Those of us who have years of experience working with catastrophically injured claimants see the disturbing pattern time and time again: The claimant presents to the emergency room with the initial injury and subsequently travels through a fragmented healthcare delivery system that all too often stops woefully short of meeting the claimant’s long-term needs. While naturally there is significant focus on early intervention strategies and medically managing the workers’ compensation aspects of a new catastrophic (CAT) claim during the early life-saving and acute phase of the injury, there is dangerously little attention and effort devoted to the coordination of long-term management of these high-risk for failure claimants.
If injured workers’ rehabilitation is not addressed from the inception of the claim, they can travel down catastrophic paths leaving them unnecessarily stuck in a detrimental and expensive “vortex of failure.” Recognizing that a case is potentially a CAT claim and making the referral as soon as it is identified is a must. Referrals for facility assessment, Nationwide Centers of Excellence need to be made without hesitation. Gearing down if the case turns out better than expect is always better than missing the mark and start off in the wrong and irreversible direction.
Reference: Risk Management, Loss Control; Jul 31, 2017 | By Lydia Hendrix