OBJECTIVES : Use objective data on all-cause utilization of work absence benefits [sick leave (SL), short- and long-term disability (STD/LTD, respectively) and workers' compensation (WC)] in employees with skin conditions 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 skin conditions were identified annually. Annual severity assessed by Charlson Comorbidity Index (CCI). For each benefit, analysis focused on prevalence, percent of eligible employees (EMPs) filing leaves, mean days of leave, and median payments as a percent of salary (PMTs). Disability/WC payments included lump-sum distributions and potentially extended beyond the year initiated. WC claims without work absence were excluded. All leaves were aggregated by initiation year. Average days and PMTs for each benefit were compared to baseline (2001).

RESULTS : Prevalence of skin conditions averaged 12.0% (range=8.7—13.4%) during the study, with CCI increasing from 0.312 to 0.517. At baseline, 58.2%/8.9%/0.3%/1.3% of EMPs had leaves for SL/STD/LTD/WC. EMPs averaged 5.5/37.5/183.8/43.3 SL/STD/LTD/WC days, with median payments 100.0%/70.5%/23.8%/67.4% of salary. During 2002—2019, SL utilization ranged from 36.9%—77.9%, and days more than doubled before ending at 184% of baseline; 7.1—10.4% of EMPs filed STD claims for 80.2—122.6% of baseline days (BDs) and 68.6—136.7% of PMTs; 0.3—0.7% of EMPs filed LTD claims for 70.5—353.6% of BDs and 107.8—209.7% PMTs; 0.5—1.3% of EMPs filed WC claims for 139.0—403.7% of BDs and 85.4—146.7% PMTs. STD/LTD/WC PMTs were highest in 2004/2006/2006. SL/STD/LTD/WC days of leave were highest in 2017/2019/2008/2010.

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