Health, Wellness, and Workers' Comp: A Promising Cost-Saving Connection

We all know that staying physically and mentally well reduces healthcare costs. But have you thought about how health and wellness affect workers' compensation costs? By improving physical and mental health and preventing disease, wellness programs can lower workers' compensation costs. 

Comorbidities in Workers' Compensation

When we think of workers' comp claims, we imagine things like back strains from heavy lifting, knee injuries from a trip and fall, or wrist problems from repetitive tasks such as keyboarding. Some employees may have prior injuries involving the same body parts they have re-injured on the job. We know these pre-existing conditions can aggravate workers’ comp injuries. However, anxiety, depression, diabetes, substance abuse, heart disease, and hypertension don't usually come to mind when thinking about workers’ comp scenarios. These conditions are known as comorbidities, which are medical conditions that exist simultaneously in a patient. Just like pre-existing problems, these comorbid conditions can worsen workers’ comp injuries and increase their costs by requiring longer periods of time off, more costly medical treatment, and higher permanent impairment.

Comorbidities are often overlooked as a cost driver in workers’ comp claims. Most employers believe these belong outside the workers’ comp arena and in the private medical sector. However, comorbidities are significant because most state workers’ comp jurisdictions rely on some variation of the "accept the person as you find them" premise. It is challenging to tease out comorbid conditions from a workers’ compensation claim. Employees are hired as whole-person packages, not an unbundled group of body parts and systems. An employee who suffers from non-industrial medical conditions is more adversely affected by an industrial injury than an employee with a similar injury without the additional conditions. 

Evidence-Based Insights

In general, workers' comp claims with a comorbid aspect have a two-fold increase in medical costs compared to similar claims with a non-comorbid diagnosis, according to a study by the National Council on Compensation Insurance (NCCI).  In addition, a 2024 survey conducted by Healthesystems in collaboration with Risk & Insurance Magazine found 65% of stakeholders believe comorbidities are the number one barrier to injured worker recovery. 

A 2024 study found that 65% of stakeholders believe comorbidities are the number 1 barriers to injured worker prevention.” —Healthesystems

Other studies have found that obesity affects both medical and indemnity claim costs, and injured workers who were also obese filed more claims, saw higher medical costs, and took longer to return to work.

Further, a report from earlier this year found increased workers’ comp costs for claims with comorbidities and degenerative conditions. It stressed the importance of preventative measures to mitigate the impact of these conditions on claims.

There are many other common examples of how comorbidities apply:

• An employee with type II diabetes who suffers a work-related crush injury to their foot has a higher likelihood of infection, and even amputation, when diabetes is present, particularly if uncontrolled. The work injury did not cause diabetes, but the existence of diabetes has significantly worsened the injury.  
• An employee with a pre-existing mental health condition may encounter a work-related psychiatric event, such as being robbed at gunpoint. Employees with underlying mental illness are more prone to experience higher levels and longer-lasting anxiety and depression from such a traumatic incident.
• An injured employee with a history of substance abuse is more at risk of abusing pain medication prescribed for their injury.
• Employees who are obese or otherwise deconditioned are more likely to suffer injuries and take longer to recover. They are also more likely to have secondary comorbidities such as hypertension and diabetes.

Historically, the focus in addressing comorbidities in workers’ comp has been reactionary. Carriers may increase case reserves to account for higher costs associated with such claims. In an attempt to argue against employer/workers’ comp carrier liability, lengthy and costly litigation is undertaken with often minimal positive or cost saving outcomes. While it is appropriate to continue these efforts in applicable cases, it is prudent to become more proactive and turn our attention to efforts to prevent and lessen these problems.

This is where health and wellness programs come into play. Ideal programs address lifestyle factors, with components designed to improve physical fitness, emotional/mental wellbeing, and even financial wellness, which has been shown to improve overall mental wellbeing and reduce employee stress. Employees who actively participate in employer-sponsored wellbeing programs are less prone to diseases and comorbidities that are cost drivers in workers’ comp claims.

The Impact of Health and Wellness Programs on Workers' Compensation

The Institute for Healthcare Consumerism completed an analysis of various studies on wellness programs, showing that organizations that implemented such programs saw a 30% average reduction in workers' compensation claim costs. Employees with better physical conditioning are less likely to get injured, and when they do, they rebound more quickly.

Organizations that implemented wellness programs saw a 30% average reduction in workers’ compensation claim costs. —Institute for Healthcare Consumerism

Programs that offer nutrition counseling, tobacco cessation, and substance abuse support resources lead employees to make healthier lifestyle choices, thus reducing other comorbidities and directly impacting safety and workers’ comp costs.

Mindfulness is a part of emotional wellness and can improve safety.  Large employers like Google and Nike have even incorporated mindfulness training in their workplace. Mindful employees are more present and have increased situational awareness in their environment. They are more focused and more careful, which can lead to fewer workplace accidents. Additionally, employees who practice mindfulness are better able to manage stress, are less likely to file stress-related claims, and have less costly claims overall. 

Ways to Build Your Wellness Program

Employers may implement stand-alone wellness programs, integrate with their health carrier, or adopt a hybrid approach. Additionally, some workers’ comp carriers offer well-being services as part of their loss control programs. The programs can help employers reduce both health insurance premiums and workers’ comp costs by collaborating with medical clinics, for example, to train employees in the prevention of musculoskeletal claims.

Ohio, a monopolistic state for workers’ comp, offers Better You, Better Ohio through its Bureau of Workers’ Compensation. It’s a free resource for enrolled employers and their employees to aid in injured worker recovery by improving mental and physical health and wellness after sustaining an injury.  This model could offer employers insights and strategies to build their own workers’ comp wellness initiatives.

Regardless of the type of program, any wellness program should be results-oriented, increase accountability and goal-setting behavior, and provide incentives for successful outcomes. Continuous evaluation of program results is also key to ensuring the program is constantly evolving to meet its intended goals and changing course as needed. 

Wellness programs can be implemented and driven by any department within the organization; however, the best wellness programs include all levels of employees and departments to ensure broad support across the organization. Consider including a dedicated team made up of people from different departments to encourage collaboration and provide ways to make participation a coveted experience, as opposed to an appointed task for any member of the group. Broad collaboration across the organization helps prevent burnout and affords greater reach for more long-term success. 

Health, Wellness, Workers' Comp, and a World in Turmoil

In today’s workplace, employee stress has reached critical levels due to burnout, financial pressures, workplace demands, and fears about AI taking over jobs. Job insecurity itself is now driving stress for more than half of American workers, with the American Psychological Association’s  2025 Work in America survey finding that employment uncertainty significantly impacts 54% of US workers' stress levels. This heightened anxiety is aggravated by global politico-economic issues, climate-triggered natural disasters, and cultural shifts. The APA survey showed an increase in mental health disorders, namely anxiety and depression, since pre-pandemic levels. It also points to the significant ways in which the body’s physiological response to stress impacts physical health, potentially causing inflammation, digestive issues, and heart disease. These factors may cause decreased productivity and increased distractibility, raising the risk of injuries.

The rise of artificial intelligence has also introduced a new layer of workplace anxiety, with 52% of workers worried about AI's future impact in the workplace and 32% expressing concern about AI's impact on their future career opportunities. This AI-related stress compounds traditional workplace hazards, as anxious and distracted workers face increased risk of workplace injuries and accidents, potentially driving up workers' compensation claims and costs for employers.

Employee Assistance Programs (EAPs) are always a great resource to implement or publicize. Another idea for emotional support is to add a crisis line for employees to anonymously call and speak with a counselor. Initiatives that focus on healthy and active lifestyles and personal empowerment are also effective strategies.  

As Stephen Glazier points out in his article, The Aging Workforce: Ergonomics, Comorbidities, Lighting, and Strategies for Reducing Claims, employers can also implement loss control measures, such as ergonomic improvements, to help prevent injuries and support better health outcomes for workers with comorbid conditions.

In general, wellness programs increase employee motivation, productivity, and job satisfaction, leading to less turnover. Employees retained longer have fewer workplace accidents due to having more job experience and practice, leading to lower workers’ comp claims.

Now is an ideal time to make health and wellness initiatives part of both your employee benefits and workers' compensation safety plan—or to add new resources to your existing program.

Reach out to a Woodruff Sawyer workers’ compensation claim or a Benefits Specialist for additional information and to help get you started on the road to better health—and possibly lower risk.