Have you ever wondered how long an employee’s medical treatment will continue after an injury occurs? It would be great if there was a medical guide stating, “If employee has X type of injury, the recovery time is 29 days.” but unfortunately, there is no precise recovery time for each type of injury. The speed and extent of recovery for the same type of injury can vary significantly from employee to employee.
The speed of recovery from an injury varies depending on different factors including:
1. the degree of damage caused by the injury,
2. the age of the employee,
3. the physical condition of the employee prior to the injury (obese employees and employees who have poor physical conditioning have longer recovery times),
4. the occurrence of injury to another body part at the time of the accident,
5. the post injury treatment program (for example – many musculoskeletal injuries resolve faster for employees given physical therapy than for employees not given physical therapy),
6. the activity level of the employee post injury,
7. the nature and extent of any underlying pathologies,
8. the overall health of the employee
9. the personal habits of the employee (smoking, alcohol use, illicit drug use),
10.the stress level and the emotional state of the employee,
11.the employee's sleeping habits and general health habits
Even with all these caveats, the employer still can estimate with some degree of certainty the amount of time an employee will be off work for certain types of injuries. Some general guidelines for average disability recovery time would be: This information is provided in a generic context and may not to be used without independent medical verification by your doctor.
| Simple fracture | 6 to 8 weeks |
| Compound fracture | 8 to 16 weeks |
| Fracture with surgical intervention | 18 to 30 weeks |
| Simple sprains | 6 to 10 weeks |
| Simple strains | 4 to 6 weeks |
| Surgical recoveries | 6 to 24 weeks |
| Burns, first degree | 3 to 6 days |
| Burns, second degree | 2 to 3 weeks |
| Burns, third degree | 12 to 40 weeks, depending on percent of body surface |
| Anterior Circulate Ligament (ACL) | 3 to 4 months |
| Rotator cuff | 3 to 4 months |
| Lumbar surgery | 8 weeks to 6 months |
| Cervical surgery | 6 weeks to 3 months |
To determine the severity and seriousness of the injury, the medical provider often performs various test including x-rays, MRI (magnetic resonance imaging) and CT scans (computed tomography). The results of these tests can guide the claims adjuster and the employer on whether the employee should be out of work closer to the minimum time or the maximum amount of time on the schedule above. (WCxKit)
Medical management with a nurse case manager should be considered as soon as any of the above minimum periods are reached if the medical provider has not given an estimated release date. A nurse case manager should also be considered if the employee has any underlying pathologies exacerbating the injury or delaying the recovery. It is also recommended that a nurse case manager be utilized when the employee is non-compliant with the prescribed medical treatment, the employee has had multiple prior injury claims or the employee has a preexisting disability.
If it appears the full recovery from the disability is going to exceed the normal amount of time needed for disability recovery, the workers comp adjuster should request an independent medical evaluation be performed to verify the extended disability time and to determine (or verify) the medical course of action to bring the employee to the point of maximum medical improvement. (MMI)
The average disability recovery time should NOT be confused with the time the employee should be off work. The average disability recovery time is the amount of time from injury to maximum medical improvement. The time the employee should be off work is determined by the availability of modified duty or transitional duty and the time off work should be considerably shorter than the disability recovery time.(WCxKit)
There are some severe injuries where the recovery period can be a very long time or the injury is so severe that there will never be full recovery. Examples of this include:
1. Closed head injury
2. Brain stem injury
3. Spinal cord injury
4. Amputation of a major extremity
5. Loss of an eye
6. Loss of hearing
These types of severe injuries normally require the insurance carrier or third party administrator to report the claim to the reinsurer.
The total disability recovery time for an injury depends upon the severity of the injury and the medical condition of the employee prior to the injury. Anytime the employee's recovery from the injury is taking longer than the minimum amount of time needed, a nurse case manager or an independent medical evaluation should be considered. By properly monitoring the medical care, the employer and the adjuster will be able to know if the medical recovery is
Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. [email protected]
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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
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