OBJECTIVES : Use objective data to compare prevalence of musculoskeletal conditions, all-cause utilization of sick leave (SL), short-/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 the United States Agency for Healthcare Research and Quality musculoskeletal conditions 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 compared to baseline (2001).

RESULTS : The prevalence of musculoskeletal conditions ranged from 7.3—11.3% and CCI increased from 0.342 to 0.621 during the study. At baseline, 61.4%/13.6%/0.5%/1.9% of EMPs had leaves for SL/STD/LTD/WC. EMPs averaged 6.5/41.8/184.3/53.6 SL/STD/LTD/WC days, with median payments 100.0%/70.6%/28.4%/68.0% of salary. During 2002—2019, SL utilization ranged from 35.5% to 81.1%, and days more than doubled before ending at 177% of baseline; 12.1—18.4% of EMPs filed STD claims for 81.7—126.7% of baseline days (BDs) and 68.6—129.3% PMTs; 0.7—1.5% of EMPs filed LTD claims for 70.4—394.1% of BDs and 93.1—211.0% PMTs; 0.8—2.0% of EMPs filed WC claims for 112.6—378.7% of BDs and 76.9—152.8% PMTs. STD/LTD/WC PMTs were highest in 2013/2002/2005. SL/STD/LTD/WC days of leave were highest in 2017/2016/2008/2010.

CONCLUSIONS : Management of musculoskeletal conditions is a growing concern for employers. Their employees with musculoskeletal 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.