A tough nut to crack: Understanding no-lost-time claims in Ontario

Ontario’s no-lost-time claims increased from 56 per cent of all accepted claims in 1991 to 68 per cent in 2006, according to new research from the Institute for Work & Health. But it’s too soon to say what’s driving this phenomenon.

Accepted lost-time claims fell much more rapidly than no-lost-time claims in Ontario from 1991 to 2006. This is a key finding of a project led by Institute for Work & Health (IWH) Scientist Dr. Peter Smith, and the subject of the latest Issue Briefing from IWH.

Although the study was unable to confirm the reasons behind the increasing share of no-lost-time claims, it did lead researchers to an important conclusion: Both lost-time and no-lost-time claims should be used to monitor trends in workplace injuries and illnesses and to target enforcement and prevention strategies. This study highlights that whether or not time is lost from work may not be the distinguishing factor between serious and less serious injuries, says Smith.

The ratio between types of claims

Workers’ compensation claims fall into two main categories: those that involve taking time off work, or “lost-time claims” (LTCs); and those that do not involve taking time off work, or “no-lost-time claims” (NLTCs). LTCs should typically be less frequent and more serious than NLTCs.

But does the ratio between the incidence of LTCs and NLTCs stay constant from year to year? If it varies, what could explain this?

  • Have the types of injuries changed over time? 
  • Is more attention paid to preventing LTCs than NLTCs when workers’ compensation premiums depend on the employer’s claims experience?
  • Are injured workers better accommodated to avoid taking time off?
  • Are LTCs being suppressed, or serious injuries being reported as NLTCs, to avoid higher insurance premiums?

This is the somewhat unsettled terrain in which Smith’s research unfolded. Using claims data from the Workplace Safety and Insurance Board (WSIB) and data on hours worked from Statistics Canada’s Labour Force Survey, the IWH team computed the rate of LTCs and NLTCs per full-time-equivalent (FTE) worker for each industry from 1991 to 2006. 

Sharp contrast between trends

The principal finding of Smith’s team is the sharp contrast between the trends in LTCS and NLTCs: LTCs fell much more rapidly than NLTCs in Ontario from 1991 to 2006—a decrease of 46 per cent compared to a decrease of nine per cent. 

The team also looked at the pattern of claims across different sectors of the economy, trends in health-care costs for NLTCs, and trends in types of injuries reported as NLTCs. The team’s key findings were the following: 

  • The highest ratios of NLTC rates to LTC rates were found in mining/utilities, construction and manufacturing/transportation/warehousing—sectors with above-average premium rates.
  • Health-care expenditures per NLTC slightly decreased between 1991 and 1997 and increased between 1998 and 2006. The increase in health-care costs per claim after 1998 was greater for medium-sized and larger firms than for smaller employers.
  • The study did not find evidence of a change over time in the types of injuries registered as NLTCs. 

The question still remains: Why are fewer workers absent following work-related injuries? This is not clear; the possible sources of the rising share of NLTCs are hard to tease apart.

We can’t distinguish between changes in the injury reporting practices of firms and better employer accommodation of disability arising from work injuries, says Smith. Using administrative records of compensation claims, it is not possible to separate these things using the data available. Collecting information on modified duty practices for claims where no time is lost from work would be helpful.

Implications for the future

Two implications arise from this study. First, injury prevention strategies that are based on claims data may be wise to rely on information on both more-serious and less-serious compensable injuries. Both LTCs and NLTCs ought to be included in assessing trends in occupational health and safety outcomes and in targeting particular groups for injury prevention strategies, says Smith.

The second implication speaks to the quality of information available on the use of modified duty practices. Given the increasing adoption of these practices in workplaces in all economic sectors, says Smith, “it may be prudent to consider means by which workers’ compensation records could include information on the use of modified duties and the outcomes of disability episodes managed by these arrangements.”

The Issue Briefing can be found at: www.iwh.on.ca/briefings/no-lost-time-claims. This study was also the focus of IWH’s Research 101 series, which allowed readers to follow the path of a research project. The series is available at: www.iwh.on.ca/research-101. More information on the study findings were published in the February 2011 issue of Journal of Occupational and Environmental Medicine (vol. 53, no. 2, pp. 211–217). 

Source: At Work, Issue 66, Fall 2011: Institute for Work & Health, Toronto