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Workers' compensation carrier uses computer models in treatment

For New York City construction workers and other workers in the city, chronic pain is a central aspect of many workplace injuries. A major workers' compensation insurer, Travelers, has initiated a predictive model that it asserts focuses more intensively on the worker's treatment needs sooner after the injury occurs. This allegedly results in a shorter recovery period and counters the use of opioids in the treatment of such pain.

However, any insurer's programs must be weighed over a long period of time and must keep in perspective the company's obvious bias toward reducing compensation expenditures. One seemingly good aspect of the computerized reporting of data under the insurer's program is the use of early alternative therapies to attack chronic pain before it rages out-of-hand. The company asserts that it has had great success by using physical therapy, acupuncture, aquatic therapy and cognitive therapy, early after the injury to combat the progression of chronic pain.

The company claims that it pays more money earlier on such modalities, but gets a financial advantage in the long run by improving the results for injured workers. The program also looks at the experience of the worker and the duration of his or her employment with the employer. One of the objects is to pinpoint those workers more at risk for chronic pain, which allegedly points often toward those in their first year of a job. By using analytical models, the company alleges being able to reduce opioid prescriptions and the need for surgery.

However, any insurer's attempts to use predictive models is subject to abuse by the insurer and the employer. Whenever the emphasis is on getting the employee back to work as soon as possible, there is the possibility that the worker's best medical interests will be ignored in favor of saving money. The New York City worker should quickly seek a free consultation with an experienced workers' compensation attorney whenever it appears that the worker's interests are being short-changed by the workers' compensation carrier.

Source: claimsjournal.com, "Travelers' Sees Reduced Costs, Earlier Return to Work With Early Severity Predictive Model", Denise Johnson, May 2, 2017

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