There is no I in team, we all have heard. Nor is there one in workers' comp success or in return to work. Taming the workers' compensation beast and wrestling costs to the ground is a team effort. For risk managers, that team often consists of claim adjusters, rehab vendors, private investigators, skilled workers' compensation defense attorneys, and independent medical examination physicians.

Often overlooked, though, is the role that occupational medicine specialists can play in workers' compensation claim management. They should be part of the team! But these specialists examine patients; what could they do with workers' compensation claim files? Plenty.

Workers' compensation claim professionals constantly review medical records, but they might not always fully understand what they are reading. Occupational medicine specialists can help claim people translate what they read into understandable English. These specialists also can add value to risk managers in managing workers' compensation costs in other way, including:

  • Spotting inconsistencies in medical reports and records.
  • Identifying inappropriate medical treatments.
  • Spotting blind alleys in courses of treatment, which could represent a significant waste of money.
  • Recommending alternative courses of treatment to the claim adjuster or to the treating physician.
  • Examining compensability issues. Occupational medicine specialists can help adjusters avoid claim “creep” in instances where it is questionable whether an aggravation or exacerbation is due to an on-the-job injury.

Ignoring the Obvious?

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