N.L. chiropractors� association says workers also get back on the job faster
CBC News
The Newfoundland &�Labrador Chiropractic Association
Seeing A�Chiropractor First After�A Workplace Injury Gets Workers Back On The Job Faster
Dr. Darrell Wade, CEO of the association, said the September 2016 study�analyzed data from more than 5,500 injured workers in Ontario.
�What it found was that the initial provider of care for back pain was a very strong determinant of the duration of financial compensation for at least the first five months of the claim,� he told CBC Radio�s On the Go.
The study, published in the Journal of Occupational Rehabilitation, found that workers who saw a chiropractor first, rather than a physician or a physiotherapist, needed full compensation for a shorter time.
�What they found was that people who had seen a chiropractor first had seen about a 20 per cent less cost in these claims over those who visited their family physician,� he said.
The study involved more than 5,000 injured workers in Ontario, comparing time lost depending on which health care professional they saw first. (CBC)
A majority of workplace injuries are related to joints and muscles, making chiropractors a logical choice for the first visit, said Wade.
�Getting to the person who is most adequately equipped to treat your injury in the first place is what really accounts for the reductions in lost time from work and compensation costs,� he said.
In the study, done by researchers at the University of Montreal, just 11 per cent of the workers saw a chiropractor first, and Wade says that percentage would be less in Newfoundland and Labrador.
�It does speak to a great potential for improvement in our system, were we to use chiropractors more as the front line for musculoskeletal injuries, in particular, back pain,� he said.
�All too often these patients are not getting to us until three�months after an injury and at that point the chance of success decreases significantly.�
The owner of a Houston health clinic pled guilty to insurance fraud after billing for medical services � often provided to injured employees � despite having no licensed medical staff at the clinic. Instead, investigators found that the clinic was using foreign medical students to provide care.
Rosemary Phelan, the owner of Rose�s Houston Healthcare Clinic, entered a guilty plea in Harris County Court and was sentenced to seven years deferred adjudication and ordered to pay $88,000 in restitution.
A joint investigation by the Texas Department of Insurance Division of Workers� Compensation and Texas Mutual Insurance Company revealed that Phelan�s clinic had no licensed medical providers on staff yet continued to accept patients. She would then file fraudulent workers� compensation claims to collect from insurers.
According to investigators, the clinic had a licensed doctor on staff at one time. When that doctor left in 2012, Phelan began hiring foreign medical students to act as doctors and treat patients.
Workers� Compensation Commissioner Ryan Brannan said this case was particularly egregious. �Someone filing false claims is bad enough,� he said. �But this scam put people�s health at risk. It�s unconscionable.�
Phelan submitted $166,843 in fraudulent workers� compensation claims, representing more than 50 injured employees, claiming they had been treated by the clinic�s previous doctor.
Phelan pled guilty to second degree insurance fraud and a felony charge of practicing medicine without a license. The investigation found that her clinic was supplying narcotics to patients using the credentials of doctors and physician assistants who no longer worked at the clinic without their knowledge.
You can report suspected cases of insurance fraud to TDI-DWC by calling the Consumer Help Line at 1-800-252-3439 or by visiting�www.tdi.texas.gov/fraud/report.html.�
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Additional Topics: Neck Pain and Auto Injury
During an automobile accident, the body is exposed to a sheer force from the impact which causes the head and neck to abruptly jerk back-and-forth in relation to the rest of the body, which remains stationary in the car seat. Due to this motion, it’s common for the neck to suffer from whiplash, a painful injury which leads to neck pain as well as other symptoms.
Since its establishment five months ago, the new in-house fraud unit at the Division of Workers� Compensation has opened more than 40 investigations and hired additional fraud investigators to extend its reach.
�It�s a huge benefit to have a fraud unit that is 100 percent dedicated to workers� compensation,� said Commissioner of Workers� Compensation Ryan Brannan. �In-house investigators are more exposed to workers� compensation issues, so they are aware of the latest schemes.�
Teresa Carney, DWC�s Director of System Monitoring and Oversight, said that in an effort to coordinate anti-fraud efforts, the unit reaches out to insurance carriers, district attorneys, fraud prevention groups, and DWC employees.
�We can�t do it alone,� she said. �Workers� compensation fraud impacts all Texans, and we want to work with people who want to help stop workers� compensation fraud. Many complaints come from injured employees or insurance carriers, but we can also be proactive by reviewing the claim or medical billing data already on hand or tap people in our Hearings Division or maybe a field office, who help in the workers� compensation system every day.�
The fraud team was set up in May and has already issued warning and education letters as well as referred a case for prosecution. In one recent case, a Houston health clinic owner entered a guilty plea and was sentenced to seven years deferred adjudication and ordered to pay $88,000 in restitution.
Carney says that while the fraud unit does catch and punish bad actors, it�s important to remember there�s a lot of good in the workers� compensation system as well.
�When you are looking for fraud, you only see a small part of the workers� compensation system,� she said. �We know there�s also lots of good stuff happening�when people get their workers compensation benefits on time, they get back to work, everyone is happy. We like to think our work helps the system work better and that leads to more of the good stories.�
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
Additional Topics: What is Chiropractic?
Chiropractic care is an well-known, alternative treatment option utilized to prevent, diagnose and treat a variety of injuries and conditions associated with the spine, primarily subluxations or spinal misalignments. Chiropractic focuses on restoring and maintaining the overall health and wellness of the musculoskeletal and nervous systems. Through the use of spinal adjustments and manual manipulations, a chiropractor, or doctor of chiropractic, can carefully re-align the spine, improving a patient�s strength, mobility and flexibility.
Injured workers in Texas have better access to physicians who can treat them more quickly than they did 15 years ago, according to a September 2016 study by the Texas Department of Insurance�s Research and Evaluation Group (REG). The study found 84 percent of injured workers received initial care in seven days or less in 2015, compared to 76 percent in 2000.
�That�s significant because improved timeliness means workers have a much better chance of getting back to work, and the cost for their care will be much lower,� said Workers� Compensation Commissioner Ryan Brannan.
Effective Workers’ Compensation System
The study measures the effectiveness of the workers� compensation system to deliver timely and appropriate medical care to injured employees. It found that injured workers who aren�t treated within seven days have an average of about 40 percent more in medical costs over the first six months of an injury. In 2015, about half of injured workers saw a physician in one day or less. The average wait was 4.5 days.
�In terms of timeliness, when REG�s results are compared to the NCCI study of 35 states, Texas appears to be among the faster states.� Brannan said. �We have ongoing recruiting efforts to increase physician participation, and any issues with physician access are primarily due to a low number of physicians practicing in specific areas, not a low rate of physicians treating workers� compensation patients in Texas.�
The number of physicians in Texas who treated injured workers increased 6 percent from 2000 to 2015. During that same period, there was an 11 percent drop in the number of workers� compensation claims filed.
The decrease in claims also means injured workers in most of the state have options when searching for a physician.
In 2000, each physician who participated in workers� compensation treated an average of 21 patients. By 2015, that figure had dropped to 15, a decrease of 26 percent.
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Additional Topics: Preventing Work Disability with Chiropractic
After being involved in an unfortunate accident at work, injuries and aggravated conditions resulting from the incident can often lead to a variety of painful symptoms and complications, if left untreated, along with missed days at work and lost wages. A new research study showed that workers who received regular chiropractic care experienced less work-related injuries.
After a successful pilot project, the Texas Division of Workers� Compensation rolled out a statewide program in October 2016 that has helped speed up the resolution of some disputes.
The program splits up related claim issues so that a hearing officer can decide the most far-reaching issue first. This can clear the way for secondary issues to be resolved sooner. In the pilot program, the approach helped speed resolution of many workers� compensation disputes.
�We�re always looking for ways to stay on the cutting edge of workers� compensation, and this process is a great example of finding a way to improve efficiency in the system,� said Workers� Compensation Commissioner Ryan Brannan. �From what we�ve seen in the pilot project and in the statewide roll-out, the two-step approach to deciding some of the most complex issues in a dispute is a good option for system participants in many cases.�
Two-Step Program Introduced for Workers’ Comp
When an injured employee has a dispute about a claim, it often involves three issues: extent of the injury, the date that the employee reached maximum medical improvement and the impairment rating for the injury.
According to Deputy Commissioner for Hearings Kerry Sullivan, even though extent of injury is a �threshold issue� that can affect the other issues, it�s often addressed at the same time as the other issues in the dispute process.
�It can be challenging to come into a hearing and know there are so many alternatives for the hearing officer to address,� Sullivan said.
Parties in a dispute may base their arguments about impairment ratings and dates of maximum medical improvement on what they think the extent of injury should be. If the hearing officer decides a different extent of injury, then parties will often have to request more time to adjust those recommendations.
The new two-step program is voluntary, and the existing system is still used in many cases. The option to participate is presented by the presiding officer at the initial benefit review conference for cases that may benefit from the approach. The two-step approach is used only if both parties agree to it.
�The presiding officer usually knows going into the dispute whether a decision on extent of injury will move things along,� Sullivan said. �Deciding the extent of injury issue first can lead to a better outcome, a more efficient hearing, and more agreements. We�re pleased it�s been working out so well.�
The two-step program started at DWC�s Weslaco office in May 2015 and soon was expanded to Dallas. It�s now available at all 20 offices statewide.
For more information, call (512) 804-4010.�
Further information on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Additional Topics: Preventing Work Disability with Chiropractic
After being involved in an unfortunate accident at work, injuries and aggravated conditions resulting from the incident can often lead to a variety of painful symptoms and complications, if left untreated, along with missed days at work and lost wages. A new research study showed that workers who received regular chiropractic care experienced less work-related injuries.
The Texas Division of Workers� Compensation is taking a promising pilot program statewide to help simplify and speed resolution of some disputes.
A pilot started last year splits up related claim issues so that a hearing officer can decide the most far-reaching issue first. This can clear the way for secondary issues to be resolved sooner. So far, about half of the disputes accepted for the program have had a hearing, and a third of those have resulted in full agreement to resolve the dispute.
Workers� Compensation Commissioner Ryan Brannan said he is encouraged by the outcomes.
�The division has a number of tools in its toolkit to manage claims disputes,� Brannan said. �The two-step approach to deciding some of the most complex issues in a dispute can be a good option for system participants in certain cases.�
Solving Common Disputes for Workers
When an injured employee has a dispute about a claim, it often involves three issues: extent of the injury, the date that the employee reached maximum medical improvement, and the impairment rating for the injury. Deputy Commissioner for Hearings Kerry Sullivan said even though extent of injury is a �threshold issue� that can affect the other issues, it was addressed at the same time as the other issues in the dispute process.
�It can be very challenging to come into a hearing and know there are so many alternatives for the hearing officer to address,� he said.
Parties in a dispute may base their recommendations for impairment ratings and dates of maximum medical improvement on what they think the extent of injury should be. If the hearing officer decides a different extent of injury, parties often request more time to adjust those recommendations.
The program is voluntary. The option to participate is presented by the presiding officer at the initial benefit review conference for cases that may benefit from the approach. The two-step approach is used only if both parties agree to it.
�The presiding officer usually knows going into the dispute whether a decision on extent of injury will move things along,� Sullivan said. �Deciding the extent of injury issue first can lead to a better outcome, a more efficient hearing, and more agreements.�
Dallas-Fort Worth area attorney Daniel Morris, of the Morris Law Firm, said several of his clients who are injured employees have opted to have their disputes handled under the two-step approach. He said there is a benefit to examining issues separately.
�When you�ve got four or five different combinations of possibilities for the extent of a worker�s injuries, it allows everybody to weigh their options before getting to the other issues,� Morris said.
Jeremy Lunn, who represents insurance carriers for the Silvera Law Firm in Dallas, said he agreed that some proceedings are slowed as attorneys try to guess what a hearing officer will decide on the extent of injury issue.
�This is a good thing that the division is trying to deal with delays in certain cases,� Lunn said. �DWC management really has been reaching out to attorneys and asking us to help it work.�
The two-step program started at the division�s Weslaco office in May 2015 and soon was expanded to Dallas. It�s now available at all 20 offices statewide.�
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Additional Topics: Preventing Work Disability with Chiropractic
After being involved in an unfortunate accident at work, injuries and aggravated conditions resulting from the incident can often lead to a variety of painful symptoms and complications, if left untreated, along with missed days at work and lost wages. A new research study showed that workers who received regular chiropractic care experienced less work-related injuries.
Texas employers are invited to join the Division of Workers� Compensation in Austin for the Texas Safety Summit on May 9-11. The 21st annual workplace safety and health conference offers important information for everyone who plays a role in safeguarding employees, from the beginner to the seasoned safety professional.
Employers will hear from top safety experts about some of the most critical safety and health issues facing Texas businesses. Attendees will learn practical tools and techniques to use in their workplaces to better protect their employees.
�The Safety Summit is a proactive way for us to help Texas businesses,� says Commissioner of Workers� Compensation, Ryan Brannan. �Not only does it help foster a positive safety culture for your company and its employees, it ultimately helps reduce costs associated with on-the-job injuries and illnesses.�
What to Expect
Presentations from experts at the National Safety Council, the Occupational Safety and Health Administration (OSHA), and many more.
Interactive exhibits on transportation safety.
Great networking opportunities with safety professionals from across the state.
Early-bird registration is $375 through April 17, 2017. The cost is $400 after that date.
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Additional Topics: Preventing Work Disability with Chiropractic
After being involved in an unfortunate accident at work, injuries and aggravated conditions resulting from the incident can often lead to a variety of painful symptoms and complications, if left untreated, along with missed days at work and lost wages. A new research study showed that workers who received regular chiropractic care experienced less work-related injuries.
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