2005 Injured Worker Survey Results

1
2005 Injured Worker Survey Results
Texas Department of Insurance Workers
Compensation Research and Evaluation Group March
2006

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What does the survey ask?

• Medical Care provider selection/change,
  satisfaction with provider, satisfaction with
  quality of care, medical disputes
• Access to Care ability to schedule appointments,
  claim denials, and problems getting the type of
  care deemed necessary
• Health Status physical and mental functioning
  scores of injured workers
• Return-to-Work employment status, lost-time from
  work, reasons behind unemployment, experiences
  with at-injury employer
• Hardships financial and personal hardships
  resulting from work-related injury
• Socio-demographic Information gender,
  educational attainment, race/ethnicity, language
  of interview, etc.

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Survey Sample and Administration

• TDI made modifications to the survey instrument
  previously developed by the Research and
  Oversight Council on Workers Compensation (ROC).
• TDI pulled a random probability sample
  (stratified by injury type and geographic region)
  of workers injured between November 2003 to March
  2004 from the claims database maintained by the
  Division of Workers Compensation.
• TDI and the Public Policy Research Institute
  (PPRI) at Texas AM University conducted, during
  the early fall of 2005, 2,039 interviews of
  workers with 7 days of lost work time
  (approximately 18-22 months of post injury).

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Overview of Presentation

• Selection of First Non-Emergency Doctor
• Access to Care
• Satisfaction with Care
• Return-to-Work
• Physical and Mental Functioning
• Experiences With Being Fired/ Laid Off
• Claim Denials

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Selection of First Non-Emergency Doctor

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Note Selected in Other Manner includes getting
a referral from the ER doctor or company doctor,
went to the hospital, etc. Source 2005 Injured
Worker Survey from the Texas Department of
Insurance Workers Compensation Research and
Evaluation Group and the Public Policy Research
Institute (PPRI) at Texas AM University. 6

7
Source 2005 Injured Worker Survey from the Texas
Department of Insurance Workers Compensation
Research and Evaluation Group and the Public
Policy Research Institute (PPRI) at Texas AM
University 7
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Top 3 Most Frequently Mentioned Reasons for
Changing Treating Doctor by Selection of First
Non-Emergency Doctor

• Employer Recommend Doctor
• Saw company doctor
• Felt treatment was not helping
• Dissatisfied with the doctors manner and caring

• Doctor Selected by Worker or In Other Manner
• Felt treatment was not helping
• Saw an emergency or urgent care physician for
  first visit
• Dissatisfied with doctors manner and caring

Source 2005 Injured Worker Survey from the Texas
Department of Insurance Workers Compensation
Research and Evaluation Group and the Public
Policy Research Institute (PPRI) at Texas AM
University 8
9
Access to Care

10
Source 2005 Injured Worker Survey from the Texas
Department of Insurance Workers Compensation
Research and Evaluation Group and the Public
Policy Research Institute (PPRI) at Texas AM
University 10
11
Source 2005 Injured Worker Survey from the Texas
Department of Insurance Workers Compensation
Research and Evaluation Group and the Public
Policy Research Institute (PPRI) at Texas AM
University 11
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Types of Problems Encountered by Injured Workers
Who Experienced Problems Getting Medical Care
Note Other reasons include problems with
insurance company, not treated in expected way,
problems getting treatments approved, etc.
Percentages do not add up to 100 percent because
injured workers were allowed to cite more than
one type of problem. Source 2005 Injured Worker
Survey from the Texas Department of Insurance
Workers Compensation Research and Evaluation
Group and the Public Policy Research Institute
(PPRI) at Texas AM University.

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Satisfaction with Care

14
Source 2005 Injured Worker Survey from the Texas
Department of Insurance Workers Compensation
Research and Evaluation Group and the Public
Policy Research Institute (PPRI) at Texas AM
University 14
15
Source 2005 Injured Worker Survey from the Texas
Department of Insurance Workers Compensation
Research and Evaluation Group and the Public
Policy Research Institute (PPRI) at Texas AM
University 15
16
Source 2005 Injured Worker Survey from the Texas
Department of Insurance Workers Compensation
Research and Evaluation Group and the Public
Policy Research Institute (PPRI) at Texas AM
University 16
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Return-to-Work Findings

18
Source 2005 Injured Worker Survey from the Texas
Department of Insurance Workers Compensation
Research and Evaluation Group and the Public
Policy Research Institute (PPRI) at Texas AM
University 18
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Percentage of Injured Workers Indicating Certain
Employer Actions Occurred by Employment Status
Note Percentages do not add up to 100 percent
because injured workers were allowed to respond
to each possible employer action
individually. Source 2005 Injured Worker Survey
from the Texas Department of Insurance Workers
Compensation Research and Evaluation Group and
the Public Policy Research Institute (PPRI) at
Texas AM University 19
20
Source 2005 Injured Worker Survey from the Texas
Department of Insurance Workers Compensation
Research and Evaluation Group and the Public
Policy Research Institute (PPRI) at Texas AM
University 20
21
Percentage of Injured Workers Indicating That
Certain Doctor/Patient Communications Took Place
by Employment Status
Note Percentages do not add up to 100 percent
because injured workers were allowed to respond
to each possible doctor communication
individually. Source 2005 Injured Worker Survey
from the Texas Department of Insurance Workers
Compensation Research and Evaluation Group and
the Public Policy Research Institute (PPRI) at
Texas AM University 21
22
Financially Stressful Life Events by
Return-to-Work Status 18-22 Months Post Injury
Note Other reasons include depression,
physical problems, not having enough money, etc.
Percentages do not add up to 100 percent because
injured workers were allowed to respond to each
possible life events individually. Source 2005
Injured Worker Survey from the Texas Department
of Insurance Workers Compensation Research and
Evaluation Group and the Public Policy Research
Institute (PPRI) at Texas AM University. 22
23
Financial Assistance Received by Return-to-Work
Status 18-22 Months Post Injury
Note Other reasons include a personal
disability policy, compensation from employer,
short-term/long-term disability, etc. Percentages
do not add up to 100 percent because injured
workers were allowed to respond to each possible
type of financial assistance individually. Source
2005 Injured Worker Survey from the Texas
Department of Insurance Workers Compensation
Research and Evaluation Group and the Public
Policy Research Institute (PPRI) at Texas AM
University. 23
24
Physical and Mental Functioning

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Physical and Mental Functioning of Injured
Workers 18-22 Months Post-Injury

• On average, the physical and mental functioning
  of injured workers in Texas (18-22 months post
  injury) is significantly worse than the physical
  and mental functioning observed in the US general
  population.
• The healthiest injured workers were those who
  reported that they were back at work or those who
  were not yet back at work, but had been released
  to return back to work without physical
  limitations.
• Unemployed injured workers who had not been
  released to return back to work or had been
  released to return back to work with some
  physical limitations were the least healthiest of
  all injured workers.

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Employee-Reported Experiences Regarding Being
Fired or Laid Off
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Source 2005 Injured Worker Survey from the Texas
Department of Insurance Workers Compensation
Research and Evaluation Group and the Public
Policy Research Institute (PPRI) at Texas AM
University 27
28
Source 2005 Injured Worker Survey from the Texas
Department of Insurance Workers Compensation
Research and Evaluation Group and the Public
Policy Research Institute (PPRI) at Texas AM
University 28
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Top Three Reasons Reported by Employees For Why
They Were Fired/Laid Off by Their Employers

• Employer said you werent physically able to do
  any of the jobs available
• Because you filed a workers compensation claim
• Some other reason (e.g. missed too much work/gone
  too long, not enough work to give individual, not
  able to perform job duties)

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Source 2005 Injured Worker Survey from the Texas
Department of Insurance Workers Compensation
Research and Evaluation Group and the Public
Policy Research Institute (PPRI) at Texas AM
University 30
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Conclusions

• Injured workers access to care, satisfaction
  with care, return-to-work, and physical mental
  functioning have not improved since the last time
  the survey was conducted in 2002.
• Although injured workers perceptions about their
  ability to schedule a doctors appointment were
  good, a significant portion of injured workers
  reported problems getting the medical care that
  they or their treating doctor deemed necessary.
• Overall, satisfaction with care was high among
  injured workers however, injured workers who
  selected an employer-recommended doctor were
  generally less satisfied than workers who
  selected their own doctor.

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Conclusions (contd)

• Thirty-six percent of injured workers were
  unemployed at the time of the survey and a
  significant percentage of injured workers
  reported that they had never returned to work
  almost two years post-injury.
• A significantly higher percentage of employed
  injured workers reported that their employers
  took an active part in their return-to-work
  process and their doctors discussed safety and
  return-to-work issues with them than unemployed
  injured workers.

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Conclusions (contd)

• Injured workers often experience financial
  hardships as a result of the injury, yet these
  financial hardships are exacerbated when injured
  workers remain unemployed.
• Unemployed injured workers were also more likely
  to receive other types of financial assistance,
  including public assistance than injured workers
  who went back to work after their injury.

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Conclusions (contd)

• The healthiest injured workers are those back at
  work and the least healthy injured workers are
  those that have not been released to return to
  work by their treating doctor.
• Twenty-three percent of injured workers reported
  being fired or laid off at some point after their
  injury occurred.

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Compensability Dispute

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Source 2005 Injured Worker Survey from the Texas
Department of Insurance Workers Compensation
Research and Evaluation Group and the Public
Policy Research Institute (PPRI) at Texas AM
University 36
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Source 2005 Injured Worker Survey from the Texas
Department of Insurance Workers Compensation
Research and Evaluation Group and the Public
Policy Research Institute (PPRI) at Texas AM
University 37
38
Source 2005 Injured Worker Survey from the Texas
Department of Insurance Workers Compensation
Research and Evaluation Group and the Public
Policy Research Institute (PPRI) at Texas AM
University 38
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Conclusions

• Among workers with more than 7 days lost time,
  approximately 17 percent of injured workers
  reported that all of part of their work-related
  injury was denied by the insurance carrier as not
  being work-related.
• Injured workers who reported that their injury
  was denied also reported restricted access to
  care, poor physical and mental functioning, and
  poor return-to-work outcomes when compared to
  injured workers who did not report injury
  denials.