Workers’ Comp Doctors Who Collaborate to Reduce Case Duration, Costs

Michelle Hopkins

You can look far and wide and not find workers’ comp doctors more focused on employees than the physicians and clinicians who work at Concentra®. Our medical leadership and more than 2,500 affiliated clinicians are dedicated to achieving excellent clinical outcomes, reducing case duration and associated costs, and giving employees a fresh, positive approach to life and work that avoids medically unnecessary disability.

In this article, you’ll learn five ways in which Concentra’s workers’ comp doctors distinguish themselves, and you’ll see how the injured employee’s recovery is the common thread running through the occupational health care they provide.

Workers’ Comp Doctors Determine Causation

“Occupational medicine differs from other specialties in several ways, one of which is that workers’ comp doctors and clinicians not only have to come up with a diagnosis when evaluating an injured or ill employee, but also have to think about work causation,” says Maja Jurisic, MD, CPE, Concentra vice president and medical director. “It is not always straightforward. Just because someone develops symptoms at work, it doesn’t necessarily mean that the problem is work-related.”

Concentra instructs clinicians in determining causation at orientation and at periodic times throughout the year. Concentra’s clinical manual also includes a section on causation to help clinicians ask the right questions to identify the cause of an injury or illness and relationship to the individual’s occupation.

Determining causation can also provide strong clues to a diagnosis and determination of compensability – direction that ultimately serves the interests of the injured employee, the employer, and the payor alike by helping to avoid confusion or causing extra work for everyone involved.

“If the work history, the mechanism of injury, the physical findings, and the diagnosis strongly correlate with the known work requirements, you can reasonably conclude that the condition is work-related,” explains Dr. Jurisic.

When a condition is determined not to be work-related, the individual is referred to primary care for further evaluation.

Documenting a Thorough Injury History

As is true throughout Concentra’s workers’ compensation management process, the focus in documenting a thorough work injury history is listening to the employee.

A workers’ comp doctor or clinician who asks the right questions and provides detailed documentation establishes a framework for quality care through the duration of the case.

Concentra uses a compliant, leading electronic health records solution to assist in documentation and to support physicians in engaging employees in their recovery by being able to see the information on which their provider is basing care decisions.

Medical Recheck Scheduling and Case Duration

If your workers’ comp doctor tells you it doesn’t much matter how soon you come in for a recheck after your initial visit, it may be time to look for another workers’ comp doctor.

“Empirical data tells us that timing of return visits has a significant impact on total case duration and, consequently, total cost per case. The evidence is clear that longer intervals between visits, which may be typical in other practices, result in longer average case duration,” says Dr. Jurisic.

Not only are unnecessarily long case durations costlier for employers, they are not in the best interest of an employee’s recovery either.

Concentra knows that early treatment produces the best outcomes. Because every employee is different, the clinician considers each case individually. Factors considered in scheduling a recheck appointment, include:

  • Injury severity
  • Diagnosis
  • Work status
  • Anticipation of significant change in work status to facilitate early discharge
  • Comorbid factors
  • And more

“The first few days are our golden opportunity to create an ‘ability mindset’ and encourage injured employees to focus on improvement and progress,” says Dr. Jurisic. “In general, we recheck employees when we believe they will be sufficiently better so that we can make even a small change and loosen their restrictions. In most cases, that’s between one to four days. Our data shows that extending the first recheck interval to a range of seven to ten days leads to longer case durations.”

Managing the Stay-at-work/Return-to-work Process

An important way Concentra’s workers comp doctors and clinicians distinguish themselves and achieve great outcomes for employees is in strong adherence to best practices for managing the stay-at-work/return-to-work process, says Dr. Jurisic. This is done from the very first visit when the clinician sets goals and expectations for clinical improvement.

“It is a misconception that staying home until you are 100 percent better is ideal. Returning to normal activities as soon as possible is best for the employee’s physical and emotional recovery, as well as general and financial well-being,” explains Dr. Jurisic.

Dispelling the misconception that a long rest at home is the best recovery approach is vital to the employee’s long-term outlook. “The workers’ comp doctor can be instrumental in avoiding medically unnecessary disability by consistently promoting the benefits of staying at work or returning to work,” says Dr. Jurisic.

She continues, “We also help employees understand the importance of staying active to avoid deconditioning and to think in terms of their capabilities within certain parameters of activity. Creating a ‘capabilities mindset’ promotes healing and a positive outlook.” 

Concentra’s workers’ comp employees learn there is a difference between “hurt” and “harm,” and that a level of discomfort in their activity does not mean they are harming themselves or risking re-injury. Coupled with this positive reinforcement, Concentra clinicians focus on objective measures of functional recovery, rather than subjective feelings of pain. This is Concentra’s “FReSH” approach to recovery (“Functional Restoration/Status of Healing”) that can help accelerate recovery and reduce the need for pain medication.

If you are beginning to see how Concentra clinicians engage employees in their own treatment plan and recovery, then you are getting a grasp on one of the many ways Concentra workers’ comp doctors deliver exceptional care.

Work Restriction Considerations

A fifth quality of Concentra’s workers’ comp doctors is that they are instructed to identify and document appropriate work restrictions that are a precise fit for the employee and the specific work requirements.

“It is not helpful, and perhaps detrimental, to the employee’s recovery if work restrictions are blindly assigned based on the injury alone. For example, not all lumbar strains need the same lifting, push/pull, or bending restrictions. Concentra’s workers’ comp doctors and clinicians are knowledgeable about the employee’s job duties and use this knowledge to assign work restrictions that make sense for each case,” says Lisa Figueroa, MD, FACEP, Concentra’s vice president of medical operations, national medical director of health information technology, and national medical director of telemedicine.

Concentra’s workers’ compensation physicians review prior workers’ comp and physical therapy notes and work restrictions, and seek to advance the employee’s activity level with each visit, as appropriate. By reviewing the notes, the physician will be able to determine if there has been any improvement in the physical findings and review the employee’s prior activity status and restrictions.

Concentra’s workers comp doctors and clinicians are dedicated to achieving the best possible outcomes through a workers’ compensation case management approach that reduces case duration and costs – providing benefits to employees, employers, and payors alike.

Now that you see how good workers’ compensation treatment and follow-up care can be, create an account to sign up for workers’ compensation care from Concentra.