Musculoskeletal Disorders, Injuries With Lengthy Work Absences Often Not Eligible for the BLS Survey of Occupational Injuries and Illnesses

BACKGROUND: The Bureau of Labor Statistics (BLS) estimates the burden of occupational injuries and illnesses through an annual assessment of employer-reported OSHA recordable cases.  Detailed case information is collected on incidents resulting in one or more days of missed work.  According to multiple studies, BLS occupational injury and illness data fail to capture all eligible cases. Using data elements available in Washington State workers’ compensation (WC) data to approximate BLS survey eligibility, we explored the impact of inclusion criteria on BLS case capture.

METHODS: We linked cases reported in the BLS Survey of Occupational Injuries and Illnesses (SOII) to Washington State WC claims data for 2006 – 2008.  We then differentiated claims less likely to have met SOII eligibility during the survey period from those more likely to have met eligibility criteria based on claim event dates, employer protests of accepted claims, and employer responsibility of claim.  Inclusion criteria were applied to both WC claims linked to SOII cases and to unlinked WC claims assigned to BLS surveyed employers.  We then compared characteristics among three groups of claims: SOII-WC linked claims meeting SOII inclusion; unlinked WC claims meeting SOII inclusion criteria; and unlinked WC claims not meeting SOII inclusion criteria.

RESULTS: Compared to WC claims linked to a reported SOII case, a greater portion of unlinked WC claims first received medical treatment after the BLS survey year, were established more than sixty days after the survey year, and had a disability date more than sixty days after the survey year.  Unmatched claims not meeting SOII inclusion criteria were more likely to have occurred later in the year, become eligible for wage replacement much later than the initial injury date, experience a longer duration of work absence, and were classified as MSDs.  Among claims likely meeting SOII inclusion criteria, injury characteristics of SOII-WC linked claims were similar to the characteristics of unlinked WC claims.

CONCLUSIONS: Many time loss claims were either unknown to the employer or did not meet the SOII case eligibility criteria of one or more days away from work until after the survey year.  Moreover, the BLS survey methodology systematically excludes some of the most severe injuries and illnesses, as measured by duration of disability.