Getting Back To Work
  


Choosing Industrial Rehab Specialists to Treat Injuries Through Your Workers' Compensation Program

What Companies Need to Know

At a time when employers are hard hit by spiraling medical and workers’ compensation costs, it is critical that employers select an industrial rehabilitation clinic that provides comprehensive cost-effective treatment and services to facilitate the injured worker’s early — and successful — return to the workplace. If early intervention is not achieved or is ineffective, employee motivation may suffer, causing a general tendency to remain off work. For some companies, a clinic that also offers jobsite analysis and injury prevention programs may be the answer to containing workers’ comp costs. There are clear-cut benefits for employers and their insurance companies to refer injured workers to a physical therapist-owned clinic rather than to a physician-owned occupational medicine clinic. Studies in the Journal of the American Medical Association1 and the New England Journal of Medicine2 have shown that utilization and charges per patient are higher when physical therapy and rehabilitation facilities are owned by referring physicians.

In the 36 states where patients are allowed direct access to physical therapy treatment without a physician’s referral, employers may be able to refer, or at least encourage, their injured employees to use a particular industrial rehabilitation clinic, depending on the requirements of their insurers. Injured workers referred directly to physical therapy needed fewer visits and were less costly (averaging 7.6 visits at $1,004 per patient) than physician-referred patients (averaging 12.2 visits at $2,236 per patient), according to a study in Physical Therapy.3 Advocates of direct access say earlier availability of physical therapy reduces disability, as well as workers’ comp costs, because the longer it takes to get treatment at the outset of an injury, the longer employees tend to be out of work.

When selecting an outpatient industrial rehabilitation clinic to treat their employees, companies should consider the following advice from PTPN practitioners:

  • Choose experienced providers who are knowledgeable about the workers’ compensation process, ADA (Americans with Disabilities Act), employment laws, and OSHA record-keeping guidelines. Providers should have specialized training and verifiable certification in functional testing and ergonomics.
  
  • The clinic should allow prompt provider response to an employer’s questions along with timely communication including weekly progress notes to claims adjusters, case managers, and health/safety staff.
  • Contact references that the providers have done business with in the areas of work injury management and prevention and case resolution services.

--Steve Allison, PT, OCS, MHS, CAE (PTPN member, Tri-State Physical Therapy, Shreveport, Louisiana)

  • A one-on-one PT-to-patient relationship is critical for a productive outcome. Instruction and supervision should include aerobic conditioning, strength, flexibility, coordination/balance/proprioception training, and of course skillful hands-on care specific to the areas in which weak, damaged, or shortened structures require attention.
  • Therapists should provide an arsenal of therapeutic options and equipment which challenge strength, coordination, balance, and aerobic capacity, and is versatile enough to reproduce or mimic the work environment so that key muscles and joints are trained as closely to a work environment as possible.

--Pablo Ruiz, PT (PTPN member, White Tanks Physical Therapy and Orthopedic Rehabilitation, Goodyear, Arizona)




1 Mitchell, J.M., Scott E., “Physician Ownership of Physical Therapy Services. Effects on Charges, Utilization, Profits, and   Service Characteristics.” Journal of the American Medical Association, October 1992.
2 Swedlow, A., Johnson, G., Smithline, N. Milstein, A., “Increased Costs and Rates in the California Workers’ Compensation System as a Result of Self-Referral by Physicians,” New England Journal of Medicine, November 1992.
3 Mitchell, J.M., de Lissovoy, G., “A Comparison of Resource Use and Cost in Direct Access Versus Physician Referral Episodes of Physical Therapy Background and Purpose.” Physical Therapy, January 1997.