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For insurers and disability management

Duration is the cost. Delay is the cause. Measurement is the lever.

An average claim runs 2 months or longer, and 15% are still on wage replacement at 3 months. The variable that best predicts a long claim is not injury severity; it is how long the worker waited before treatment started.

01Claim frequency02Claim duration03Downstream imaging04MSK and mental health overlap

A claim runs 2 months or longer

Average claim duration in days

Each board publishes a different duration measure, so these bars are not a like for like comparison.

SourceA135A158A143

A written return to work policy halved time off

Average days off after a work related injury, one Ontario hospital system

Niagara Health, more than 4,800 workers. The peer group of 29 hospitals improved 25% over the same period.

SourceA408A409A410
Published dataEach board publishes a different duration measure, so those provincial bars are not a like for like comparison. What they agree on is the order of magnitude: a claim is a 2 month event, not a 2 week one.
4 levers

Where an objective capacity number actually changes your numbers.

01

Frequency

Soft tissue injury is the largest lost time claim category in Canada, and it is the category most responsive to loading. Capacity work before the incident moves the frequency curve, not only the severity curve.

116,372

Claims to muscles, tendons, ligaments and joints

AWCBC

50,801

Back claims. The most claimed body part in Canada

AWCBC

02

Duration

Duration is the cost driver and delay is what produces duration. A defined care pathway with objective retesting compresses both, with published Canadian effect sizes to show a claims committee.

66 days

Shoulder injuries healed and got back to work about 2 months sooner under a proper care pathway.

as published: MD = 66.4; 95% CI 49.1, 83.7

Journal of Occupational Rehabilitation (Springer)

1.4x

Wait too long to start treatment and the worker is 1.4 times more likely to never come back at all.

as published: RRRadj = 1.4, 95% CI 1.03, 1.8

Journal of Occupational Rehabilitation (Springer)

03

Downstream utilisation

Conservative care first reduces imaging and shortens the surgical queue for the people who genuinely need it. Nationally, 30% of low back pain patients with no red flags still received imaging.

decreased by 31%

Referral MRI use under a shared care low back pathway

Canadian Journal of Surgery

30%

Low back pain patients without red flags who still received imaging

Canadian Institute for Health Information, in collaboration with Choosing Wisely Canada

04

Comorbidity

Musculoskeletal and mental health claims are not separate books. Nearly half of musculoskeletal long term disability claimants also submit claims for mental disorder medication, and mental health now drives almost 40% of new long term disability claims.

49%

Musculoskeletal LTD claimants also claiming mental disorder drugs

Sun Life

almost 40% of claims

Mental health share of new long term disability claims, 2024

Sun Life

What you receive

Something better than a subjective note.

Capacity data is defensible, repeatable and comparable over time. It gives a case manager a reason to approve modified duty on a date rather than negotiate one.

1.8 times greater (95% CI 1.4, 2.3)

Relative risk of returning to modified duties under the pathway

Journal of Occupational Rehabilitation (Springer)

33% greater

Increase in the probability of being off wage replacement benefits

Institute for Work & Health

45% improvement

Improvement against a peer group of 29 hospitals, which improved 25%

Institute for Work & Health

$232 million (5%) per year

Annual reduction in the burden of illness attributable to physiotherapy

Deloitte LLP, prepared for Canadian Physiotherapy Association

Our positionOne boundary we hold: individual clinical results belong to the worker. What flows to a payor is what the worker has consented to release, and aggregate reporting stays above a minimum group size so nobody is identifiable by inference.

Pilot it on one book of business.

Pick a client with a musculoskeletal problem. We will measure, benchmark and retest, and you will have a duration trend line to look at.

A body map marking where reported low back pain concentrates