How to Get Started (and Be Successful) in Workers’ Compensation Rehabilitation

Did you know, there is a patient out there that pays on average 30% more than your other patients?

Or rather, there is a payer that reimburses on average at a 30% higher rate than government or commercial payers, it’s workers’ compensation. Granted, you have to take on a more complicated process, more paperwork and a whole new set of regulations and state rules – but hey – that 30% isn’t going to come for free.

The workers’ compensation market is a great area to get involved in if your clinic has the skill set and right know-how to do it well.

What Differs?

The exact process varies significantly by state and even by type of occupation. Each system of regulations changes and evolves at its own pace.

An injured worker’s claim is managed by an adjuster and is subjected to utilization reviews and often arbitrary limits on care. Providers must supply regular progress updates, documentation notes and jump through extra hoops to extend or make adjustments to care plans. This is a challenge, but also an opportunity to advocate for your patients, protect their livelihood and help them regain something they’ve lost.


Strength of Skills

PT/OT services are ideal for rehabilitating injuries commonly sustained on the job site. Therapy services offer equivalent or better outcomes for many types of injuries when compared with surgeries and with lower risk to the patient.1 Employers and payers prefer PT/OT over surgery as well. Therapy services are far cheaper than acute care and patients that start therapy sooner cost thousands less in imaging and surgical costs.2,3

Those benefits create a strong push to bring PT/OT into the mix. The analytical ability of talented PTs and OTs to craft work conditioning programs that bring an injured worker back to full function stands apart from any standard post-surgical care.

Ultimately, any specialization is a mix of investment and reward, dependant upon the clinical skill and know-how of the therapist to create the best outcomes. Ensuring that your team is trained in assessing the needs of this type of patient, skilled in providing the unique care they require and are informed about the latest changes to local laws that govern the process are the keys to being successful in this type of care.

Want to know more about the workers’ compensation process and lifecycle of a claim? MedBridge offers two new courses that take a closer look at Workers’ Compensation:

  1. Delitto A. Surgery Versus Nonsurgical Treatment of Lumbar Spinal Stenosis: A Randomized Trial. Ann Intern Med. 2015;162(7):465-473.
  2. Fritz JM. Physical Therapy or Advanced Imaging as First Management Strategy [...]. Health Serv Res. 2015 Dec;50(6):1927-40
  3. Fritz JM. Primary care referral of patients with low back pain to physical therapy: impact on future health care utilization and costs. Spine (Phila Pa 1976). 2012 Dec 1;37(25):2114-21