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Rheumatoid Arthritis Disability and Absence Trends in the United States

Objectives: Employers increasingly focus on absence benefits and connections with employee health. United States absence benefits include Sick Leave (SL), Short- and Long-Term Disability (STD and LTD, respectively) for non-work-related injuries/illnesses, and Workers’ Compensation (WC) for work-related injuries/illnesses. This research explores all-cause absence (SL, STD, LTD, and WC) utilization and changes from baseline for eligible employees with rheumatoid arthritis to determine if the use a constant payment factor is appropriate for models. Study Design: Retrospective multi-year database analysis. Methods: The Workpartners database (1/1/2001-12/31/2019) was used to identify employees with rheumatoid arthritis with adjudicated medical claims. Annual prevalence, benefit utilization, mean days of leave, and median payments (as % of salary) were analyzed. Annual outcomes were calculated as a percent of baseline (2001). Results: Rheumatoid arthritis prevalence averaged 0.5% between 2001 and 2019. At baseline, the percent of eligible employees using STD = 15.5%, LTD = 0.7%, WC = 1.7%, SL = 61.7%. Mean absence days were 48.5, 367.5, 43.8 for STD, LTD, WC, respectively and median payments were 70.5%, 22.2%, 65.7% of salary for STD, LTD, WC, respectively. From 2002-2019: 11.7%-16.9% of eligible employees filed STD claims for 82.1%-995.9% of baseline days and 80.4%-125.9% median payments; 0.6%-2.9% of eligible employees filed LTD claims for 66.6%-114.7% of baseline days and 63.2%-254.8% median payments; 0.3%-1.6% of eligible employees filed WC claims for 44.0%-472.8% of baseline days and 70.4%-271.5% median payments. Median payments were highest in 2012, 2019, 2003 for STD, LTD, WC, respectively and the most absence days were used in 2017 for SL and LTD, 2008 for STD, and 2005 WC. Conclusion: Employees with rheumatoid arthritis used absence benefits at differing rates over time with varying leave-lengths and payments. Using a constant cost or salary replacement factor for absence costs over time and across benefits is not accurate.