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

Workers Comp Medical Provider Shortage Effect


Workers Comp Medical Provider Shortage = Losing Control of Claim

The Workers Comp medical provider shortage can easily cause the loss of medical control that many states afford their employers and their insurance carriers or third party administrators (TPAs).

pic clinic workers comp medical provider shortage
Wikimedia Commons – hyolee2

Earlier this month when I attended (and posted live) the 2024 WCRI Workers Comp Conference, one of the sessions brought up an important point. The process had begun before the pandemic.  The pandemic and post-pandemic effect on the workers comp medical provider shortage could lead to losing control of claims – see later in this article.

Business Insurance’s Jon Campisi authored a great article that you can find here on the shortage. By the way, you should sign up for a few of the Business Insurance newsletters including the weekly editions – worth it.  One of the passages from the article on a panel on the employer outlook for 2024 and beyond –


For example, nursing turnover rose in the pandemic and is beginning to normalize to pre-pandemic levels, but it’s “still too high,” said Charles Kyles, director of workers’ compensation for Duke University & Health System in Durham, North Carolina.

Workers comp claimants have been affected by provider shortages during the past few years, as fewer health practitioners meant limited care, Mr. Kyles said, adding the issue is still prevalent.


Who better to experience and identify workers comp medical provider shortages than Duke University Medical Systems?

Workers Comp Medical Provider Shortage = Losing Claim Control

Many articles on this website cover medical control of the claims as a key to cutting workers comp costs.   The most important part of having medical control is most workers comp systems see the treating physician as an impartial party to the claim.

Cutting costs while providing the highest level of medical care for a gainful return to work can be obtained if there are enough medical providers in a certain area who accept Workers Comp patients.

Most states allow for the employer to choose the initial treating physician.  Even in states where the employee chooses the medical providers, the injured employee will often go to the medical provider suggested by the employer.

Medical treatment networks have become even more critical with the workers comp medical provider shortage.

Bottom Line – What to Do

  1. Check to make sure that the initial medical treatment (physician or clinic) still accepts worker comp patients.
  2. If you are using a recommended provider network that your carrier or TPA provides – obtain an updated medical provider listing from your carrier or TPA.
  3. Do not wait until an accident to find out that the injured workers cannot be seen by the usual medical providers that have seen your injured workers before now.
  4. Contact your workers comp claims office or adjuster by email and ask them if they know of any changes to your list of medical providers.  Adjusters usually find out first when changes are made to the medical networks.

Keep your medical treatment network up to date. Providing the best care remains the goal even if you may experience workers comp medical treatment network shortages.




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.