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Frequent Flyer Program

A referral came in yesterday prefaced by the label, "This is one of our frequent flyers!"  If you deal with workers compensation, you know what that means - an employee that has filed several work injury claims that many times are associated with bizarre, or routine circumstances that make us question validity versus some underlying motive.  

As Case Managers, when we receive one of these referrals, there are 3 strategies that we will employ in our treatment plan.  The first and most important strategy is Choice of Physician.  In Arkansas, the employer has the right to first choice of physician.  We highly recommend employers take advantage of that and choose the best specialty fit for each injury on a case-by case basis.  In these situations, the physician should also be one that we know is willing to review all information presented - from the injured worker, from the employer, and any medical information from the case manager.  

The second strategy is again, one that is applied in every case, but with special attention in Frequent Flyers:  Correlation to the mechanism of injury.  After the physician examination is completed, the location, intensity, and dysfunction should be apparent to the case manager and physician as a direct correlation with the forces, postures, and risk factors described in the mechanism of injury.  If we don't see a correlation, we call it to the physician's attention, and request him to address it.  At times the physician is not sure, and he or she will order a Workstation Assessment which measures and documents the risk factors involved in the job tasks.  It works - I've had many adjusters deny claims when the correlation could not be made with this tool provided to the physicians.

Lastly, Keep them Working!  Light duty RTW is essential in thwarting any secondary gain. We can get creative with the employer and physician to make it happen.  Light duty RTW is beneficial for so many reasons. Whether the employee is not happy moving to a new workstation, has a bone to pick with their supervisor, or needs off work a couple days for deer season, Frequent Flying is not the ticket.  

Wouldn't it be great if we earned points for dealing with frequent flyers? Just sayin'

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