ACUTE INJURY MANAGEMENT PROGRAM TRUCKING COMPANY

ACUTE INJURY MANAGEMENT PROGRAM
TRUCKING COMPANY


Case Histories/Samples of Cases That Would Have Benefited From Acute Injury Management:

1. Ronald Trucker:
DOI: 5/28/09
R.T.W.: not yet; So far, totally disabled x36 weeks at $800/week AWW = $28,800 lost on indemnity so far.
DOR: (date of referral to medical case management): 12/12/08

Red Flags That Would Have Been Picked Up By Acute Injury Management:
> Length of time between physician/neurologist appointments.
> Physician ignoring severity of symptoms/reported falls
> Handling of causality of fall at home resulting in shoulder injury; resulting in lengthy time until shoulder was evaluated, so the shoulder became frozen.

Potential Medical/Indemnity Savings Had Acute Injury Management Been Utilized:
> With Acute Injury Management involvement, and had not 7 months been lost from the DOI until the file was referred to medical case management, the claimant would have been less deconditioned, may not have developed depression symptoms that needed to be treated with medication, and would have been further along resulting in his achieving maximum medical improvement / full recovery at an earlier date and returning to work sooner.
> Entire shoulder injury/treatment might have been avoided had more regular physician visits been occurring and had the dizziness been addressed earlier (MRI, all treatment with Dr. Pollard, shoulder P.T., and possibly a manipulation under anesthesia).
> Even with fall at home, Acute Injury Management would have aggressively addressed the compensability issue avoiding a delay in treatment of the shoulder of almost 2 months, resulting in the frozen shoulder.

2. Sam Semi:
DOI: 2/21/08
R.T.W.: Mr. Semi never lost any time at work as a result of his injury.
DOR: 6/30/08

Red Flags That Would Have Been Picked Up By Acute Injury Management:
> Length of time between physician/neurologist appointments
> Elimination of the occupation medicine physician’s involvement on the file, which might have helped to get the medical issues addressed in a more timely manner.
> Failure of the neurology office to communicate or provide reports to the adjuster, insured or case management.
> Failure of the neurology office to further work up the reported shoulder injury, once positive findings were noted in the central nervous system.

Potential Acute Injury Management Cost Savings:
> Earlier referral to orthopedics to work up the shoulder, resulting in an earlier determination that there was in fact nothing wrong with the shoulder.
> Earlier recommendation for an IME, which resulted in a diagnosis that was unrelated to the claimant’s job, eliminating all financial responsibility on the part of the insured.
> All of this would have resulted in lower costs for case management, since indemnity and ultimately medical costs were not an issue after the IME.

Risk/Benefits to Trucking Company:
1. In these challenging economic times, this Acute Injury Management program could help save indemnity and medical costs resulting in fewer location shutdowns and staff layoffs.
2. This program should be able to be implemented just like your Wellness Program.
3. No commitment to increased referrals to medical case management; in fact earlier intervention should result in better, more effective treatment early on resulting in cases closing sooner. Acute Injury Management may recommend that a nurse case manager attend a task assignment appointment or in more complex cases provide full medical case management, but Trucking Company always has the option to say “no”.
4. Time savings for Workers’ Compensation Coordinator in setting up medical appointments, monitoring treatment/attendance, and obtaining medical reports. Medical updates are automatically provided after every medical appointment, freeing the Workers’ Compensation Coordinator up for other duties. --- The SRS Group

All names are fictitious.
www.srsrheab.com
www.thesrsgroup.net