The Opioid Epidemic and Workers’ Compensation in 2019

In the last decade, the opioid epidemic has sprawled across the country, calling the attention of the White House, law enforcement, health care providers, and local governments. And while efforts have been made to come up with a solution to cut opioid addiction and use, and provide more recovery resources for former users, it remains a major health-related issue that is putting a new strain on workers’ compensation insurance.

In a new study of injured worker claims from the Workers Compensation Research Institute, 27 states showed that both treatments using non-opioid pain medications and non-pharmacologic treatments, like physical therapy, have been increasing.

With workers compensation insurance making up a large percentage of all casualty premiums, any factor that has an effect on the claim outcomes is an important one for workers comp stakeholders. California, Illinois, Florida, and New York make up more than 37 percent of direct premiums written for w.c. in the country.

Prescription Abuse

Opioid abuse as a result of pain management represents a major challenge—if not the greatest challenge—facing the workers’ compensation industry today. Dependence on opioids can be an unintentional outcome of a regular prescription for a workplace injury. This creates higher care costs for payers in the workers’ compensation system. Finding better alternatives to pain management and controlling opioid prescriptions are the major issues that workers’ compensation insurers should be addressing to see more change in this area.

States like California are trying to adopt new regulations to help cut down the opioid prescription abuse issue in motion. This is helping injured workers, insurers, and those in the workers’ compensation industry mitigate the rising claim costs as well as unintended opioid dependence.

California has a drug formulary that health providers have been utilizing since January of 2018. This has been used to help guide prescription coverages, just like in Florida, where the governor has recently signed into legislation a new program to reduce opioid addiction and require health care providers training around abuse.


State-based performance is an important benchmark for workers’ compensation stakeholders to comprehend. Workers’ compensation claims have actually decreased since 2012, but when opioids are involved, claim durations are more than likely to stretch more than a year. And while financial expenditures are declining as well, the impact on injured workers remains a major concern.

Claim professionals are needed to validate each prescription drug during the duration of a claim and push forward training and education around the proper use of opioids. This remains critical in order to get the best outcomes from those own medications. Additionally, claims professionals should be able to seek out the latest information about the best types of treatment practices and treatments for pain management.

What’s more, alternative pain treatment is growing, providing options like acupuncture, chiropractic treatment, and cognitive behavioral therapy instead of depending on prescription drugs. There are even insurance providers diving into virtual reality as a way to treat pain and manage expenses related to workers’ compensation expenses.

About InsureMyWorkComp

InsureMyWorkComp is a digital brokerage that helps clients find the right workers’ compensation solution for their business needs. Unlike other online platforms, we will help you to work with an agent who can provide you the right solution for your risk profile. Our staff has over 50 years of workers’ compensation underwriting and sales experience, and we are confident that we will provide you the support that you need. For more information or to get a quote, contact us today at (855) 340-9138.