OBJECTIVES : Use objective data to compare prevalence of respiratory conditions, all-cause utilization of sick leave (SL), 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 the Workpartners Research Reference Database (RRDb, 2001—2019). Employees with medical claims for United States Agency for Healthcare Research and Quality respiratory conditions category were identified annually. Annual severity measured by Charlson Comorbidity Index (CCI). For each benefit, analysis focused on prevalence, % of eligible employees (EMPs) filing leaves, mean days of leave, and median payments as a % of salary (PMTs). Disability and WC payments included lump-sum distributions and potentially extended beyond initiation year. WC claims without work absence were excluded. All leaves were aggregated by initiation year. Average days and PMTs for each benefit were calculated and compared to baseline (2001).

RESULTS : The prevalence of respiratory conditions averaged 26.3% (21.8—30.4%) during the study. CCI increased from 0.361 to 0.605. At baseline, 64.0%/8.6%/0.3%/1.5% of EMPs had leaves for SL/STD/LTD/WC. EMPs averaged 5.7/36.7/179.7/53.7 SL/STD/LTD/WC days, with median payments 100.0%/70.5%/22.5%/68.1% of salary. During 2002—2019, SL utilization rose to 80.9%, and days more than doubled before ending at 189% of baseline; 7.3—10.6% of EMPs filed STD claims with 82.6—120.7% of baseline days (BDs) and 74.3—127.7% of PMTs; 0.4—0.7% filed LTD claims with 75.5—413.3% of BDs and 109.0—265.0% of PMTs; 0.5—1.5% filed WC claims for 122.4—304.5% of BDs and 77.6—145.1% of PMTs. STD/LTD/WC PMTs were highest in 2013/2002/2005 and days of leave were longest in 2019/2005/2007.

CONCLUSIONS : Management of respiratory conditions is a growing concern for employers. Their employees with respiratory conditions used a different mix of absence benefits over time with varying durations and payments. Using constants to estimate costs over time for all benefits is not accurate or appropriate.