Sometimes, we like to look at the broad trends in the workers’ compensation arena. These trends can help anticipate new changes to the North Carolina and Virginia worker’s compensation laws. They can help us understand what limits and expansions of benefits might apply – particularly for medical and vocational benefits. Trends help understand why workers get injured, what can be done to reduce the risk of injury, and what medical benefits may help the worker. Trends can also address the administrative end so that claims are filed faster and decisions are made on a quicker basis.
According to Managed OutSource Solutions Medical Record Review, these are some of the new trends and concerns for 2019:
- Many states have adopted Medicaid Expansion. Medicaid expansion may help low-wage workers get medical treatment when workers’ compensation is untimely or when an accident isn’t covered by state workers’ compensation insurance.
- As prescription drug costs continue to increase, new strategies are being developed to address the high cost of these drugs.
- With each new election cycle, state administrations may change power. There may be changes in Governorships, state House seats, and state Senator seats. These officials help decide who the next workers’ compensation Commissioners will be. We saw this not long ago in North Carolina, which has turned decidedly Republican. As a result, the workers compensation system in North Carolina as well as the personal injury laws underwent a massive change toward less rights for injured workers in 2011. And in 2019, the Industrial Commission, as a result of republican appointments, has become far more conservative and company-oriented than in previous years. But there are sometimes benefits to change. Many states, including Virginia, now have statutes to help first responders (police, firefighters, and emergency medical technicians) get their workers’ compensation benefits faster and to cover injuries such as post-traumatic stress disorder and heart disease. Some states are making payments to the spouses of first responders a priority in the case of the tragic death of a first responder.
- A possible new trend is to focus more on the emotional and psychological scars of any workplace injury. New treatment plans may be compensable. Doctors may be encouraged to help workers get evaluations and treatments for this side of their pain. Workers may be more encouraged to seek treatment with psychologists and mental health professionals.
- There will be more reviews of the American Medical Association (AMA) impairment guidelines. Doctors use these AMA guidelines to determine a worker’s level of physical impairment in a specific body part. The relationship between physical impairment and loss of earning capacity due to that impairment might become part of the analysis of an employee’s work injury claim and his/her permanent partial impairment rating, especially if there is a permanent and total disability.
- Another trend will focus on such issues as safe housing, transportation access and other socioeconomic factors. For example, the review states that “Many insurers are already addressing these concerns by providing meal replacement delivery services after surgery and also caregiver services for food preparation and companionship.”
- The use of telemedicine as a way of improving the patient’s health and providing access to more physician service will be explored. Telemedicine may be especially useful for workers who can’t get a ride to see their physicians. Telemedicine also gives employees a chance to speak with specialists who aren’t local to where the worker lives.
- As claims adjusters are retiring, new claims adjusters will need be trained
- Employers are now offering more leave of absence programs and more enticements for workers as the economy begins to rebound. Employers, according to the Review, claim that leave of absence programs are more than just an enticement. They help companies keep employees.
- Newer workers are more likely to be injured because they don’t have the training and experience to handle complex tools, machines, and business requirements.
Insurance industry trends
Heffernan Insurance Brokers provides the following trend review for California. Some of their trends should be taken with a grain of salt as insurance companies favor the employers who hire them. Insurance companies are not the worker’s friend when there are disputes.
Many of these trends may become trends for North Carolina and Virginia:
- “Evidence based-medicine” is helping workers get improved treatments, better medications, and better access to doctors
- Some companies, such as Starbucks, are using self-reporting system that let employees self-report when they first have an accident rather than going through the company manager. The process involves more technology including a workers’ compensation call center, direct-deposit of workers’ pay, and other benefits.
- Employers are recognizing they can help their employees through early intervention. Musculoskeletal ailments, according to the Bureau of Labor Statistics account for nearly 13% of all worker injury and illness claims. These disorders include back injuries, muscle strains, tendinitis, and carpal tunnel syndrome. Early medical care can help the worker get the care he/she needs and return to work sooner.
- Like the Managed Outsource Solution study, Heffernan believes that telemedicine will be a major workers’ health trend. In addition to providing physical care, telemedicine is being used to provide psychological care. Workers with mental health problems find that speaking with a counselor or doctor directly through the Internet is more comfortable than driving to an office, seeing other patients, and having to work with office personnel. Telemedicine is available for desktops and smartphones.
- Onsite triage programs. One California company uses an onsite triage program to make a quick diagnosis of a worker’s injuries and then arranges for a ride-hailing service to get the worker to the hospital as quickly as possible.
- Robotics. Robotics are helping workers’ compensation insurance companies and doctors reduce costs while providing physical therapy, clerical help, and other services to the worker
Workers’ compensation lawyer Joe Miller Esq. has been fighting for injured workers for more than 30 years. We’ve helped thousands of injured workers get the wage loss benefits and medical compensation they deserve. We work to keep abreast of industry trends so we can better understand how workplace accidents happen and what medical options are possible. At the core, we are strong advocates for anyone who is injured at work for any reason. To speak with a strong experienced advocate, please call attorney Joe Miller at 1-(888) 667-8295 or fill out my contact form to make an appointment. Initial consultations are free.