WorkComp Advisory
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Proper care at the right place

When an injury occurs you want to be sure the injured worker has timely access to the highest quality of care and that the treating primary care physician or specialist will render care aimed at returning the employee to work. Unfortunately many injured employees’ first experience with workers’ comp is in a medical practice that does not understand occupational health.

All too often it is believed that if a medical provider is credentialed through a network, he or she is a professional who values injury management. It is important to realize that there are differences between occupational health delivery systems and those of the general medical community.

As L5 WorkComp Advisors, it is our role to establish a continuum of care and communication between the three most influential parties in the workers’ comp claim process – the employer, the injured employee and the medical provider. A key component of this process is identifying medical providers where injury management is a core value.

This philosophy places the injured worker and his or her care at the forefront. Such medical providers offer proper intervention at the right time and resolve problems before they become too costly. They engage the employer and provide for continuous communication.

In assessing a medical provider, some factors that we evaluate are: treatment guidelines or protocols in the care of the injured worker; the ability to identify ergonomic job risks; the use of standardized work restriction forms; the availability of case management; the absence of social decisions when determining a release to work; and the willingness to coordinate and manage treatment and rehabilitation with other providers to facilitate a speedy recovery and return to work.

Channeling injured employees to the right medical provider will:

• Improve access to care that results in early intervention and a speedier return to work

• Establish causation of injury (is it really a workers’ comp claim?)

• Improve efficacy of treatment (treatment that is appropriate for the problem, yielding the best medical results for the injured worker)

• Reduce claim costs (by returning the injured employee to full productivity sooner)

• Let your employees know that you value them and are committed to their return to work

Experience shows that the longer an injured worker is out of work the more difficult it is for him or her to return to the job. The key to reducing claim costs is not to let the injured worker get out of the normal routine of coming to work. Effective medical care reduces time lost from work, enhances the relationship between employer and employee and makes good fiscal sense.