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
Sunday, December 14, 2008
Managing Risk at Work
A friend recently called me on her experience at a local Maryland hospital, supposedly noted to be excellent and customer friendly. After she explained her experience at the hospital ER, where she was seen for over 7 hours for blood work and IV fluid administration; I was uphauled as to the experience she reported and what caregivers perceive when they see patients. That gets me to think and raise the question to our forum members and guest, What do you see when you approach your clients in your various field of work? Why companies fail? How did we allow our ER quality care to fall bismally in this country with the highest cost in the world? Why are CEO's and managers failing their organization? What changes do we need to make at the personal, professional and corporate level to alter this direction?
My issue is that many good people may need to stop surviving and sacrifice some to position themselves in areas of passion to ease the process to their calling. Many of us are just coping and surviving in jobs just to earn a living and never materialize to meet the daily expectations, demands and uphold necessary values and rules that defines the job. Therefore, performance become substandard, customer relations are poor, and organizations struggle meeting benchmarks because of poor and underperformed employees. Suffice to say, my friend experience at this hospital was very unsatisfactory in all performance measures ranging from admissions to nursing, tech support, physician services and medical care.
My contention is that we can do better if we start thinking as to the reasons for our organizational existence, vision, act compassionately, show humility and develop confidence, respect for our clients, respect yourself and your chosen profession. In a time of economical hardship were organizations are closing doors and handing out pink slips, I hope we all begin to take the role we play in our various field of work seriously; become an asset to your organization and save yourself from the first in line to be handed the pink slip or sued for negligence, descrimination and malpractice. Start by taking things a little seriously, give 125% to your job and ask for more responsibility, treat your clients as you would like to be treated and be compassionate; remember you are paid at the end of every two weeks as a commitment to stay in line with company vision and policies. And so, see others as person's with need, someone in need of your service, someone as important because they are and so are you.
Of course, you know I have to do my rightly civil, community and personal duty to drop a letter to the CEO of that hospital as a warning for a stormy weather in their future in the shadow of poorly and unsatisfactory care standard, insurance fraud, patient negligence and malpractice; simply because the organization and its employees failed to deliver at the minimum standard of care expected and promise to their clients. Part of managing risk is that every employee and manager develop the awareness of what their role is, what is expected of them and avoid going outside of corporate policies and procedures.
Dr. Diallo
http://www.ezrehabsolutions.com/
My issue is that many good people may need to stop surviving and sacrifice some to position themselves in areas of passion to ease the process to their calling. Many of us are just coping and surviving in jobs just to earn a living and never materialize to meet the daily expectations, demands and uphold necessary values and rules that defines the job. Therefore, performance become substandard, customer relations are poor, and organizations struggle meeting benchmarks because of poor and underperformed employees. Suffice to say, my friend experience at this hospital was very unsatisfactory in all performance measures ranging from admissions to nursing, tech support, physician services and medical care.
My contention is that we can do better if we start thinking as to the reasons for our organizational existence, vision, act compassionately, show humility and develop confidence, respect for our clients, respect yourself and your chosen profession. In a time of economical hardship were organizations are closing doors and handing out pink slips, I hope we all begin to take the role we play in our various field of work seriously; become an asset to your organization and save yourself from the first in line to be handed the pink slip or sued for negligence, descrimination and malpractice. Start by taking things a little seriously, give 125% to your job and ask for more responsibility, treat your clients as you would like to be treated and be compassionate; remember you are paid at the end of every two weeks as a commitment to stay in line with company vision and policies. And so, see others as person's with need, someone in need of your service, someone as important because they are and so are you.
Of course, you know I have to do my rightly civil, community and personal duty to drop a letter to the CEO of that hospital as a warning for a stormy weather in their future in the shadow of poorly and unsatisfactory care standard, insurance fraud, patient negligence and malpractice; simply because the organization and its employees failed to deliver at the minimum standard of care expected and promise to their clients. Part of managing risk is that every employee and manager develop the awareness of what their role is, what is expected of them and avoid going outside of corporate policies and procedures.
Dr. Diallo
http://www.ezrehabsolutions.com/
Monday, December 1, 2008
The Employee Responsibility
According to compnewsnetwork, employees have a responsibility in a workers compensation program to promote efficient and effective program management. The following 10 responsibilities are highly recommended,
Employees must participate in the program as follows:
1- Know what to do if you are injured on the job
2- Sign an acknowledgement of these responsibilities
3- Seek medical care from the employers medical provider (or their own primary treating physician as allowed by law)
4- Keep the employer informed and updated of their condition/status
5- Complete forms required by the employer truthfully.
6- Attend weekly meetings to keep the employer informed of their condition and any obstacles to return to work full duty
7- Participate in transitional duty (this must be a condition of employment).
8- Attend all medical and rehabilitation appointments.
9- Return to work in either transitional duty or full duty as soon as medically able.
10- Other tasks as required by the employer and allowable by law
Each state is different.
For more cost savings tips go to WC Cost Reduction Tips.Show the REAL cost of workers comp with the Real Cost Calculator.Do not use this information without independent verification. All state laws are different. Consult with your corporate legal counsel before implementing any cost containment programs.©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Imailto:Info@WorkersCompKit.com
Dr. Diallo
www.ezrehabsolutions.com
Employees must participate in the program as follows:
1- Know what to do if you are injured on the job
2- Sign an acknowledgement of these responsibilities
3- Seek medical care from the employers medical provider (or their own primary treating physician as allowed by law)
4- Keep the employer informed and updated of their condition/status
5- Complete forms required by the employer truthfully.
6- Attend weekly meetings to keep the employer informed of their condition and any obstacles to return to work full duty
7- Participate in transitional duty (this must be a condition of employment).
8- Attend all medical and rehabilitation appointments.
9- Return to work in either transitional duty or full duty as soon as medically able.
10- Other tasks as required by the employer and allowable by law
Each state is different.
For more cost savings tips go to WC Cost Reduction Tips.Show the REAL cost of workers comp with the Real Cost Calculator.Do not use this information without independent verification. All state laws are different. Consult with your corporate legal counsel before implementing any cost containment programs.©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Imailto:Info@WorkersCompKit.com
Dr. Diallo
www.ezrehabsolutions.com
Tuesday, November 4, 2008
Work Injuries Among Nurses: Review of Prevalence
Employers will best serve their organizations by investing in preventative programs and processes to curtail the incidence and prevalence of MSDs as a result of either traumatic and or repetitive work injuries. Reviews of several research studies conducted by international and national authors, showed compelling associations and correlations of work related injuries among nurses working in various settings and shifts. 
M. Shayesteh Azar et. al emphasized the magnitude of LBP among nurses, citing lifting as a primary injury mechanism with prolonged standing and rest as been aggravating and relieving factors, respectively. The impression is that repetitive lifting and poor lifting training and mechanics probably needed to be studied more elaborately to specify cause and effect relationship. Also, Hasnat Alamgir, et. al, cited full time direct patient care occupations as having a greater risk for work injury compared to part-time and casual health care workers, suggesting an apparent need to evaluate work demands and work hours. The functional issues of significance here is addressing the work capacity demands and the worker relationship in order to identify stressors and improve safety as a mean to proactively prevent injuries. As emphasized by Shoko Ando et. al, focusing on associated perceptions of job demands and MSDs among hospital nurses, suggested a likely association with actual work tasks , postures, condition of work and work organization. Also, Yassi A et. al, dissecting through epidemiological research on back injury in hospital nurses, suggested an increased prevalence among young and Junior level nurses working in orthopedic, neurology, medicine, spinal and surgery wards with lifting and patient transfers reported to be highest risk mechanisms, and inadequate training and staffing as risk factors. As health care system evolves, a positive correlations with neck, shoulder and back injury complaints are shown, suggesting a revisit to current health care changes to reduce adverse impact on the health of workers. In summary, the volume of evidence in regards to matching the work to the worker is compelling in realizing an effective work injury prevention and management program. It is clear that work injury is evident in routine work without a management process that comprises of an education, ergonomic and functional testing components. The key is for the employer to implement a process with both employee's and management ownership and active participation in a vision of a safe working environment.
As employers begin to realize the impact of health care and workers compensation costs to the organization bottom-line, it is compelling the outstanding adverse effect of an uncontrolled and poorly managed cost on growth, and profit at a crucial time of global economical slow-down. However, organization's still have an opportunity to reevaluate their system and implement a process to promote health, wellness and safety at the work place.
Dr. Diallo, PT, DPT
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