Physical Therapy Study – Great Workers Comp Loss Control

September 10, 2020 By JL Risk Management Consultants

Physical Therapy Study – Early Use Means Lower Costs – WCRI

A recent physical therapy study proves what we have been saying for over 30+ years.

picture army physical therapy study clinic

Public Domain

Two of the most-read read articles on this website consist of articles on therapy in general. I did not think about why they were popular. Two covered physical therapists while the other covered occupational therapy.

Those three articles are:

The second article was my experience with a tough but great physical therapist when I crushed the bones in my left wrist (ouch!). My recovery turned out excellent with full use of my left wrist – no surgery to place pins in my wrists.

The physical therapist started aggressively exercising my wrist right out of the cast. My hand swelled the first few times then the therapy started to really help me with my injury.

My experience with therapy agrees totally with the recent WCRI study – early use of physical therapy saves costs. One needs to remember that the physical therapist will be the medical provider the injured workers see the most for treatment.

Bills, Bills, Bills

Any adjuster or insurance carrier/TPA medical bill payer will tell you that other than prescriptions, physical therapists produce more bills than almost any provider.

I used to look at that aspect as a burden on making sure the therapist did not exceed the treating physician’s prescription or the maximum number of treatments allowed under the state Workers Comp rules.

I was keeping tabs on the Keys To Workers Comp Savings. The savings provided by using physical therapy early was drowned out by the number of bills received from the therapist or clinic.

The bottom line – the number of billings were generated because therapists see the injured worker more often than any other medical provider.

The WCRI Massive Physical Therapy Study Skinny

man doing physical therapy study on the other man

Wikimedia Commons – Free stajler

The study can be found here for purchase.

Some of the highlights are: my comments in italics

Later timing of PT initiation is associated with longer TD duration. On average, the number of TD weeks per claim was 58 percent longer for those with PT initiated more than 30 days postinjury and 24 percent longer for those with PT starting 15 to 30 days postinjury, compared with claims with PT within 3 days postinjury. You snooze on physical therapy – you lose – plain and simple.
Workers whose PT treatment started more than 30 days postinjury were 46 and 47 percent more likely to receive opioid prescriptions and MRI, respectively, compared with those who had PT treatment initiated within 3 days of injury. The differences between PT after 30 days postinjury and PT within 3 days postinjury were 29 percent for pain management injections and 89 percent for low back surgeries. Physical therapy remains a much cheaper option if used timely – notice the 30-day cutoff time
The average payment for all medical services received during the first year of treatment was lower for workers with early PT compared with those with late PT. For example, the average medical cost per claim for workers who had PT more than 30 days postinjury was 24 percent higher than for those who had PT within 3 days postinjury. You can pay physical therapy now or pay a big claim later.

This study is based on nearly 26,000 LBP-only claims with more than seven days of lost time from 27 states, with injuries from October 1, 2015, through March 31, 2017, and detailed medical transactions up through March 31, 2018.

The 27 states are Arkansas, California, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin.

The two previous paragraphs mean the study was comprehensive.

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Physical Therapists – Seen Most Often By Injured Workers

February 11, 2014 By JL Risk Management Consultants

Physical Therapists – The Medical Provider Seen Most Often

Physical therapists see injured workers more than any other medical provider.

This was a question that a client emailed to me earlier in the week.

Picture of Physical Therapists with Injured Workers

Wikimedia Commons – Airman 1st Class Alystria Maurer

What medical provider does the injured worker see more in a WC claim? The answer was not so obvious at first until I reviewed an old WC, then the answer became obvious. The most popular medical provider on most claims is, of course, the physical therapist.

Many claims do have the element of physical therapy.

The claim where the employee is out of work longer almost always involves PT. Have you looked at the PT’s that your employees are seeing? If not, this is an area that is often overlooked even if an employer has a full medical network or panel.

The PT can affect the claim very heavily. Now that I think back into my career when the PT heads south on the insurance carrier/TPA/employer, the claim will usually tank. I am not saying that there are very many PTs in the WC marketplace where this occurs overall.

Most PT and Occupational Therapists are encouraging people.

The personalities of the PT and the injured worker, adjuster, or physician may clash. This usually results in a much more expensive claim.

Justifying a medical provider of any type by “being in-network” as a savings tool (usually 15%)is great. However, if the savings will seem small to a claim that spins out of controls – often without the knowledge of the employer or adjuster.

Picture Physical Therapists Medical Provider

Wikimedia Commons – Mass Communication Specialist 1st Class Anastasia Puscian

I created a large study for a PT Network provider a few years ago. The one area that stood out in the study was that a medical savings of 15% is puny when the wrong provider is treating the WC patient. Most employees consider the PT on the same level as their treating physician – especially after seeing the PT every weekday for two weeks or a month before seeing the treating physician.

I used to question the need for PT until I crushed my left guitar-playing hand. The first link at the top covers what happened to me.

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What Is A Functional Capacity Evaluation (FCE)?

March 22, 2011 By JL Risk Management Consultants

Functional Capacity Evaluation – Series Of Physical Tests

FCE or Functional Capacity Evaluation in Workers Comp is a series of tests administered to a claimant by a physical therapist or other health care professional.

Picture of apple and heart with stethoscope Functional Capacity Evaluation Frequency on Table

FCEs can be beneficial in determining an injured worker’s restrictions and capabilities. FCE evaluators can review job descriptions and make a determination

regarding whether the injured employee is capable of performing certain jobs. After a claimant undergoes an FCE, the evaluator typically provides a detailed report on the results, including the claimant’s capabilities and restrictions.

Some FCE’s can also show if the tested injured employee gave full effort on the tests. The full effort test produced a few negative reactions questioning whether or not the test actually can show a less than full effort.

Functional Capacity Evaluations keep the injured employee from reinjuring themselves when the employee returns to work. The FCE’s are usually given to evaluate the injured employee for work hardening. The FCE’s can also be administered at the conclusion of the work hardening program.

Functional Capacity evaluations can be a successful tool for a safe return to work. The treating physician usually reviews them at the return to work assessment appointment.

Is Physical Therapy Really Worth It?

December 14, 2010 By JL Risk Management Consultants

Physical Therapy From A Very Personal Viewpoint

Is Physical Therapy really worth the cost and time? I recently was asked this question by a Workers Compensation adjuster trainee. My response came from more personal than professional experience.

Wikimedia Commons – Melissa Peterson

In 1996, I was walking across a carpeted floor without shoes carrying two boxes. I slipped and fell backwards on my left wrist fracturing it in over 10 places. I was rushed to the emergency room and had my wrist aligned, set and casted. My injury was known as a severe Colles fracture. It was painful. I refused to have pins inserted in my wrist. However, the worse pain was yet to come.

Six weeks after my injury, my cast was removed. The moment the cast was removed I was introduced to my physical therapist. As I have long been a guitar player, I asked if I was ever going to play guitar again. The physical therapist twisted and pulled on my wrist until it swelled up like a balloon. There was two more months of every kind of painful exercise imaginable to get my wrist back in shape.

One of the interesting techniques for soothing my aching wrist involved no medication. I placed my wrist in hot water and then in ice water for a few minutes each. After alternating between icy water and hot water, my wrist would quit hurting for the most part. I was willing to do just about anything to get my left wrist back to a guitar playing mode.

Physician Doing Physical Therapy To Patient

StockUnlimited

After six weeks, my wrist was actually in great shape. I was able to function like my old self and the guitar playing was back to normal. Typing was painful for quite some time. I asked the orthopedist to satisfy my curiosity and assign a Permanent Partial Disability (PPD) rating due to my Workers Comp background.

The Dr. assigned a PPD rating of 2%. I thought that was an amazing recovery. I owed a large amount of the recovery to the painful, yet important physical therapy.

The bottom line is that in my opinion physical therapy, if followed by the injured employee, can be extremely helpful to recovering from a Workers Compensation injury. It is up to the employee as to how helpful the physical therapy is for their recovery.