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Worker's Compensation
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Worker's Compensation - June 23, 2003 2:27:00 PM
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mcap56
Posts: 617
Joined: October 26, 2002
From: New York, NY
Status: offline
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There was an article in the paper today about the worker's compensation crisis in California. In the face of steep rate increases, many employers are laying people off....the only way to reduce your compensation premiums.
Not all of the rate increases can be attributed to medical care. The insurance industry has had a bad few years. The terrorist attacks hit them hard. Also, bad financial decisions and market losses are a huge problem. But medical costs are rising even as the number of claims goes down.
The article mentioned the number of chiropractic visits per case, an average of 34 per patient (compared with 17 nationally). That is way too much chiropractic. But...before we go down that road, I think PTs need to think about their own role in the crisis.
How many times, as PTs have we had to treat Comp. without much of a choice. The doctor wants the care and the clinic owner is all too happy to oblige even when gains are no longer apparent. For some patients, the system becomes a mill with excessive PT as part of the bargain. If PTs were practicing in enlightened conditions, they would be a member of a team that could be decide how to get the worker back to work as soon as they can.
I know there are going to be posts about how many people are taking advantage and how they just don't want to work. But there doesn't seem to be any evidence to suggest that. It appears that returning to work in many cases requires support and the right conditions. An adverserial, multi-layered system like we have now, turns what would be motivated patients into combatants.
Best,
mcap
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Re: Worker's Compensation - June 23, 2003 3:00:00 PM
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flexion
Posts: 151
Joined: August 7, 2002
Status: offline
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Whats unfortunate about workers comp is that 60% of the costs are administration. Honestly I think it has little to do with abuse by a PT/DCs. I agree that we should all be mandated to report any fraud we see though to get the abusers out of the system.
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Re: Worker's Compensation - June 26, 2003 5:15:00 PM
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fconijn
Posts: 20
Joined: January 2, 2003
From: The Netherlands
Status: offline
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G'day Mcap,
You said: "I know there are going to be posts about how many people are taking advantage and how they just don't want to work. But there doesn't seem to be any evidence to suggest that."
I would disagree with the latter. See [URL=http://www.ptlitup.com]http://www.ptlitup.com[/URL] | Archive & Search | Editorial March 2001 (freely accessible), and see for yourself that there is a body of evidence for it. I wouldn't say that all of the described patients do not want to work, but I would say that Workers' Compensation does have a significant influence on the (self-reported) recovery rate.
R.,
Frank Conijn, PT
Editor
Physical Therapist's Literature Update
The Internet Journal of Literature Updates for Clinicians in Primary Care Orthopaedic Medicine & Rehabilitation [URL=http://www.ptlitup.com]http://www.ptlitup.com[/URL]
[This message has been edited by fconijn (edited June 26, 2003).]
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Re: Worker's Compensation - June 28, 2003 6:58:00 AM
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mcap56
Posts: 617
Joined: October 26, 2002
From: New York, NY
Status: offline
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I went to the site but I am not sure of how to proceed. Do you do an archive search?
With regard to worker's compensation and outcome........the evidence is clear that compensations status negatively affects outcome. I would never argue otherwise. However, that does not mean that the worker's are intentially milking the system. The complex interaction of comp beaurocracy, unsympatheic management and poor health care combine to create disinsentives up and down the line. It can get to a point with many patients where it just seems like they have given up. However, it doesn't mean that they started out that way or that they are frauds.
mcap
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Re: Worker's Compensation - June 28, 2003 8:13:00 AM
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steve
Posts: 470
Joined: May 14, 2003
From: Canada
Status: offline
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mcap,
I agree that workers are for the most part not intentionally malingering and that they are caught up in a system that promotes disability. Recent research from countries where there is no 3rd party payer system for MVAs indicate that those individuals with whiplash do not have chronic neck pain - generally they 4-6 weeks of pain and in a two year follow their incidence of chronic neck pain is the same as the general population. Disability from low back pain is minimal in 3rd world countries. Does anyone else think that the present system is not only expensive but promoting disability and chronic pain for a portion of the population? What kind of system would work better?
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