The work comp system can be confusing and frustrating to deal with – if you don’t fully understand how it works. The stakeholders and processes are different than for patients insured with private insurance, Medicare or Medicaid.
A different approach.
Providing treatment for patients with work-related injuries requires a different approach from that of treating other outpatient populations. Following a “worker/job matching” methodology allows the treating therapist to have more accurate and objective information when treating work-related injuries and when recommending return-to-work. This approach requires you to understand the patient’s job and its associated physical demands.
In addition, a clear understanding of your state’s workers’ compensation laws and regulations is extremely important.
Who are the major players?
The major players in workers’ compensation are the case managers, insurance adjusters and the physicians who treat patients with work related injuries.
What are their needs and interests?
The case manager and insurance adjustor want fast effective return to work. If return to work is not possible, then case closure becomes the goal. They need therapists who objectively measure patient progress in the treatment process utilizing objective information regarding patient‘s physical ability compared to job demand.
Case managers and adjusters need to know your prognosis for patients. Are patients progressing as planned or are complications arising? They don’t like surprises at the end of treatment. They also need therapists who will respectfully confront non-compliant patients. Therapists typically don’t like this aspect of treating patients with work-related injuries, so having a systematic process for dealing with self-limiting and inconsistent behavior with specific objective boundaries is essential for success.
Physicians want patients who improve and return to work with minimal intervention on their part. Success and good outcomes on your part, requires less stress and involvement is on their part. If the therapist can provide concise information about the most demanding aspects of the patient’s job and a brief functional return to work screen, it makes the physician’s return to work decision much easier and more defensible.
The worker’s compensation system may seem like an obstacle course, but once you understand the process, it is no more daunting that another other course. In fact, treating work comp patients can be both rewarding and lucrative when you master the process.
The ErgoScience Work Comp Mastery Series can help you understand and navigate the work comp system. Click here to learn more.