Is Employer-Directed Medical Care Associated With Decreased Workers’ Compensation Claim Costs?

Abstract

States that permit employer selection of treating physician have slightly higher cost due to the higher prevalence of attorney involvement in the claims process.

Treatment and provider choice in worker injury rehabilitation: A systematic literature review

“…Another found that allowing complete choice of treatment provider increased costs yet permitting change of provider after initial treatment reduced costs (Shraim et al, 2015). Another considered that the highest cost occurred where the worker could choose their own treatment physician after an initial restriction, but that this group also incurred higher incidence of litigation (Tao et al, 2018). The same study proposed that inability to change providers could lead to mistrust and disputed decisions, thereby indirectly increasing costs.…”

“…Conversely, a systemic blockage to enabling change of provider has been proposed to lead to increased costs due to development of mistrust, disputations and even litigation (Shraim et al, 2015;Tao et al, 2018).…”

“…Client-centric approaches to worker injury are a growing focus of rehabilitation, perceived as improving the rate of return to work (Safe Work Australia, 2020). Yet the worker's preferences during rehabilitation may be constrained, for several reasons (Allen et al, 2014;Blanchette et al, 2017;Gilkey et al, 2008;Neumark et al, 2007;Tao et al, 2018), beyond the system's acknowledged complexity (Dean et al, 2019;Hutson & Dunning, 2020;MacEachen et al, 2013) Firstly, the injured worker may have little experience of self-advocacy and limited formal education that could enable them to meet the normative expectations of the system structure (van Hal et al, 2012).…”

“What We Have Here Is a Failure to Communicate”

“…In addition, in this series of more complex injury cases, only 7 (1%) of 556 claimants in Utah were represented by an attorney; this is an unusually low rate. Tao et al 2 reported the experience of a single nationwide American employer with 13% of all “lost-time” claimants (not just those with more complex claims) having an attorney in states where the employer cannot direct medical care and 17% to 24% of claimants in states where employers have at least some choice of the treating provider. Attorneys typically believe that it is their role to advise clients of their legal rights (principles) under Workers’ Compensation law and that this is not a physician role.…”

Prevention, Medical Management, and Adjudication of Workplace Injuries

“…These efforts have been successful both within single employer environments and among multiple employers. [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] Because they were introduced at the same general time in the JHWCP or constantly refined, the relationship between any one of the programs and changes in medical and indemnity payments over time was difficult to assess. We did not study changes in the rates of workers' compensation lost-time claims for specific conditions such as carpal tunnel syndrome or low back disorders which would have been beyond the scope of this overall assessment of the program.…”