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The Effect of Opioid Use on Workers' Compensation Claim Cost in the State of Michigan

White, Jeffrey A. MS; Tao, Xuguang MD, PhD; Talreja, Milan MA, PMP; Tower, Jack MS; Bernacki, Edward MD, MPH

Journal of Occupational and Environmental Medicine: August 2012 - Volume 54 - Issue 8 - p 948–953
doi: 10.1097/JOM.0b013e318252249b

Objective: To investigate the association between opioid utilization and catastrophic claim (≥$100,000) cost.

Method: A total of 12,226 workers' compensation indemnity claims that were opened and closed from January 1, 2006 to February 28, 2010 in the State of Michigan were selected for multivariate logistic regression analyses.

Result: Controlling for sex, age, claim duration, number of distinct International Classification of Diseases–Ninth Revision codes per claim, and legal involvement, the presence of short-acting opioids on a claim were 1.76 (95% confidence interval: 1.23 to 2.51) and long-acting opioids 3.94 (95% confidence interval: 2.35 to 6.89) more likely to have a final cost $100,000 or more than a claim without any prescription.

Conclusion: The use of opioid medications, particularly long-acting opioid medications, is an independent risk factor for the development of catastrophic claims.

From the Medical Management Practices and Strategy (Mr White), Medical Center of Excellence (Mr Talreja), and Data Analytics and Medical Trends (Mr Tower), Accident Fund Holdings, Inc, Lansing, Mich; and Department of Medicine (Drs Tao and Bernacki), Division of Environmental and Occupational Medicine, Johns Hopkins School of Medicine, Baltimore, Md.

Address correspondence to: Edward J. Bernacki, MD, MPH, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Billings Admin 131, Baltimore, MD 21287; E-mail:

The study received partial funding from Accident Fund Holdings, Inc.

Disclosure: The authors declare no conflict of interest.

©2012The American College of Occupational and Environmental Medicine