Worker’s Comp Injuries

By Edward S. Pratt, M.D., M.B.A.

Back injuries are the most common cause of lost work days in employees under 45 years of age. Two percent of the U.S. workforce suffers an on the job work injury each year accounting for 175 million lost work days per year, costing 23.5 billion dollars annually. It’s no wonder that employers are scratching their collective heads looking for ways to decrease these expenses. Ironically, the worker’s compensation system was designed to be a “no fault” system in which dollars were spent directly on patient care rather than in expensive court battles to determine whether employer or worker was at fault in any particular injury. In many injured employees the system has worked well, however in most studies it has been established that average outcomes for worker’s compensation patients are inferior to those for patients in a non worker’s compensation environment. The current worker’s compensation system unfortunately creates a negative incentive for patients to get back to work or to get well.

Some patients anxious about re-injury upon returning to work, may delay their treatment or recovery, yet continue to be paid two thirds of their normal wage while avoiding work return, reinforcing their undesirable behavior. A patient, who magnifies his disability successfully, stands to increase his final monetary settlement. Such behavior has lead to insurance adjusters hiring nurse case managers to move cases along. Employers and employees all too often become adversaries in the process as employers see the costs mount day after day as loss work days add up, while patients feel they are being pushed back to work with very little concern for their personal well being.  Patients sometimes focus on their disability rating and cash settlement losing focus on getting well. The final financial settlement seldom reimburses an injured worker for the loss of earning capacity, independence, and self esteem that nearly always occurs in this situation.

As a result, all parties lose. Physicians must deal with patients that are often evasive and not focused on recovery, while being forced to complete volumes of paperwork documenting treatment progress. Employers feel they pay too much for employees that may never be productive again, uncertain when and if an employee will return to work. Employees often squander their best chance to get well striving for a cash settlement that is uniformly disappointing. They come out of the system alienated from their employers, and marked as a worker with a bad back that no employer will hire, all for the sake of a cash settlement that often won’t even support the patient a single year.

The bottom line? If you are unfortunate enough to have an on the job neck or back injury, realize that resources provided for your care will not last forever. Your greatest asset is your friend, the back, and your focus should be on doing anything and everything you can to get it as healthy as possible. When all is said and done, a healthy back is worth more than any settlement you will ever receive. Bad things can happen to good people, and once you have recovered as much as possible, it is time to move on, and use whatever settlement you may receive to maximize your long term earning potential. If you are an employer realize that the best predictor of a successful worker’s compensation claim is an employee’s satisfaction with his employer. Offer limited duty to facilitate your employee’s return and welcome them back into the fold. Be supportive, honest and consistent by setting expectations with your employee right from the start of an injury. Let them know that just as it was prior to their injury, if they are responsible, keep their medical appointments, show up on time, and work hard, you will support them with your resources throughout the process.