OBJECTIVES : Employers offer a variety of absence benefits. Benefit design impacts the use of benefits, leave-length, and payments in employees with cancer. Use objective data to measure annual cancer prevalence, all-cause utilization of short- and long-term disability (STD & LTD, respectively) and workers' compensation (WC) and determine if constants are accurate over time and across benefits.

METHODS : Retrospective analysis of Workpartners Research Reference Database (RRDb, 2001—2019). For each year, employees with medical-claims from the US Agency for Healthcare Research and Quality’s oncology (cancer) category were identified, and the annual prevalence and Charlson Corbidity Index (CCI, a measure of severity) was calculated. Each year, the analysis focused on %-of-eligible-employees (EMPs) utilizing each benefit, mean days of leave, and median payments as %-of-salary (PMTs). Disability and WC payments included lump-sum distributions and potentially extended beyond initiation-year. WC-claims without absence from work (medical-only) were excluded. All employees' claims were included based on year initiated. Average days and PMTs for each benefit were calculated and compared to baseline (2001).

RESULTS : Cancer prevalence ranged from 3.2—5.9% (4.7% overall average). CCI increased from 0.876 to 1.615. At baseline 11.6% of EMPs filed STD-claims, 0.6% filed LTD-claims, 1.0% filed WC-claims. STD/LTD/WC days of leave averaged 42.1/133.6/53.7 days with 70.6%/15.6%/68.1% PMTs. During 2002—2019, 11.2—16.6% of EMPs filed STD claims at 85.0—121.5% of baseline days (BDs) and 67.8—131.3% of baseline PMTs; 1.0—1.8% of EMPs filed LTD claims at 102.3—362.5% of BDs and 142.3—337.3% PMTs; 0.3—1.1% of EMPs filed WC claims at 80.7—313.0% of BDs and 76.4—164.8% PMTs. PMTs were highest in 2007/2002/2003 and days of leave were longest in 2019/2006/2010 for STD/LTD/WC.

CONCLUSIONS : Management of cancer is a growing concern for employers. Employees with cancer used a different mix of absence-benefits over time (varying durations and payments). Using a constant cost/day for all benefits and years is not accurate or appropriate.