Category: CompMed Insights

Challenges to Established Practices In general, workers’ compensation systems will not cover experimental medical procedures or treatments. This is because these procedures have not yet been proven to be safe or effective and therefore may not be considered “reasonable and necessary” medical treatment for a work-related injury or illness. However, with the unfettered access to medical literature, and the use of artificial intelligence platforms, injured employees have decided that this experimental…

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Those who know me understand that my initial formal training was as a Physician’s Assistant. When I attended PA school, the standard of entrance for such training was to utilize those individuals who served as medics during that era’s conflict. These individuals would undergo an intensive 24-month training program and be utilized to provide healthcare in areas with noted shortages. After my training, there was a national certification that required…

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As an individual who has been dealing with impairment ratings for more than 35 years, it is clear that the original intent was to establish an objective parameter to begin the point for the discussion of the last aspect of indemnity benefits or compensation for the injured employee. Unfortunately, there are problems with this process. However , there are several proactive steps to be taken to ameliorate any issues that…

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It seems there is always a new tool to make handling a workers compensation claim that much easier. Remember when we had cardboard wheels to assess future dates? The newest tool in the chest would appear to be the use of artificial intelligence (AI) and using predictive analytics to aid you in managing that file. We all know that the workers compensation claims file landscape is changing, rules are always…

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Subsequent to the December 2024 tragedy in New York City, it is clear that frustrations with the overall insurance process can rise to a level of significant tragedy. It is not lost on those of us in the workers’ compensation ecosystem that similar frustrations are at all to frequent occurrence. Fortunately, to my knowledge, it has not risen to the level of assassination. However, I find it quite astonishing that…

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To paraphrase David Letterman, here are my Top 10 reasons that constitute barriers to successful adjudication of a workers compensation claim: 10.  High caseload: Not to be overly simplistic, there are simply a limited number of hours in the workday. Paying attention to an excessive number of cases leads to errors, oversight, and compromising the attention each case deserves. Additionally, studies have demonstrated that high caseloads lead to “burnout” and…

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It is the season at a time for political change. With the current power structure being shifted significantly, one must take into consideration the politics of healthcare and the Worker’s Compensation system. Healthcare within the Worker’s Compensation system is deeply intermingled with the prevailing political forces within any particular jurisdiction. A key question is are cost issues more important than providing all appropriate care to address the actual injury sustained?…

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I came across a rather infrequent but recurrent situation that appears to confuse some of those managing workers’ compensation claim files. This involves pain in the distal lower extremity and the confusion is the difference between plantar fasciitis and Achilles tendonitis. Both of these diagnoses are noted to be causative of distal lower extremity and or heel pain. However, both of these specific pathologies are very specific and different disease…

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If there is anything that would be considered the scourge of workers’ compensation, it is low back pain. As we are an aging workplace population, and the mechanical design of the human body really does not support being upright or placing the amount of force through the lower lumbar region, I would doubt that there is even one individual over the age of 18 who has not experienced low back…

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Both pathologies involve similar structures and are very close together. However, they are distinctly different conditions, have different onset, and have different treatment protocols. With respect to rotator cuff injuries, the more often they occur secondary to acute trauma such as a fall, or any blunt force injury. However, impingement syndrome occurs when the tendon component of the rotator cuff becomes pinched or otherwise compromised by the bones of the…

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