A new study by the Workers' Compensation Research Institute (WCRI) found the likelihood of injured workers getting back surgery, under workers' compensation, depends upon the geographic location where they seek treatment for their back pain.
The study, Why Surgery Rates Vary, found that 1/5 of the injuries covered by workers' compensation are back injuries. And while the injuries are common in workers' compensation, the best way to treat the injury (either through surgery or conservative measures) lacks consensus between the providers in different states. The study found the surgery rates were affected by each of the following, "more surgery-intensive local practice norms, higher reimbursement rates for surgery, and more surgeons in an area." As the stated in the study, " nearly 20 percent of injured workers with back pain had surgery in Oklahoma and Tennessee. By contrast, less than 10 percent of workers in California and Florida with the same diagnoses had surgery."
A study recently released by Liberty Mutual Insurance Company found that, "injured employees return to work faster once a nurse gets involved, with costs dropping 26% and claims resolutions happening 15% faster than without a nurse involved." What the article fails to mention is the fact that those statistics, while beneficial to the workers comp insurance carrier, show the harm done to injured workers by the Nurse Case Managers who are there to "help" the claimant. The purpose of a Nurse Case Manager is to control the costs of the case, despite the effect it has on the injured worker.
Common tactics used by Nurse Case Managers, in their effort to lower the costs of workers compensation claims, include things such as conferencing with doctors to reduce or remove restrictions which prevent the claimant from returning to work. By having the claimant return to work as soon as possible, the Nurse Case Manager is reducing the costs of workers' compensation claims to their employer, the workers' compensation insurance carrier. This is done without the Nurse Case Manager taking into consideration the harm which could come to the claimant from having to return to work before he or she is actually able to do so.
In complex cases such as these, it is imperative the claimant select an attorney who has experience dealing in such issues. The attorneys at Lancaster & Eure have over 70 years of combined experience in dealing with these issues and will put that experience to work in fighting to get their clients the benefits they deserve.
Nurses a linchpin in reducing workers comp costs
The Social Security Administration currently has the largest backlogs of any federal agency with 990,399 cases waiting for the Social Security Administration to take action. The majority of the backlog stems from the system governing applications for Social Security Disability.
Currently, the system is set up in such a way to essentially force those applying for Disability to wait 2.5 years for a chance to plead their case. The system is set up so that the first two decisions, the initial application and the request for reconsideration (used when the initial application is denied), are made by those at the local office who lack the training and expertise required to make such decisions. With such limitations imposed on those making the determinations at the first two levels, it is extremely rare to be approved before making it to the hearing level.
After filing the initial application and the request for reconsideration, the next step is to file a request for hearing. The hearing stage is when the claimant finally has a chance to truly present his case to an Administrative Law Judge who will then determine if the claimant is able to work any job in the national economy. However, due to the massive backlog the Social Security Administration has, the typical waiting time for a hearing (from the date of the request for hearing) is ONE AND A HALF YEARS.
Unfortunately, this backlog causing such large wait times is imposed on those who are the least able to weather the storm. Our attorneys at Lancaster & Eure, P.A. are available to help you navigate this complex system and ensure your case is presented in the strongest possible form at every level of your case.
Social Security- Biggest Backlog in the Federal Government