Tuesday, September 15, 2009
Monday, July 13, 2009
WC Handling
Here is a good information for employers to use in establishing effective relationship with their TPA to ensure effective handling of claims and ensure good communications with stakeholders.
http://blog.reduceyourworkerscomp.com/?p=39
http://blog.reduceyourworkerscomp.com/?p=39
Monday, June 8, 2009
Diagnostics and Work Injury
Three weeks ago, I evaluated a 24 year old male worker from a heavy labor construction company following a lifting injury while in a dynamic flexion and rotation position. While the patient complaint of back pain with mild spinal deviation to left, he reported no neurological nor radicular symptoms. Physical exam following history reveals muscle strain to lumbar paraspinals requiring physical therapy and possible degenerative disc without any neurolical symptoms. However, the adjuster wanted to hold off treatment Pending MRI report. Spinal MRI reveals multiple spinal disc dessications and disc bulges in all three regions of the spine.
Should third party claims administrators, persons with non medical credentials dictate treatment with authority to stop or delay recommended treatment based on pending diagnostics?
Does diagnostics lead or determine the course of treatment or should they be used as tools within the differential diagnosis process?
In my opinion, No. Because the presence of asymptomatic disc bulges does not comprise nor represent the cause of the pain. In any sample of normal adults MRI report studies, there will be a significant number of normal persons in any given population with positive asymptomatic, dessicated, and bulging disks. However, we do not treat patients without symptoms or complaint(s). As such, MRI reports help to confirm and guide treatment plans when a thorough evaluation determines that the complaint is of a direct cause to the pathology, thus a cause and effect relationship with a significant postive likelihood ratio exists.
As in the present patient, because of his high labor demand, repetitive bending, he showed multiple discs and joint degeneration throughout his spine; but because of his physique and youth, they are presently asymptomatic. What this patient needs is improvement of his dynamic posture, good lifting strategy and a proactive ongoing conditioning program. of course, he needs to gradually change his occupation to a light to moderate labor demand job from his present high labor and repetitive bending demands. Although therapy was then authorized following the result, mainwhile the patient had wasted two weeks doing absolutely nothing. Treatment was initiated and patient continue to function with less pain everyday. The patient is cautioned of positioning, lifting techniques and body mechanics.
This was an amazing observation, a significant number of asymptomatic disc bulges were seen in this young construction worker's spine. A worker with such involvement is a work liability if the worker is not matched or properly fitted to the work and encouraged to stay conditioned. Today, this worker was asked by his supervisor to work in the field even though he is supposedly on light duty. Such risks taken by employers against the doctors recommendation are of poor judgement, wrong, risky and unethical. Employers must use good judgement and good faith to protect their employees from harzardous and unsafe conditions in order to avoid risky actions when the result is catastrophic. Patients are to be allowed the necessary time to heal and must not be subjected to conditions that are harmful and in contradiction to their dctors orders and recomendations.
EZ Rehab over the years have helped significant amount of employees and employers realize a balanced process of returning the worker to the work, safely and cost-effectively. We can help, the EZ rehab process is comprehensive, fair, practical and effective.
Dr. Diallo
http://www.ezrehabsolutions.com/
Should third party claims administrators, persons with non medical credentials dictate treatment with authority to stop or delay recommended treatment based on pending diagnostics?
Does diagnostics lead or determine the course of treatment or should they be used as tools within the differential diagnosis process?
In my opinion, No. Because the presence of asymptomatic disc bulges does not comprise nor represent the cause of the pain. In any sample of normal adults MRI report studies, there will be a significant number of normal persons in any given population with positive asymptomatic, dessicated, and bulging disks. However, we do not treat patients without symptoms or complaint(s). As such, MRI reports help to confirm and guide treatment plans when a thorough evaluation determines that the complaint is of a direct cause to the pathology, thus a cause and effect relationship with a significant postive likelihood ratio exists.
As in the present patient, because of his high labor demand, repetitive bending, he showed multiple discs and joint degeneration throughout his spine; but because of his physique and youth, they are presently asymptomatic. What this patient needs is improvement of his dynamic posture, good lifting strategy and a proactive ongoing conditioning program. of course, he needs to gradually change his occupation to a light to moderate labor demand job from his present high labor and repetitive bending demands. Although therapy was then authorized following the result, mainwhile the patient had wasted two weeks doing absolutely nothing. Treatment was initiated and patient continue to function with less pain everyday. The patient is cautioned of positioning, lifting techniques and body mechanics.
This was an amazing observation, a significant number of asymptomatic disc bulges were seen in this young construction worker's spine. A worker with such involvement is a work liability if the worker is not matched or properly fitted to the work and encouraged to stay conditioned. Today, this worker was asked by his supervisor to work in the field even though he is supposedly on light duty. Such risks taken by employers against the doctors recommendation are of poor judgement, wrong, risky and unethical. Employers must use good judgement and good faith to protect their employees from harzardous and unsafe conditions in order to avoid risky actions when the result is catastrophic. Patients are to be allowed the necessary time to heal and must not be subjected to conditions that are harmful and in contradiction to their dctors orders and recomendations.
EZ Rehab over the years have helped significant amount of employees and employers realize a balanced process of returning the worker to the work, safely and cost-effectively. We can help, the EZ rehab process is comprehensive, fair, practical and effective.
Dr. Diallo
http://www.ezrehabsolutions.com/
Sunday, June 7, 2009
The Ethical Practitioner
Following a work injury, workers, case managers, and employers contemplate a worker's ability and safety to return back to prior work. Mainwhile, the injured patient await their appontment with a physician to decide on their return to work verdict. However, the situation is usually gaurded as physicains are wary of sending a patient back to their job when they are not quite sure of the job functional description and demands. On the other hand, the patient is wary of what his employer might just be thinking and also scared of reinjuring himself. At the same time, case managers contemplate the reliability of the injury and credibility of the worker. These are varying prospectives that slows down the effectiveness of the system. Many injured patients spend significant amount of time doing absolutely nothing while waiting for the system to sort it self. When such dynamics persist and fester over a significant duration, it becomes a burden on the employee, the system and an unnecessary expense on employers.
While all involved stakeholders focus their effort to helping the injured worker, the means to get the worker back to work should be focus on the worker and the work. Most practitioners focus their attention and decision on pain rather than function, making it difficult to start focusing on functional performance. The ethical employer and practitioner will think of the most beneficial process, an effective treatment course with least consequencies to safely return the worker back to his prior work. Employers must be willing to provide modified and transitional work to bring the employee back to the work environment. It is a win-win for all stakeholders and cost effective for the employer to have workers at the work site immediately, when it is safe to do so. Also employers should grant the injured worker time to access good medical and rehab care until it is medically necessary to be discharged.
At EZ Rehab Solutions, we are committed to making this process as smooth and efficient by rightly focusing on the most effective treatment techniques with work demands and function early on in our treatment. The result is increase patient confidence, decrease fear, better conditioning and awareness of their condition to return back to work at the earliest time possible. Our patients are happy and always greateful for our comprehensive rehab program and education on preventing work injury incidents.
Dr. Diallo
While all involved stakeholders focus their effort to helping the injured worker, the means to get the worker back to work should be focus on the worker and the work. Most practitioners focus their attention and decision on pain rather than function, making it difficult to start focusing on functional performance. The ethical employer and practitioner will think of the most beneficial process, an effective treatment course with least consequencies to safely return the worker back to his prior work. Employers must be willing to provide modified and transitional work to bring the employee back to the work environment. It is a win-win for all stakeholders and cost effective for the employer to have workers at the work site immediately, when it is safe to do so. Also employers should grant the injured worker time to access good medical and rehab care until it is medically necessary to be discharged.
At EZ Rehab Solutions, we are committed to making this process as smooth and efficient by rightly focusing on the most effective treatment techniques with work demands and function early on in our treatment. The result is increase patient confidence, decrease fear, better conditioning and awareness of their condition to return back to work at the earliest time possible. Our patients are happy and always greateful for our comprehensive rehab program and education on preventing work injury incidents.
Dr. Diallo
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