Among the most difficult workers compensation claims for the adjuster to resolve are the situations where the injured employee has the simultaneous presence of the work related injury and another medical condition. In science, morbidity refers to a diseased state, disability or poor health due to any reason. Comorbidity refers to having two unrelated medical issues at the same time which impact the individuals recovery from either condition. The workers compensation adjuster will often cringe when they learn that the injured employee is also suffering from other health issues, as the adjuster knows the claim will most likely turn into a long, drawn-out affair.
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While it may be tempting to say “thats the adjusters problem”, the employer can have a positive and direct impact on the cost of workers compensation claims by addressing the health issues of the employee before an accident occurs. Many of the conditions that create a comorbidity problem are potentially preventable, and if not preventable, treatable before the injury occurs. There are several steps an employer can take to create a holistic approach and reduce the increased cost of comorbid claims.
When an employee who has a preexisting medical condition is injured on the job, early intervention in the medical care by a nurse case manager can impact favorably the future outcome of the work comp claim. The nurse case manager can work with the adjuster, treating physician and employee to coordinate the medical care and manage the underlying pathology creating the comorbid condition.
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.
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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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