The Path to Better Catastrophic Claims Management - Part Two

Written by on 8/21/2017 1:40 AM in , , , . It has 1 Comments.

Catastrophic injuries are complex, costly, life-altering events for injured workers and their families. In this next installment, we’ll continue looking into the path to improved catastrophic workman’s comp claim outcomes.

Other Considerations for Catastrophic Claims:

Comorbidity Complications
Comorbidities such as diabetes, heart disease, high blood pressure, poor circulation, obesity, and age greatly complicate injuries and recovery. By identifying these factors and monitoring corresponding issues, a catastrophic claims team can better circumnavigate pitfalls.

Ask the Worker
The worker knows best which treatments/equipment are working/lacking. Today’s technology allows for this information to be directly compared with physician notes, case management reports, and claims data to provide a broader picture and better outcome.

Include the Family
The catastrophic claims team should also meet with the family to discuss care progress and pitfalls, as well as clarify care and recovery expectations.

Understand Home Care May be Unavoidable
Most suffering catastrophic injuries will never return to work. Worse, some may not gain full independence. In these situations, options of 24-hour home care, nursing care, and family care must be carefully considered based on dynamics and injuries, to ensure quality of life.

Consider Environment/Modifications
Environment can significantly impact post-discharge plans. Payers may have to cover the additional costs of home modification/relocation necessary to meet care needs.

Don’t Overlook the Importance of Ongoing Monitoring
Regardless of the point in the path of the injured worker’s journey, regular file reviews are essential to identifying red flags. This safeguards compliance, and ensures the continuation of proper, quality care.

Helping workers avoid catastrophic workman’s comp claims is job #1. If the unimaginable occurs, know that Minnesota Comp Advisor is here to help. Learn how today.


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