Caveats that Affect the Return-to-Work Timeline
Kimberly Radcliffe, MHA, PT
Vice President Operations, 2nd.MD
When an individual suffers a workplace injury, as workers’ compensation professionals, we work to put them on a path to recovery. But we all know even the most well thought out plan can go awry. Here are four factors that can impact the recovery timeline of an injured worker and solutions for how to proactively mitigate risks before they cause the lifetime of a claim to extend.
Comorbidities
Issue
Comorbid conditions are medical disorders and diseases that affect or accompany a primary condition or injury. These conditions include obesity, diabetes, hypertension, tobacco use, mental health issues and substance abuse. When not properly managed, these conditions can have a negative effect on an injured worker’s recovery process.
In 2016, Harbor Health Systems, performed a study of comorbidities and found that claims with multiple comorbidities experienced an average total incurred cost increase of more than $20,000 when compared to the control group.
Solution
Early identification and patient education are key to mitigating risks and offering more holistic care to injured workers with comorbidities. This two-pronged approach also creates a more realistic return-to-work timeline for the employer.
Incorrect Medical Equipment
Issue
From mattresses to prosthetics, injured workers require different types of equipment to fully recover.
Think about an injured worker who works on a factory line and needs a prosthetic device. We have to take into account the fit, function and job requirements of the injured worker – if any detail is missed, it could cause discomfort for the injured worker, delays in recovery, and extended return-to-work timelines.
This mindset is equally important when treating wound patients. Wound injuries cost the healthcare industry $50 billion annually; however, a vital component often overlooked is a proper mattress/bed. A mattress isn’t just for sleep, it provides prevention, healing and stability. Let’s think about an injured worker who has a wound on their back. The wound needs open air and minimal pressure to heal; however, if the patient can’t sleep comfortably on their front or side, lack of sleep and constant moving could significantly delay recovery times.
Solution
When it comes to equipment, it’s often the little things that make a huge difference. Patients need proper equipment for a successful recovery and return-to-work.
Dental Issues from Opioid Use
Issue
Some recovery roadblocks aren’t as easily or quickly seen. Long-term opioid use, for example, causes significant dental issues – the most common being dry mouth. Opioid use inhibits saliva production, meaning food particles linger in the mouth and eventually lead to decay and gum issues. Opioids can cause a claim to extend because dental issues are not normally discovered until long after the initial claim – sometimes even years later. By the time issues arise, they’re often so severe they require long-term or extensive care, such as dental implants.
Solution
Educate patients by helping them establish regular dental maintenance. This will help to mitigate risks related to long-term opioid use. It’s also important to establish a baseline. When possible, obtain dental records regarding your patient’s past dental health.
Social and Psychological Factors
Issue
The workers’ compensation industry has increased its focus on factors outside of the physical injury, and for good reason. Biopsychosocial health is an unseen driver in patient outcomes. Improperly managed pain, stress, and even the injured worker’s level of motivation, have an impact on recovery and return-to-work timeline.
Factors can be personal or work-related. For instance, many injured workers endure added stress from trying to provide for their family while injured or feeling pressure to heal quickly because of mounting responsibilities at work.
Solution
In order to mitigate these risks, a provider must be able to quickly identify factors and document them in their treatment plan so everyone involved can play a role in recovery. A behavioral health program might even be recommended as part of the plan moving forward.
Conclusion
Education, early identification and engagement, a holistic approach, and an eye for detail all play an important role in keeping an injured worker on the road to recovery.
*The views and opinions expressed in the Public Risk Management Association (PRIMA) blogs are those of each respective author. The views and opinions do not necessarily reflect the official policy or position of PRIMA.*
Kimberly Radcliffe, MHA, PT
Vice President Operations, 2nd.MD
Summary of Qualifications
Kimberly has been a physical therapist for over 20 years. She has over 20 years experience in management and leadership within the healthcare industry, with a focus on outpatient ancillary services.
Business Experience
Kimberly joined Align Networks in 2006 and developed a comprehensive clinical review program focused on monitoring the quality of care, treatment patterns, utilization and appropriateness of care. Within five years, she was the SVP of operations, leading all operations, network development and clinical programs. She is now the vice president operations at 2nd.MD
In 2016, Kimberly became SVP of clinical operations at One Call as part of the merger between One Call Care Management and Align Networks.
Prior to Align Networks, she was a regional director for Brooks Rehab, one of the largest in-patient and out-patient rehab facilities in the SE.
Professional Affiliations
Member of APTA
Education
Bachelors of Health Science in Physical Therapy from the University of FL in 1997 & a Masters of Health Administration degree from the University of North FL in 2007.
