A recent study by the California Workers’ Compensation Institute (CWCI) has revealed that a small fraction of COVID-19 workers’ compensation claims in California — those involving Long COVID — accounted for the vast majority of claim-related costs during the accident years 2020 through 2022.
Out of 126,397 insured and self-insured COVID-19 claims analyzed, only 4.7% involved medical treatment extending beyond 90 days after the date of injury. These Long COVID cases, while representing a small portion of total claims, made up 82.1% of the medical treatment payments and 73.7% of the total claim payments, which include indemnity costs and expenses. In total, medical payments across all claims reached $128.4 million, with Long COVID claims responsible for $105.5 million. Total payments across all claims amounted to $350.6 million, with Long COVID cases accounting for $258.3 million.
The study also noted that just 14.6% of all COVID-19 workers’ compensation claims involved any medical treatment, suggesting that most claims were relatively minor in nature. However, the nearly 6,000 Long COVID cases often involved significant long-term medical needs that delayed or prevented employees from returning to work, contributing to higher costs.
Payment discrepancies between Long COVID claims and shorter-duration claims were notable. On average, medical payments for Long COVID were 105 times higher, and indemnity payments were 37 times higher. These elevated costs were consistent across all body part classifications, with the most pronounced differences observed in cases involving the lungs, multiple body parts, or unspecified (“other”) body parts.
The study identified the top 10 diagnostic categories associated with Long COVID claims, which reflect the condition’s multisystem nature. These categories included:
- Respiratory system disorders (17.8%)
- Circulatory system disorders (9.0%)
- Nervous system disorders (8.7%)
- Connective tissue, soft tissue, and bone disorders (5.2%)
- Endocrine system disorders (4.9%)
- Mental health conditions (4.4%)
- Digestive system conditions (3.4%)
Together, these categories accounted for over 80% of all diagnoses tied to Long COVID claims in the dataset.
The study arrives at a time when COVID-19 claim volume has declined sharply in California’s workers’ compensation system. After a surge in claims following Governor Gavin Newsom’s state of emergency declaration in March 2020, recent months have seen a dramatic drop-off. However, renewed concerns have emerged regarding a potential summer COVID-19 surge, prompted by the identification of the NB.18.1 variant and recent changes to CDC vaccine guidelines that may impact access to immunizations during peak travel season.
CWCI’s full report, titled Long COVID-19 Claim Characteristics and Treatment in California Workers’ Compensation, includes detailed findings and graphics. It is available to CWCI members and subscribers at www.cwci.org, and can be purchased by non-members through the institute’s online store.
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