Source: Employer Measures of Productivity, Absence and Quality website (www.EMPAQ.org) Sep 4, 2010

About Workers' Compensation

Workers' Compensation (WC) provides coverage for medical expenses and wage replacement for employees disabled due to occupational injury or illness. WC expenses are typically associated with medical expenses, wage replacement payments, legal or investigative expenses, settlement costs or general expenses for claims administration. While workers' compensation is often thought of as similar to other disability coverage (i.e. short-term and long-term disability), it has several key differences:
  • WC is not considered an employee benefit but rather a property and casualty risk coverage, regulated differently by every state.
  • Wage replacement benefits can be supplemented by short-term and long-term disability benefits, but never the other way around. WC always pays first if the claim is work-related.
  • All states have WC laws dictating benefit amounts, how benefits are determined, claim management practices, funding arrangements, and ability to opt out of state plans.
For EMPAQ® purposes, WC focuses on only two types of claims: medical-only and indemnity.

EMPAQ® Metrics

EMPAQ® metrics are ratios (i.e. numerators over denominators) that can be used to calculate the effectiveness of health and productivity management programs. They establish a consistent method for measuring cost, utilization and other performance issues.

When you submit data to EMPAQ®, the secure online data submission tool will automatically calculate metrics for you. Simply enter your data (i.e. numerator and denominator values) into the tool and EMPAQ® will calculate the metrics for analysis and reporting. The results will be delivered to you as a set of benchmarking and decision-support reports.

EMPAQ® WC Metrics

There are 9 EMPAQ® metrics that describe the cost and lost-time expenses arising from workers' compensation.

These metrics include information on indemnity and RTW claims. Indemnity claims refer to work-related injuries or illnesses involving time lost from work. Costs for indemnity claims include both medical care and wage replacement. Within the category of indemnity claims, there are four different types of lost time claims: Temporary Total Disability (TTD), Temporary Partial Disability (TPD), Permanent Total Disability (PTD) and Permanent Partial Disability (PPD).

Return-to-work (RTW) refers to those claims where an employee returns to work in a modified capacity after being disabled due to a WC-covered illness or injury. The employee may work reduced hours or be unable to complete their assigned duties. EMPAQ® RTW metrics help measure the utilization and effectiveness of RTW programs.

Metric Ratio Explanation
Annual Claim Incidence per 100 FTEs
Annual Claim Incidence = Total Number of New Claims

Total Number of FTEs
Covered for WC
× 100
This metric calculates the number of new claims incurred per 100 covered FTEs during a defined period of time.
New Indemnity Claim Percentage
New Indemnity Claim Percentage = Total Number of New
WC Indemnity Claims

Total Number of New
WC Claims
This metric calculates the percentage of total new WC claims that are new indemnity claims incurred during a defined period of time.
Lost TTD Workdays per Closed TTD Claim
Lost TTD Workdays per Closed TTD Claim = Lost Workdays from Date of Injury for Closed Temporary Total Disability Claims

Total Number of Closed Temporary Total Disability Claims
× 100
This metric measures the average number of lost workdays (associated with closed TTD claims) per closed TTD claim. For this metric, the lost workdays are calculated from the date of injury.
Lost TTD Workdays per 100 FTEs
Lost TTD Workdays per 100 FTEs = Lost TTD Workdays for Temporary Total Disability Claims

Total Number of FTEs
Covered for WC
× 100
This metric is a measure of lost productivity in that it calculates the number of lost workdays due to Temporary Total Disability per 100 FTEs.
Cost per Full Time Equivalent (FTE) Employee
Cost per FTE = Total Active Claim Costs

Total Number of FTEs
Covered for WC
This metric calculates the cost of WC (measured as total active claim costs) per FTE (full-time equivalent employee) for a defined period of time.
Cost per Active Claim
Cost per Active Claim = Total Active Claim Costs

Total Number of Active WC Claims
This metric calculates the per claim cost of WC coverage for a defined period of time.
Cost per Closed Claim
Cost per Closed Claim = Total Costs of Closed WC Claims

Total Number of Closed Claims
This metric calculates the cost of WC coverage (measured as the cost of closed claims) per closed claim for the lifetime of the claim.
TTD RTW Claim Percentage
RTW Claim Percentage = Total Number of Temporary Total Disability Claims with Return-to-work Transitional Duty

Total Number of Active Temporary Total Disability Claims
This metric calculates the percent of all active TTD claims that also have associated RTW transitional duty for a defined period of time.
RTW Transitional Workdays Percentage
RTW Transitional Workdays Percentage = Total Number of Workdays with Employees on Transitional Duty, Associated with Active Temporary Total Disability Claims

Number of Lost Workdays for Active Temporary Total Disability Claims
This metric calculates the percentage of total lost workdays with active TTD claims that are lost due to transitional RTW-related TTD claims.


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