Comorbid conditions are medical disorders and diseases that either affect or accompany a primary condition or injury. These conditions, when not properly managed, can have a very negative effect on the healing process. They can also have a large impact on workers’ compensation claims as they may or may not be compensable. High blood pressure, heart disease, insomnia, obesity, depression, arthritis, diabetes, and substance abuse are all examples of common comorbid conditions.
Workers with comorbid conditions are at higher risk of developing complications in their recovery process. For example, an injured worker with a low back injury who suffers from chronic pain is at higher risk of developing depression, or a worker who fractures an ankle and has diabetes may experience complications in the healing process. These complications can lead to various effects on workers compensation claims, from longer claims duration to increased litigation rates to more temporary disability days. Here are some ways employers can develop a holistic strategy in managing comorbid conditions in the workplace.
It’s beneficial to identify comorbid conditions early on in the claims process. It can give the employer more realistic expectations for the time it takes for the employee to recover and return to work. Proactive strategies such as talking to a nurse case manager to assess injuries can help identify comorbidities early on. Using analytics can help payers screen claims with comorbid conditions. They can then reduce the risk of medical and indemnity costs by applying clinical management.
Healthcare Provider Coordination
Catastrophic claims that include comorbidities need to be assessed from multiple perspectives in order to ensure that the employee is receiving correct and effective care. This can range from coordinating home care to transportation, to the purchase of medical equipment. A hotline with nurses that can serve as a liaison with these providers is useful in the coordination of all the services an employee might need during the injury treatment process.
Prevention Through Wellness Programs
Workplace wellness programs have demonstrated a 4:1 return on investment as savings on healthcare costs. These can include on site fitness facilities, weight loss programs, access to healthy food and snacks, and many more options. Ergonomics consultation can also prevent musculoskeletal disorders, one of the most prevalent injuries on the job. These wellness programs can have a profound impact on the prevention of comorbid conditions, such as reducing the risk of heart disease and obesity through fitness and healthy eating.
At DORN, our on site PainFree™ therapies and education programs play a large part in reducing or eliminating medication usage. With opioid abuse being a large issue among claims with comorbid conditions, other treatments such as our on site manual therapy programs can be a useful preventative measure. According to our 2016 Survey on the Efficacy of Worksite Pain Management, 42% of all participants reported reducing or eliminating medication usage.
With a correlation between increased costs and comorbidity, addressing and managing comorbid conditions is obvious when dealing with workers’ compensation claims. Companies should implement preventative measures such as wellness programs and use analysis tools to identify the risk of comorbid conditions early in the claims process. In order to do this effectively, all parties in the claims process must work collaboratively to develop reasonable and affordable solutions to tackle these issues.