Reducing Medical Costs in Workers' Compensation Cases In litigated Workers' Compensation cases, medical expenses can rise rapidly, and frequently exceed 50% of the total cost of the entire claim. What steps can employers, insurers, self-insurers and other workers' compensation professionals take to reduce these rising medical expenses. A Workers' Compensation [...]
Cost-effectiveness and the expanded coverage under the Affordable Care Act is driving the rapid expansion and use of work-site clinics to treat injured workers. A recent study by the research firm Mercer found that more than 500 large companies have these clinics already in place. Approximately 27% of large and [...]
Workers who suffer a significant head/brain injury will often require substantial and costly medical and rehabilitation treatment that can keep them out of work for lengthy periods of time. The Washington State Industrial Fund reported on 797 cases of work outcomes after traumatic brain injury. Of these cases: 9% had [...]
Psychological risk factors play a substantial role and present significant obstacles in the delayed recovery of injured workers. Modifiable risk factors such as fear-avoidance beliefs, catastrophic thinking, perceived disability and perceived injustice all have been found to play a role in the delayed recovery of injured workers. The workers' compensation [...]
The Insurance Journal reports that cost containment is the number one priority of employers (3/19/12 issue). Nearly half of the employers surveyed recently reported a Workers' Compensation premium increase. The latest statistics show approximately $60 billion in benefits paid almost equally divided between medical costs and payments directly to injured [...]
The U.S. Worksite Wellness index has been worsening for the past several years. The latest statistics indicate a score of 84.7 out of a possible 100 where there would be no individuals at high risk. What this means for companies is increased costs in lost time, medical expenses, ADA, FMLA [...]
Consulting For Physicians What are you really good at that clients will pay for? That is the essence of developing a successful and lucrative physician consulting practice. Physicians living with the constant state of uncertainty in the economy and their reimbursements, are looking for additional revenue streams that they can [...]
How to Write an IME Report Drafting an IME report presents numerous challenges. The biggest challenge of course is that the IME report is likely to be part of a contested claim and may be aggressively challenged by claimant’s counsel. A good outline for how to draft an IME [...]
How to Perform an Independent Medical Examination Physicians who are new to IMEs will need to know how to conduct an IME (Independent Medical Evaluation). IME physicians should understand: What clients (attorneys, insurers, and case managers) are looking for (defensible answers to their questions) from independent medical examiners. How to [...]
How to Detect Symptom Magnification Detecting symptom magnification can be a challenge for independent medical examiners. Diagnosing symptom magnification and malingering is usually not a part of a physician’s traditional medical training. Fortunately, there are a number of fairly simple tests that IME physicians commonly use to detect symptom [...]