Category: CompMed Insights

As seasoned Worker’s Compensation professionals, and even for those of you who have just joined our little party, you are all aware of the crucial role you play in effectively managing claims, ensuring fairness to all parties concerned, and each of the identified stakeholders. It has been my experience, as someone who has run a cost containment concern for the Worker’s Compensation ecosystem for more than three decades, those who…

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Dealing with Unscrupulous Medical Providers in Workers’ Comp Show Me the Money: The Core Truth of Workers’ Compensation In the world of Worker’s Compensation, there is one absolute truth; and to quote from Jerry Maguire, “show me the money.” Those who have been reading my blog understand that it is my position that all appropriate care should be delivered to the injured employee. You as the claim file handler need…

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Rediscovering Medical Knowledge: Lessons for Workers’ Compensation Professionals I was doing some housecleaning the other day and decided to clean out my personal library. At the bottom shelf was my collection of medical texts dating back to my Physician Assistant training. One text that caught my eye was Harrison’s Principles of Internal Medicine, 12th edition. I can remember that paying $33 for that textbook seemed wildly expensive. For fun, I…

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Understanding T2 and STIR MRI Findings In my training as a Physician's Assistant, and while working in orthopedic surgery, there are aspects of our education, training and experience that become second nature. However, at times, we tend to overlook the importance of what is perceived as routine everyday use, and the value of these data points is lost on the general population. One of these items is the component of…

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When I first entered the world of case management and cost containment dealing with workers compensation cases, a frequent request was for injured individuals with low back pain complaints to have a treadmill placed into their homes, precipitating weight loss and improvement with respect to the low back pain complaints. The running joke became what was the world's most expensive clothes hanger, and the answer is that treadmill. The Rise…

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The Evolution of Medications: When Side Effects Lead to New Discoveries In medicine, things are always changing. Constant experimentation, research, and modifications to the original intent are always being investigated. A prime example of an altered pathway would be the development of a new antihypertensive medication. During clinical trials, there was an unintended side effect in terms of blood flow to the corpus cavernosum. With the identification of this side…

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For those who’ve followed my blog, it’s clear that the adjudication of workers’ compensation cases has undergone a significant transformation in recent years. Successful rehabilitation from a compensable injury now demands a holistic perspective, focusing on the entire individual, particularly the injured employee, and their active role in the recovery journey. This collaborative approach creates a positive ripple effect, leading to benefits for the injured employee, reduced expenses, and ultimately,…

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When evaluating your new file, and noting that there are reported degenerative changes, such as those from chronic conditions like arthritis, disc degeneration, or repetitive strain injuries, focusing solely on immediate costs is a critical oversight. To manage the full scope of treatment, it’s essential to determine which degenerative issues are directly related to the reported injury. The Hidden Costs: Beyond Immediate Treatment Expenses Within the context of workers’ compensation,…

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A frequent finding on enhanced imaging studies such as MRI is that the radiologist reports change consistent with a tendinitis or at times changes that reflect a tendinosis. Unfortunately, all too often these two very distinct clinical conditions are used interchangeably. This would be an error. Taking note of the differences in these two clinical scenarios would modify the treatment delivered. To begin this discussion, one must understand what a…

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Introduction: Alcohol and Workers’ Compensation I came across an interesting article today regarding alcohol consumption and the compensability of a workers’ compensation claim. It was noted that a commercial driver crashed his truck after downing several beers. A judge in Delaware ruled that this act alone established that the injured driver was not entitled to a workers’ compensation claim. Legal Misstep by the Delaware Industrial Accident Board What is interesting…

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