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Workers Comp Physical Therapists As Initial Primary Providers Good Idea


Physical Therapists =Primary Workers Comp Initial Medical Treatment Provider?

Workers Comp physical therapists have received a huge amount of good press over the last two months.   I had always thought that physical therapists could treat certain injuries from the onset.

I have always been a proponent of physical therapy.  Check out these two prior articles that I wrote years ago on the subject:

Is PT Worth the Cost? 

Who Sees The Workers Comp Injured Worker The Most?

2020 WCRI Study

picture workers comp physical therapists
Public Use Wikimedia Commons – chiaravdberg

ND Becomes Test Case for Workers Comp Physical Therapists

North Dakota Decided to Step Up and become the state test case for physical therapy.   WSI (Monopolistic Carrier) changed its law in August of this year to allow physical therapists to treat injured workers as the primary provider. (thanks WorkCompCentral)  The WSI even provided a pamphlet on how this would work in workers’ compensation.

WSI Website Changed For Physical Therapy

The following is directly from the WSI website.

WSI considers the following types of practitioners eligible to be a primary treating provider: MD, DO, APRN, PA, DC, DPM, OD, DDS, DMD, PT. An injured employee may only have one primary treating provider, who will manage treatment, assess functional capabilities, and determine when the injured employee achieves maximum medical improvement. 

WSI requires a referral for therapy treatment if the primary treating provider is not a physical therapist. Initial therapy treatment on a claim does not require prior authorization for the first 10 visits or 60 days of care, whichever comes first. WSI refers to this as an initial window period. 

WCRI New Study Says Workers Comp Physical Therapists Cut Costs

Man doing workers comp physical therapists with other man sitting on therapy bed
Wikimedia Commons – Free stajler

I was not going to write an article on one state approving physical medicine providers as the primary treatment providers.  Then WCRI (Workers Comp Research Institute) published a study yesterday that shows physical therapy as a major cost-cutter if the treatment starts very early in the claim.

The update from the 2021 study covered these points:  See the study here

Among workers with LBP who received manual therapy, early manual therapy (within 2 weeks of PT care) was associated with lower costs and shorter temporary disability (TD) duration as compared with late manual therapy (after 2 weeks of PT care). Early manual therapy was also associated with a lower likelihood of receiving magnetic resonance imaging (MRI), pain management injections, and opioids, as compared with late manual therapy.

Will Other States Adopt the WSI Program?

We will likely see more discussion in the future on workers comp physical therapists expanding their roles in treating injured workers as primary medical providers.  Do you agree?

Also Read: Monopolistic Workers Comp States Further Examined

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James J Moore - Workers Comp Expert

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Management Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications


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