Nicole Matoushek PT MPH CSHE CEES
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Joined: January 15, 2005
From: St. Petersburg, FL
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Need for Work Injury Management Programs:
According to the U.S. department of labor, workplace injuries cost U.S. industry $13 to $20 million a year (1). The potential for losses due to lost time, exposure and costs associated injury claims can be staggering. Therefore, the objective of work injury management is to resolve any and all workers’ compensation claims, as soon as possible, to minimize these losses. Employers and insurance carriers are continuously evaluating the cost and effectiveness of various rehabilitation programs, in effort to better contain their costs and improve their return to work outcomes.
The need for effective and high quality rehabilitation services in worker’s compensation is abundant. However, obtaining a continual referral base is dependent upon the rehabilitation professionals’ ability to demonstrate the effective management of the entire rehabilitation process of the injured worker, from acute therapy to return to work.
Opportunities in Work Injury Management:
There are two main reasons for the rehabilitation professional to identify new opportunities in the workers’ compensation market. The first, is recent changes in workers’ compensation laws in several states. For example, California’s worker’s compensation reform laws now place a cap on skilled therapy visits, and other states are expected to follow suit. In addition, direct access laws and provisions can also influence clinical practice and access to patients. Second, in most states, reimbursement for rehabilitation services under workers’ compensation remains significantly higher than when compared to other payer sources such as Medicare and Private Group Insurance. For these reasons, rehabilitation providers are finding opportunities to provide ergonomic and specialized work injury management programs in the workers’ compensation sector.
Work Injury Management Programs:
There are several specialized work injury management programs. They include: injury prevention, pre-employment, work injury containment and work integration programs.
Injury Prevention Programs:
Ergonomic committees and safety teams often focus efforts on identifying high risk jobs and controlling ergonomic risks to reduce the rate at which work-related injuries occur and the costs associated with these injuries. Workplace injury prevention programs can be an effective method of injury management in the workplace. Injury prevention programs can be performed on injured workers or a healthy workforce. The objective of the program is to identify ergonomic risk factors that are present, recognize appropriate control measures and make recommendations for work modifications in order to prevent new injuries.
Pre-Employment Programs:
A pre-employment program for injury management is a systematic process of assessing a work applicant’s ability to safely and effectively perform the critical demands of the job. The desired outcome of the program is to assign work applicants to jobs that they can safely perform, thus lowering the incidence of work-related injuries that would have been caused by overexertion and inappropriate worker-work pairing. This systematic process involves an appropriate examination and “try-out” of the critical job demands of the job in question, to see if the applicant is able to fulfill the job requirements. This program is an effective tool in work injury prevention.
Work Injury Containment Programs:
The concept of injury containment is based on the premise that if ergonomic issues are not addressed when an injured worker returns to work, the current injury and the associated costs will continue to progress and escalate. However, if the ergonomic risk factors that are associated with the original injury are addressed and reduced, then the injury will heal sufficiently, and not progress. The work-related injury is therefore “contained”. The injury containment program is a process which enables the evaluator to identify and control some of the ergonomic risk factors that can influence the injury progression. Therefore, faciliting a safe and prompt return to work with a reduction in the risk for injury progression or re-injury.
Work Integration Programs:
Work integration programs are a specialized form of return to work programs for injured workers. They are performed, at least in part, at the workplace and involve the development of a plan of care that establishes a structured and progressive return to work following a work-related injury.
The program works by evaluating the clinical factors, injury factors, ergonomic risk factors and work tasks of an injured worker who can not easily return to his or her pre-injury level of work function. By evaluating the injured worker’s functional deficits, injury characteristics, critical job demands and ergonomic risk factors, the rehabilitation professional can develop a scheduled progression of work duties that will allow progressive reconditioning and adequate tissue healing, while allowing the worker to remain productive and safe at the workplace. Work integration programs can be a very effective method in injury management, as they provide prompt return to work, productive work duties and an opportunity for injury resolution, all of which can significantly influence the overall cost of the injury claim.
Marketing Work Injury Management Programs:
Opportunities to market and provide rehabilitation services in workers’ compensation are omnipresent. Patient referrals can be obtained by direct communication to the primary referral sources for patient referrals under workers’ compensation. These referral sources typically include the ordering physician, employer, insurance adjuster, case manager and indirectly, the patient. In addition, the rehabilitation professional can also act as their own, and best referral source. This can be achieved by representing themselves as specialty trained, and experienced in work injury management, in addition to providing evidence of quality outcomes in worker rehab.
In order to maximize marketing opportunities, the rehabilitation professional should focus on functional outcome measures. The functional outcomes of the worker rehabilitation services provide the most effective marketing tool for the rehabilitation provider to grow and expand in this challenging marketplace. Another key to maximizing marketplace presence is to establish a level of expertise in work injury management. This can be achieved by developing skills and competencies in these specialized programs and services. Continuing education, training and specialty certifications will identify a rehabilitation professional who has specialized in the issues, objectives, and clinical practice standards within this rehabilitation sector.
Summary:
There are ample opportunities to contribute and prosper as a rehabilitation provider in the workers’ compensation industry today. Developing and implementing specialized work injury management programs provide the rehabilitation professional with programs and services to better manage worker’s compensation patient care and return to work. The key to work injury management is a strong understanding of ergonomics and how work demands affect human performance and disease development. Core competencies in ergonomics, clinical management of work-related injuries and ergonomic risk control are essential to successful work injury management.
References:
1.U.S. Department of Labor, Occupational Safety and Health Administration, [URL=http://www.osha.gov,]www.osha.gov,[/URL] safety Pays.
2) [URL=http://www.ergorehabinc.com]www.ergorehabinc.com[/URL]
_____________________________
Nicole Matoushek, PT, MPH, CSHE, CEES
http://www.ErgoRehabinc.com
http://www.ErgoRehabBlog.com
http://www.ComputerAccessoriesOnlineStore.com
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