Signs Your Business Uses the Wrong Workers Comp Doctors
The single biggest predictor of how successful a workers compensation claim will be is the primary physician that initially treats the employee. For those that work in a state that allows the employer to direct the workers’ compensation treatment program, if you aren’t strategically picking who your primary care physician is or the physicians you include in your panel, you’re throwing away tons of money and opening yourself up to large workers’ compensation settlements that you might have been able to limit or completely avoid.
1. Most of your injured workers get time off work
Most on-the-job injuries don’t require a significant time away from work. This is standard unless you operate a business or organization in a highly risky field (i.e. – demolition, law enforcement, oil rigging, etc.). If you find that your employees consistently miss work based on the treating doctor’s recommendation, it’s likely you are dealing with what we affectionately call in the industry a “Doctor Summer-off”. An affectionate nickname given to workmans comp doctors who routinely take the employee’s feedback to extremes or can be easily swayed by an employee who wants to get additional vacation days without being charged for them.
Doctors can be very sympathetic to their patients and that is important for client-patient trust and diagnosing certain issues before they become much worse. However, in cases where basic first aid and an evaluation are all the treatment that has been prescribed, there is no need for your employees to be missing 1, 2, or more days of work. If there are slight limitations when they return to work, you can deal with those when they report back. Arbitrarily giving employees days off work can have major, negative consequences on your labor costs, employee morale, and productivity.
2. Injured workers take a long time to get back to full duty
Your workers comp doctors should be focusing on maximizing the speed at which employees regain full (or as close to full) health as possible and getting them back to full duty. Most third-party administrators, insurers, and industry professionals have access to statistics that identify average amounts of time it should take a worker to get back to full health following specific injuries. It isn’t alarming if a single employee has a setback or a complication that delays their rehabilitation. However, a track record of these types of setbacks and delays points to a much larger issue. It’s either incompetence in the treatment being given or lack of pro-active rehabilitation and oversight. Either way, they’re costing you money and eroding the integrity of the rehabilitation process you’ve put in place.
3. Several employees have developed substance abuse issues following treatment for a workers comp injury
The opioid abuse issue has reached epidemic levels in the United States. Drug overdose deaths are on the rise and ‘opioid-related deaths now exceed deaths involving heroin and cocaine combined’ as reported by the CDC. An article on how the Opioid Epidemic Plagues Workers’ Comp posted by the Insurance Journal included an interview with Dr. Leonard J. Paulozzi (medical epidemiologist with CDC’s National Center for Injury Prevention & Control). In that interview, Dr. Paulozzi looked at workers comp back injuries and concluded that “…42 percent of workers with back injuries got an opioid prescription in the first year after injury – most of the time after the first medical visit. But one year after the injury, 16 percent of those workers were still getting opioids.”
A workmans comp doctor is the front line in either perpetuating or helping to stop this epidemic. They should have access to their state’s Prescription Drug Monitoring Program (PDMP) and use it consistently. Several supporters have discussed the idea of a national PDMP, such as this article by Dr. Eric Collins on The Hill, to help states coordinate this information to prevent ‘doctor shopping’ across state lines to perpetuate a habit. In short, your chosen physican/s need to act as a buffer and not an enabler of these types of addictions. A huge red flag is if you have seen multiple employees develop addictions following treatment. This can specifically risky to their personal health and to your organization if they are involved in ‘safety sensitive’ work such as driving large vehicles!
4. Updates on employees are sparse or infrequent
A cornerstone of an effective and efficient workers comp program for every employer is a consistent and pro-active communication chain. The workers comp doctor is one of the most pivotal links in that chain. They help relay important information and updates about the employee’s status and rehabilitative progress. The subject of communication is the centerpiece of this article authored by Rebecca Shafer on the Workers Comp Resource Center Blog (aptly named – blog.reduceyourworkerscomp.com). If you’re not receiving routine updates or receiving information about dramatic changes in treatment well after the fact, your physician is derailing your ability to get employees back to full health and full duty.
Conclusion:
Any of these warning signs point to a need to at least re-evaluate who your primary workers comp doctor is and whether a change in the physician or process is needed. Every single one of these issues can result in harm to your employee, your risk management services program and your organization’s success. Don’t let these warning signs sit for too long because they have a habit of snowballing.
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