In disability claims management, we are continuously seeking to better understand the physical, psychological and social barriers that contribute to claimants' disabilities and prevent them from returning to work.
We also want to ensure that we are using resources appropriately and providing services that will result in positive claim outcomes. While predictive modeling has helped us gain efficiencies in determining which claims are likely to benefit most from our case management efforts, models alone cannot account for all the variables that may be driving claim duration.
While attending an industry conference last year, I learned of the Adverse Childhood Experiences Study (ACE Study). The ACE Study is an ongoing collaboration between Kaiser Permanente and the Centers for Disease Control and Prevention (CDC) with the primary intention of investigating the connection between the incidence of childhood abuse and neglect and general health later in life. The original ACE Study was conducted from 1995 to 1997 with more than 17,000 Kaiser Permanente members. The CDC continues to follow the original ACE Study participants and updates morbidity and mortality data accordingly.
For this study, adverse childhood experiences (ACEs) that occurred in the first 18 years of life are categorized into three groups:
- abuse (emotional, physical or sexual);
- neglect (emotional or physical); and
- family/household challenges (substance abuse, mental illness, separation or divorce, violence and incarceration).
The ACE score is the total sum of the different categories of ACEs reported by participants. This score is used to assess cumulative childhood stress. The study found that as the number of ACEs increases (with scores ranging from 0 to 10), so does the risk for drug and alcohol abuse, mental health conditions, COPD, ischemic heart disease, liver disease, obesity, and a host of other behavioral, social and economic problems. Those with ACE scores of 4 or higher are most at risk for developing such problems.
Childhood trauma was very common
Findings of the ACE Study showed that childhood trauma was - sadly - very common. In fact, almost two-thirds of the study participants reported at least one ACE. Further, 87% had more than one, and more than 20% reported three or more ACEs. The 17,000 study participants were mostly Caucasian, middle and upper-middle class, college-educated, and all had jobs with healthcare benefits (as members of Kaiser Permanente).Read More +