Is Employer-Directed Medical Care Associated with Decreased Workers' Compensation Claim Costs?

Xuguang Grant Tao, Nina Leung, Nimisha Kalia, Robert A. Lavin, Larry Yuspeh, Edward J. Bernacki

Research output: Contribution to journalArticlepeer-review


Background: The financial impact regarding choice of physician within the workers' compensation domain has not been well studied. Objective: The aim of this study was to assess the difference in claim cost between employee- and employer-directed choice of treating physician after injury. Methods: Thirty-five thousand six hundred forty indemnity lost time claims from a 13-year period at a nationwide company were analyzed with multivariate logistic regression to determine the association of medical direction with risk of high-cost claims. Results: States that have employer-directed physician choice were associated with a lower risk of having high-cost claims (≥$50,000) but higher attorney involvement than employee direction. The net effect of this enhanced presence of attorneys offsets the benefits of employer choice of treating physician. Conclusion: States that permit employer selection of treating physician have slightly higher cost due to the higher prevalence of attorney involvement in the claims process.

Original languageEnglish (US)
Pages (from-to)e232-e237
JournalJournal of occupational and environmental medicine
Issue number5
StatePublished - May 1 2018


  • attorney
  • cost reduction
  • logistic regression
  • medical direction
  • occupational injury
  • odds ratio
  • workers' compensation

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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