Certain workers’ compensation policies show state-level variation in cost, disability time and outcomes of claims for low back pain, according to data recently published in the Journal of Occupational and Environmental Medicine.
Researchers at Liberty Mutual Research Institute for Safety in Hopkinton, Mass. analyzed data of more than 59,000 low back pain (LBP) claims in 49 states. After adjusting for differences in worker characteristics, they discovered state-level factors accounted for about 5% of the total variation in medical costs and disability time. They also found 43% to 50% of this variation was due to differences in state workers’ compensation policies, according to a press release from the journal. Medical costs and disability times were higher in states that allowed injured workers, rather than employers, choose providers. Costs and disability also were increased in states that had a longer retroactive period.
According to the release, states that had a schedule of fees reimbursed for specific medical services and states that limited the option to change providers both had longer disability times. However, policies that allowed for a one-time change in the treating provider were associated with lower medical costs and shorter disability times. 
“A shorter retroactive period and early referral of injured workers to health care providers familiar with occupational health issues may reduce medical costs and duration of work disability due to LBP,” study author Glenn Pransky, MD, MOccH, of Liberty Mutual Research Institute for Safety, said in the press release.
According to the release, the data indicated that giving workers who are not satisfied with their treatment the chance to switch providers may improve both outcomes. The authors noted further studies are needed to determine whether these policies have a similar influence on other causes of these claims.