Cost Drivers of Workers’ Compensation Low Back Injury Claims in an Academic Health System, 2015–2024

OBJECTIVE: Quantify costs, durations, incidence trends, and risk factors for WC lower-back injury claims in an academic health system. METHODS: Observational review of 797 closed claims (2015-2024) evaluating demographics, occupation, mechanism, tenure, days away from work, and temporal trends. RESULTS: Mean cost $10,973 (median $3,294); mean duration 197 days (median 74). Top 5% of claims averaged $114,548 and 1,819 days, accounting for 52.1% of total costs. Nurses and patient care assistants were most affected; lifting and pushing/pulling were leading mechanisms. Higher costs were associated with longer duration, occupation, male sex, older age, and shorter tenure. Incidence declined 8.4% annually. OEM-managed claims had lower mean costs than externally managed claims ($9,701 vs $19,880). CONCLUSIONS: Lower-back WC claims show a substantial but declining burden; integrated OEM management was associated with lower costs.