Have you ever disagreed with a return to work decision on one of your workers' compensation patients but felt powerless to influence the decision? What if you had done a Return-to-Work (RTW) screen or mini-FCE as part of your standard discharge evaluation? Could that have made a difference?
Sink or Swim Just as the Great Depression hit businesses hard, the “Great Pandemic” is shaping up to be a sink or swim period for many companies. Most physical therapy clinics have taken quite a hit during the COVID19 shutdowns and restrictions. As more and more clinics share their stories with us, we are seeing a trend emerge. About 20% of clinics are already swimming and bouncing back. Another 20% are sinking. They have chosen to stick their head in the sand, waiting for the problem to go away. Still the majority, about 60% of clinics, are just stuck. They want to find a solution and get business back on track, but they just don’t know what to do. These clinics are treading water, barely keeping their heads up, looking for a lifeline. Where does your clinic fall?
How is the typical return to work decision made? You probably know the drill. The patient returns to the physician and the physician says: “So, do you think you’re ready to go back to work?” And the patient’s response drives the physician decision. Or the physician takes a look at the patient’s MRI or lab work and says, “Well it looks like you’re ready to get on back to work.” Either way, the end result is a WAG. If you’re not sure what a WAG stands for, let’s just say the first word is Wild and the third word is Guess and I’ll leave the middle word up to your imagination…
Maybe a reported injury occurred late in the day on Friday, or early Monday morning. Maybe there were no witnesses.
A lot of therapists say they don't like FCEs or steer away from workers' compensation, sometimes without any real experience in this area. Often FCE's have a negative reputation, but there are more positive reasons to consider this service than you might expect. Let's look at the TOP 10 reasons you need and FCE system… even if you really don't want to do FCEs.
For clinicians, building relationships with the referral source is a vital part of practice. Therapists must first find out who the referral source is, whether it is a physician, claim adjuster, case manager, or third-party administrator. Once that is known, two major components play into building relationships:
When it comes to work comp, referrals won’t come beating down your door unless you know how to bring them in. It is not difficult to bring them in if you know and understand the needs and interests of the referral source. This can vary depending on the service. Let’s focus on post injury services.
How many hats are you wearing when it comes to treating work comp patients???
It’s true that you can’t be “just” a physical therapist when working with the “industrial athlete”, but it doesn’t have to leave you crazy! Let’s explore some of the roles you’ll play and how to manage your personal cast of characters.
Do you ever feel like you are shooting in the dark when it comes to the return-to-work process for your workers' compensation patients?
Are your recommendations based more on guesswork than on objective data?
Or maybe you’ve disagreed with a return-to-work (RTW) decision on one of your workers' compensation patients but felt powerless to influence the decision?
When doing Functional Capacity Evaluations (FCE) or Pre-Hire Physical Abilities Testing (PAT) some clinicians and FCE vendors pull a bit of a testing protocol from here and a bit of another from there, slap it together and call it a defensible, functional test. While that might help get the job done, it won’t be anything close to defensible – unless you’re talking about the martial arts maneuvers that you, the physician, insurance carrier or employer will be doing - when the test is legally challenged.
