Catastrophically Injured Workers: How to Protect the Most Vulnerable During COVID-19

Increased incidents of depression and anxiety, substance abuse, chronic pain, and delayed outcomes — all are risks associated with the current coronavirus pandemic. They are also typically prevalent among catastrophically injured workers. The current environment exacerbates those risks exponentially. The need for prompt, appropriate care for these high-risk injured workers has never been more critical.

Treating catastrophically injured workers requires profound expertise in many areas of medicine during the best of times, as there are innumerable unique issues involved. These unprecedented times demand teams of specially trained providers are called in immediately when such a case occurs, if these injured workers are to have any chance of returning to function and productivity.

Catastrophic Injuries

Spinal cord injuries, severe burns, traumatic brain injuries, and loss of limbs can change a person’s life in an instance. A once able-bodied worker is suddenly thrust into a situation of permanent disability, long-term health problems, and possibly a reduction in life expectancy. The worker’s family is a significant part of the equation as well, since the worker’s income and other familial contributions are suddenly in jeopardy.

It’s no wonder that these injured workers are at higher risk for comorbid complications than other injured workers. COVID-19 has added to the complexities these workers face, from a physical as well as a psychological standpoint. The most critical catastrophic conditions often involve severe respiratory conditions, neurological issues, cardiopulmonary dysfunction, and infections, all of which put a person at high risk of poor outcomes if they do contract COVID-19. Additionally, a catastrophically injured worker who contracts COVID-19 may have a functional disability, such as post-Acute Respiratory Distress Syndrome and post-intensive care syndrome.

Employers and payers need to be aware of the variety of potential issues facing workers with catastrophic injuries so they can ensure appropriate care that will lead to the best outcomes and reduced costs. Treating catastrophically injured workers may require specialists in any or all of the following areas:

• Chronic pain. Managing pain is a specialty unto itself, especially for catastrophically injured workers. Despite their best intentions, treating physicians are rarely equipped to adequately deliver the care needed and may actually worsen the worker’s situation. Providers with experience in the biopsychosocial model are the best bet to help these workers. They understand how to intervene early to help prevent chronic pain from derailing the worker’s recovery.

• Substance Abuse. More than 35 states have reported an increase in opioid overdoses during the past several months, according to the American Medical Association. Among people in pain management, incidental addiction is on the rise. Appropriate treatment for catastrophically injured workers is, therefore, imperative. Providers must have expertise in both substance abuse and catastrophic injuries to be effective. Addiction recovery professionals can determine which type of treatment is most appropriate for an injured worker at risk, as there are many varieties available, such as inpatient, outpatient, detoxification, medication management, and other methods.
• Depression/anxiety. Mental health issues are one of the most common comorbidities among catastrophically injured workers, especially during the COVID pandemic. However, the symptoms may not be evident to treating physicians, claims handlers, nurse case managers, or others involved in the claim. Psychologists who specialize in helping catastrophically injured workers are best positioned to make the call early in the claim and determine the best treatment option.

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Early Intervention is Key

Once a catastrophic injury occurs, a team of specialists is best equipped to foster an optimal outcome. Some of the steps include:

• Assessment of the injury. The diagnosis should be clarified, as incorrect diagnoses are all too frequent and can have a devastating effect on the claim.

• Medical service needs must be quickly identified and coordinated.

• The proper integrated team of providers should be lined up and may include psychologists, burn surgeons, leading researchers in brain injuries — all with deep expertise in caring for catastrophically injured workers.

• Identifying and providing the very best possible treatment. In addition to specializing in their various fields, the team of providers also needs to be up to date on the latest available treatments and their effectiveness. It is extremely difficult for those not solely focused on catastrophic injuries to understand the latest procedures and costs. They must understand, for example, opportunities and the value of 3D printing, neuroendocrine screening, and prosthetics.

Conclusion

Catastrophic injuries, while rare, occur and can upend an injured worker’s life. The associated costs can bankrupt an organization. But that need not be the case. Providing the best care as quickly as possible can get the worker on a successful path to recovery and protect the employer as well.

Author Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%. He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is the founder & lead trainer of Amaxx Workers’ Comp Training Center, which offers the Certified Master of Workers’ Compensation national designation.

Contact: mstack@reduceyourworkerscomp.com.

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