Report
The Frequency, Severity, and Economic Consequences of Musculoskeletal Injuries to Firefighters in California
Jun 21, 2010
Musculoskeletal disorders (MSDs) are the most common type of occupational injury among firefighters, so there is considerable interest among policymakers and stakeholders about how best to monitor, prevent, and treat firefighter MSDs. The authors update analyses from a 2010 study on firefighters in California, considering the impacts on injured firefighters of recent workers' compensation reforms and the economic shocks of the late 2000s.
Trends and Outcomes over the Past Decade
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Musculoskeletal disorders (MSDs) are the most common type of occupational injury or illness suffered by firefighters, so there is considerable interest among policymakers and stakeholders about how best to monitor, prevent, and treat firefighter MSDs. In this report, the authors update analyses from a 2010 RAND study on firefighters in California and consider the impacts of the 2013 workers' compensation reforms and the economic shocks of the late 2000s on outcomes for firefighters with MSDs.
The California Department of Industrial Relations requested that the authors address a wide range of specific research questions on various aspects of firefighters' injury risk and outcomes in the workers' compensation system, from case mix and economic consequences to permanent disability rating and medical treatment patterns. The authors analyzed administrative data from the California workers' compensation system linked to data on earnings for workers injured between 2005 and 2015, with additional analyses to tailor the results to the new reforms. They compare firefighters with three groups of workers in broadly comparable occupations — police, other public-sector workers, and private-sector workers with job demands that resemble firefighting — and supplement the analysis using outside data.
The authors found, among other things, that firefighters continue to face elevated risk of work-related MSDs and that earnings losses for firefighters worsened after the Great Recession of 2008–2009. Their findings will be of interest to policymakers in California and other states and to other audiences concerned with the occupational health and safety of firefighters.
Chapter One
Introduction
Chapter Two
Background on Work-Related Musculoskeletal Disorder Risk for Firefighters Compared to Workers in Other Occupations
Chapter Three
Recent Trends in Injury Rates and Composition Among California Firefighters
Chapter Four
Economic Consequences of Musculoskeletal Injury for Firefighters and Other Workers
Chapter Five
Incidence of Post-Traumatic Stress Disorder and Other Psychiatric Comorbidities for Firefighters with Musculoskeletal Disorders
Chapter Six
Disability Ratings and Benefits for Firefighters with Musculoskeletal Disorders
Chapter Seven
Treatment Caps and Claim Denials
Chapter Eight
Conclusion
Appendix A
Additional Details on Methods
Appendix B
Sensitivity Analyses and Additional Results
The research described in this report was prepared for the Commission on Health and Safety and Workers' Compensation and conducted by the RAND Institute for Civil Justice (ICJ), part of the Justice Policy Program within RAND Social and Economic Well-Being.
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