The California Workers’ Compensation Institute (CWCI) published Long COVID-19 Claim Characteristics and Treatment in California Workers' Compensation, a new report that reviews the mix of treatment payments at different points of development, and demographic differences between long COVID and shorter duration COVID claims.
Approximately one out of every 21 California workers’ compensation COVID-19 claims from accident years (AY) 2020-2022 involved medical treatment beyond 90 days from the injury date, but that small number of “Long COVID” cases consumed 82.1% of the treatment payments on COVID claims and 73.7% of all COVID claim payments.
The study, based on a review of 126,397 insured and self-insured COVID-19 claims, found that most were relatively inexpensive due to little-to-no medical intervention. Only 14.6% of COVID claims involved medical treatment, but 4.7% – or nearly 6,000 of them – were long COVID claims that involved long-term medical conditions that impeded or prevented the claimants from returning to their jobs and resulted in significant costs.
Medical payments for the COVID-19 claims in the study sample totaled $128.4 million, with long COVID claims accounting for $105.5 million, or 82.1% of payments, while total payments on the COVID-19 claims, including medical treatment, indemnity costs, and expenses, were $350.6 million, with Long COVID claims consuming $258.3 million, or 73.7%.
Overall, average medical payments were 105 times higher on Long COVID cases than on shorter duration COVID claims, and average indemnity payments were 37 times higher. Long COVID claim payments were significantly higher regardless of the body part involved, though the difference was most pronounced for injuries involving the lungs, multiple body parts, and “other” body parts.
While the number of new COVID cases has decreased, the CWCI notes growing concern about a potential COVID surge after the CDC adopted new guidelines that may make it more difficult to obtain COVID-19 vaccines just as the summer travel season hits and the new NB.18.1 COVID variant has been detected in multiple locations around the U.S.
