Getting Medical Expertise is a Key to Success (Is there a doctor in the house?)
Having medical expertise allows you to offer employees a better safety net of care as well as act as a deterrent to those who would extend the length of their disability unnecessarily.
Another key team member is a corporate medical director or medical consultant. The medical director, either part-time or full-time, reviewsclaim, has doctor-to-doctor contact and serves as a medical resource. Claim review should be done proactively rather than reviewing large losses.
We must remember, we are dealing with medical situations, thus, our expectation the adjusters will be able to make medical judgement calls is unrealistic.
A medical director reviews all injuries if s/he is on-site. If on call, s/he review all lost time claims and all independent medical examines (IME) Reports. Prior to claims being sent for IMEs, the medical director reviews the file to make sure pertinent medical records are included. Often adjusters are not able to determine if the length of absence is disproportionate to the injury. Also, the medical director can determine very quickly whether an injury is work-related or is a new injury or a reinjury.
If a treating doctor indicates one of your employees is unable to perform transitional duty tasks or an employee is uncooperative with transitional duty, it’s worth having the medical director telephone the treating physician to discuss the injury doctor-to-doctor.
A doctor- to- doctor contact both more helpful and faster than waiting for an IME. So while it will cost more per hour to have an MD review the file and make a phone call, it saves many additional indemnity payments for lost wages because the employee returns to work faster. (workersxzcompxzkit)
Whether your medical doctor is on-site or off, every employee needs to know a company doctor reviews all work-related injuries and medical absences. Injuries are reported to the on-site physician, s/he examines all injured employees and reviews their claims. Off-site medical staff receive reports of all work-related injuries and reviews all reports and claims.
Author: Rebecca Shafer, J.D.
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