,125 16,893 715 2,286 1,810 10,003 1 1,171 6,411 545 1,424 1,081 4,843 Days of benefits (days) 5 176 452 73 247 150 397

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1. Immortal time bias • No, bias is small 2. Labour-force exit

• Maybe, we don’t have the data to test this 3. Effect of prior claim history

• No, Victoria saw the same pattern using true “first” claims 4. Long-duration claims have lower repeat claim risk

• Yes, costs and durations for claims < 365 days similar for repeat and non-repeat claimants

• Labour force exit?

• Changed occupation/task?

(24)

Single First

Median Mean Std Median Mean Std Duration < 365 Benefit days 8 33.6 59.1 8 29.7 53.5 Wage replacement 418 1,611 3,136 413 1,431 2,775 Medical 143 562 2,071 138 443 1,023 Duration > 365 Benefit days 365 365 0 365 365 0 Wage replacement 15,380 15,964 10,607 8,335 11,074 9,901 Medical 3,176 6,249 18,049 2,223 3,227 4,609

First year claim costs and duration (Ontario)

• Probability of second claim within 5 years: • Duration < 365 = 0.23

(25)

• Design 2:

• 10 years of time-to-event data

• Two alternating time-to-event processes • Time-to-RTW

• Time-to-next-claim

• Unmeasured competing risk: insured labour market exit • School

• Home keeping

• Non-WC disability benefit • Retirement

• Self-employment • Emmigration

• Similar to Alberta study: Cherry et al. (2011)

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Risk of lost-time claim by industry of previous claim and number of previous claims (Ontario; 2000-2009)

Number of previous claims

H a za rd r a ti o r e la ti ve t o m a n u fa ct u ri n g 0.5 1.0 1.5 2.0 0.5 1.0 1.5 2.0 Accommodation/Food/Beverage Retail Trade 1 2 3 4 Construction Transportation/Storage 1 2 3 4 Health/Social Service Wholesale Trade 1 2 3 4

(30)

Risk of lost-time claim by occupation of previous claim and number of previous claims (Ontario; 2000-2009)

Number of previous claims

H a za rd r a ti o r e la ti ve t o sa le s a n d se rvi ce 0.8 1.0 1.2 1.4 1.6 0.8 1.0 1.2 1.4 1.6 0.8 1.0 1.2 1.4 1.6

Business, Finance, Administration

Management

Social Science, Education, Government Service, Religion

1 2 3 4

Health

Processing, Manufacturing, Utilities

Trades, Transport, Equipment Operators

(31)

• A large fraction of lost-time claims are repeat claims

• Risk of second claim varies by industry, occupation as for first claims • Risk of second claim varies little by nature of injury

• A large fraction of repeat claims are with the same employer

• A large fraction of repeat claims are for a different nature of injury • Risk of repeat claim depends on age & duration of previous claim

• The pattern of repeat claims in Ontario, Victoria and Alberta are similar • Long-duration claims have lower re-injury risk

• Long-duration claims followed by re-injury had lower wage replacement and medical costs

(32)
(33)

References

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