Working With Your Medical Provider

As promised, here is the installment on working with your occupational health medical provider. You want one who is sure to support your return to work program consistently.

Your company’s preferred medical provider(s) must understand return to work programs for your program to be effective. Someone with daily responsibilities in workers' compensation, needs to make prior arrangements with one or more to let them know of your Transitional Duty Program. There may be more than one medical provider in your location that is willing to work with you, so reach out to all of them to determine the best fit for you and your employees.

Most hospital systems and traditional ‘walk-ins’ have occupational health programs, however many of them merely accept workers’ compensation insurance, and/or provide health, wellness, and pre-placement screenings. Although they may provide very appropriate medical evaluation and treatment, they may not provide consistent return to work restrictions. 

They also may be inclined to give an employee ‘some time off’ (many times at the request of the injured or ill worker), not realizing that state requirements may limit the amount of money an injured/ill worker can receive. Many employees cannot survive on approximately 60% of their salary allowed by most workers’ compensation programs, and many programs have caps for high earners. Be sure to let the provider know what the rules are for your state. I can almost guarantee you that they will not know.

Your occupational health manager and nurse/coordinator should attend the meeting with each of the medical providers in your immediate location. You can do your own research or ask other employers in your area for recommendations. A drive of more than 20 minutes is probably too long, so you will want to stick to a provider as close to you as possible.

At the meeting, ask the provider’s liaison to explain their program, show you which forms you should expect to see from them, and if they issue return to work restrictions for all injured/ill workers. Minimally providers should give you a tour of their location and be open to tailoring their program as best they can to meet your needs.

When interviewing the health care provider, ask for statistics such as: 

• What percent of injured/ill workers are returned to work with no restrictions
• What percent are returned to work with restrictions
• What percent are placed out of work
• As a rule of thumb, your out of work orders should be no more than 10% of the total number of injuries/illnesses who received evaluation
• Wait times to evaluation
• Many providers will expedite injured/ill workers if you ask, and the provider can do so safely without harm to other waiting patients
• Average length of stay for non-critical care and treatment
• Important to know how long your employees are expected to be away from the work site (We found that following evaluation, some employees 'got lost' or went out to eat on their way back to the work site)
• Expectations for specific injuries
• What is typical for treatment and work restrictions for injuries easily accommodated in a transitional duty program, such as:
• Back strains
• Hand lacerations
• Repetitive motion symptoms (typing or machine induced rotations)

Be sure to advise the health care provider that you do indeed accommodate all types of injuries in your return to work program. Invite the health care provider to tour your facility to obtain a greater understanding of your industry and environment.

You should feel comfortable asking them to expedite evaluation and treatment for your injured/ill workers. The medical provider may or may not be able to accommodate on a daily basis, but may make every effort to comply when possible. Also ask for volume discounts should you expect to send workers regularly for evaluation or if you purchase other services such as drug testing or pre-employment physicals. 

What you want to establish is a working, reciprocal relationship with your medical provider so that if and when problems arise, you feel comfortable calling them to discuss.

If you find that the medical provider does not already provide work restrictions it may be difficult to get them to do so consistently as there are generally many physicians, physician assistants, and nurse practitioners working at any one facility. Gearing all of them up to your needs can be a huge undertaking. Move on to the next provider to see what they can offer.

Once you have selected a provider, be sure to educate all of your employees where they are located, times of operation, etc. Your medical provider should be able to provide you with a document for posting. Post the list for your supervisors and employees and regularly update them as needed. 

A couple of key points that will reduce employee anxiety and increase cooperation are that you have made arrangements up front for no long waits and that the provider is located no more than 20 minutes away from your facility.

Next week I will speak on the Workers' Comp Company Doc, pros and cons.