Workers Comp Audit Stress Reducer
Use It For Your Next Premium Audit

Workers Comp Physical Medicine – Adjusters’ Bane – WCRI Report


Workers Comp Physical Medicine Extended Treatment – National Study – WCRI

WCRI’s (Workers Comp Research Institute) recent study and report on workers comp physical medicine came as no surprise.  After handling, consulting, and performing studies on thousands of files, I noticed that when the cost of any medical treatment was reduced the utilization increased proportionally to offset the reduction.

Workers Comp physical medicine was the one medical cost that I studied the most for insurance investors, carriers, TPAs, and providers.  One area that has been the bane of claims adjusters for years has been coordinating everything that occurs in a claim to provide proper and timely benefits. WCRI covers an important point on the coordination of workers comp physical medicine treatment.

pic woman workers comp physical medicine low back pain
(c) Public License 2.0 Nenad Stojkovic

When multiple medical providers including physical medicine do not sync up their treatment and referrals, the adjuster’s job becomes exponentially more difficult.

WCRI Study Confirms Both Points

Extended physical medicine (PM) use was relatively frequent in most study states and less coordination of care was among the key factors associated with a higher likelihood of having extended PM use.

WCRI studied low back pain injuries.  From my experience, all injuries that involve physical medicine have an extended PM use concern.

Definition – Workers Comp Physical Medicine

The basic definition according to Google/Oxford Dictionaries is:

  • the branch of medicine concerned with the treatment of disease by physical means such as manipulation, heat, electricity, or radiation, rather than by medication or surgery.
  • the branch of medicine that treats biomechanical disorders and injuries.

The study, Factors Associated with Extended Use of Physical Medicine Services for Workers with Low Back Pain, is designed to address the following questions: (see the below link for more info)

  • How prevalent is the extended use of PM services and how does it vary across states?
  • How is extended PM use associated with overall costs and duration of temporary disability?
  • What are the factors that help predict the likelihood of extended PM use, focusing on the factors that can be used for better management of claims and care?

Based on utilization patterns of PM services, the study defined extended PM as claims that had PM services initiated within six weeks of the injury and continued to have PM services after three months. According to the study, some claims with extended PM use may have more serious or chronic conditions that need additional services. However, the frequency of extended PM use appears to be higher than the rate of chronic back pain reported in other studies, suggesting other factors affect the use of extended PM in workers’ compensation.

Click here to learn more about this study or to purchase a copy.  Check out this link for the WCRI annual conference later this month.



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


Get the latest workers' comp news FREE!

This field is for validation purposes and should be left unchanged.