Workers' Comp Insurers Unhappy With Cost of Prescription Painkillers

When an occupational injury puts you out of work, workers' compensation is a safety net that can help you through your time of need by providing wage replacement and medical expense payments. Most employers provide workers' compensation benefits through partnerships with workers' comp insurers.

After a decade of incentivizing doctors to pursue drug-heavy treatments in lieu of alternatives like therapy, workers' comp insurers are now complaining about the rising costs of prescription painkillers. If you've been injured at work, workers' comp insurers' gripes could ultimately mean changes in your care.

Narcotic Painkillers Underperforming as Treatment for Workplace Injuries

According to The New York Times, workplace insurers spend approximately $1.4 billion on narcotic painkillers (otherwise known as opioids) every year. The appeal of a "magic pill" in medical treatment runs deep in the American psyche; simply taking medicine and watching health issues melt away would certainly be easier than trying behavioral interventions. It would be also be cheaper — at least that's what workers' comp insurers used to think.

While powerful drugs can tremendously benefit many patients, there are no magic pills. One study of workers' comp claims found that workers treated for injuries like back strain with high doses of opioids stayed off the job three times longer than individuals with similar injuries who relied less heavily on painkillers.

A separate analysis conducted by a workers' comp insurer operating in 18 states found that the total cost of a workplace injury is nine times higher when a strong narcotic is used than when such a drug is not included in treatment.

"What we see is an association between the greater use of opioids and delayed recovery from workplace injuries," Alex Swedlow, head of research at the California Workers Compensation Institute, told The New York Times. There is little evidence that opioid drugs provide long-term benefits; even worse, they cause drowsiness and lethargy, can lead to addiction and often have other serious side effects.

Injured in a Massachusetts Workplace Accident? Changing Insurer Attitudes Could Impact Your Claim

There is no doubt that in the right situation, the correct dose of a strong pain drug like OxyContin, Percocet or Duragesic can improve the outcome for a workers' comp beneficiary. The problem is not the drugs themselves, but over-reliance: Between 2001 and 2008, narcotics prescriptions as a proportion of all drugs used to treat occupational injuries skyrocketed by 63 percent.

Massachusetts is one of the worst offenders in terms of relying heavily on strong prescription painkillers to treat workers' injuries. According to the Workers Compensation Research Institute in Cambridge, Massachusetts, doctors in Louisiana, Massachusetts, New York and Pennsylvania are the biggest prescribers of powerful narcotics for injured workers.

More workers' comp insurers are taking note of the costs associated with overuse of narcotics, and are rapidly backpedaling on their policies of readily reimbursing doctors for painkillers while denying payments for nondrug treatments. If you are truly in need of a painkiller to treat your occupational injury, this could mean you will face added difficulty in your workers' comp claim. Talk to a workers' compensation attorney today to learn more about getting the full benefits you need.