Eli's Rehab Report

Published on Mon Apr 19, 2010 PDF

The first key steps can make the difference between bank and bust for these claims.

Worker's comp cases can bring in great money -- and keep that money flowing if you establish good business relationships with the employer. But getting reimbursed this way means you'll need to take important steps right from the start that you wouldn't do with regular health insurance claims. Ensure your coffers are flowing with the reimbursement you deserve with these strategies.

The best business move is not to make any assumptions or judgments when a worker's comp patient walks through your door. You may lose good business.

Mistake: "Unfortunately, many people classify worker's compensation cases as illegitimate or a sign of being lazy," notes Barry G. Inglett, PT, CHT, Cert. MDT,with Wayne Physical Therapy & Spine Center and Mailly & Inglett Consulting in Wayne N.J. "I have often had patients come to me that have gone to other facilities telling me that they were treated rudely by the physical therapist as well as other staff members."

Everyone deserves to be treated with dignity. And more often than not, the patients will work hard to resolve their problem and return to their previous job duties, Inglett observes.

Don't miss: Have the injured worker sign a release stating that you, the therapist, may share information regarding the worker's injury and any job restrictions with the employer, says Bubba Klostermann, OT, CVE/R, CEAS, a worker's comp expert with West Texas Rehab in Abilene, Texas.

With the release in hand, phone the patient's employer as soon as possible. "Ask to speak to the risk management or HR person," Klostermann advises. "Many workers won't know they were supposed to report the injury, and the employer might not even know the patient has had an accident."

Plus: The patient's story and the employer's story might not agree, "so you have to close that loop as well," Klostermann explains. For example, your patient may have told you he lifts a 150-pound object eight times a day, but the employer might reveal that the patient has access to lifts and hoists. Or, on the flip side, the patient might be doing more work than the employer realizes.

Do this: Once on the phone with the employer, get a job description for your patient. "Remember that the rationale for physical therapy with a worker's compensation patient is always RTW (return to work) -- not much else matters to the system," says Jim Dagostino, DPT, PT, PTPN board member and owner of Dagostino Physical Therapy, a PTPN member office in Oceanside, Calif.

The job description will help you build the skeleton to your care plan. For more details on gathering a job description, see the "Clip and Save" following this article. In addition to getting the job description, find out if the  employer can offer your patient a modified duty so the patient can return to work as soon as safely possible. "Modified duty, in the past, referred to light duty," Klostermann explains. "Getting back to work quicker has proven to save lost days and lost wages and save in overall medical costs as well." Studies have also shown the sooner  an injured worker returns to work, the higher the chance of a successful case closure, he adds.

Finally, then tell the employer that you will update them regularly as to the progress of the injured worker and give them an idea of the time frame to complete the full process of closing the case, Klostermann recommends.

If you're smart, you can rake in more than just your worker's comp reimbursement for each case. When you're on the phone with the employer getting a job description, ask if you may come onsite to do a job analysis. "Offer to go to the jobsite to measure and weigh things, to assess what the requirement of the job is, etc.," Klostermann says.

What's in it for you: "Cost for this service can range up to $150 per hour," Klostermann says.

Even if the employer doesn't want a job analysis, be aware of the business opportunities in establishing a good relationship from the start. "If you handle things well, the employer may want to keep sending you their worker's comp injuries -- and they might also spread the word to their business colleagues," Klostermann says.