WCRI – Time From First Injury To Workers Compensation Medical Treatment – Comparison Across 18 States
Most Workers Compensation medical treatment foretells how a claim will progress over its lifetime. One of My Six Keys To Saving on Workers Comp claims involves having a preset medical network in place.
The other likely involved key concerns the timely filing of the medical report.
These two keys can easily escalate a claim to over 800% more than if the first report filing time – called employer reporting lag time– tallies in with a high number along with the medical treatment not being provided to the injured employee ASAP. The 800% figure came from my research into claims on two different public entity sets of files that involved over 10,000 claims.
The study can be purchased here for $5, yes just $5 for a great study.
WCRI (Workers Compensation Research Institute) attempted to answer three different questions. I was hoping the answers to these three questions would agree with my old research. Those three questions were:
- How much variation was there across states in the time from injury to first treatment for physical medicine and “specialty” services (such as surgery, major radiology, and pain management injections) across injury types?
- Were there consistent patterns in time to first medical treatment; that is, did some states show shorter or longer time to treatment across injuries and services?
- How much variation was there across states in the time from injury to first treatment for “entry” services, such as emergency, office visits, and minor radiology?
The study’s data sets were:
The study examines claims with more than seven days of lost time for injuries occurring from October 1, 2014, through September 30, 2015, evaluated as of March 31, 2016. This would, in a way, eliminate medical only claims from the data set.
The 18 states in the study are Arkansas, California, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Texas, Virginia, and Wisconsin.
Two different reporters contacted me on my opinion of the study. One aspect that I had not read yet was that North Carolina was one of the lagging states in providing Workers Compensation medical treatment. (wow!) I decided to read more into the study.
Page 17 of the study (flash report) shows the average of all the states. The table (Table A-2) shows the comparison across all medical treatment types with the 18 studied states.
The states that were the slowest in providing medical treatment were (overall):
- Massachusetts
- North Carolina
- Louisiana
- California
I am not sure exactly what to draw from the study and flash report. California with its utilization review process would make the delays almost understandable. I am not so sure about the other three.
Our HQ state – North Carolina – surprised me quite a bit. North Carolina has employer-controlled worker compensation medical treatment. North Carolina did not place last or near the bottom in all of the study’s categories. I will likely need to read the study again to see if any hidden data nuggets exist in the workers compensation medical treatment data.
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