Category Archives: Injury Management

Workers’ Comp and Back Surgery: Listen Up, Medical Travel

My fellow blogger, Joe Paduda has published a post today about the latest information on back injury and treatment, so I thought I’d let you read it straight from Joe, and leave the commentary out of it for the time being.

Here is the link to Joe’s article. I think you should pay heed to what he says and reports on. It might bring you more business.



Medical malpractice at Pilgrim’s Pride…the poultry company?

It sounds like malpractice to me. That’s what I’ve been thinking ever since learning how the injuries sustained by poultry workers are treated (and not treated) at the company nursing stations.

Source: Medical malpractice at Pilgrim’s Pride…the poultry company?

Infographic on Most Dangerous Industries in US

Back in March, I wrote an article called, “Top 10 Causes of Workplace Injuries: How Medical Tourism Can Save Employers Money“.

Today, Michael Stack, Principal of Amaxx Risk Solutions, posted the following infographic on the most dangerous injuries in the US, that illustrates more graphically the issue I wrote about in March.

Here is the link to the infographic:

For those of you in workers’ comp, this data is a reminder of what you deal with on a daily basis. For those in the medical travel industry, it represents areas you need to consider going after if you want to implement medical travel into workers’ comp.


I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at:

Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp.

Connect with me on LinkedIn, check out my website, FutureComp Consulting, and follow my blog at: Share this article, or leave a comment below.

What Are the Transportation Guidelines for Medical Travel?

WorkCompWire reported last week that GENEX Services, a provider of integrated managed care services, has recently launched the most comprehensive guidelines for the use of transportation services, by ground or air, for workers’ compensation injuries.

Here is the link to the article on WorkCompWire:

The guidelines were introduced to the company’s 1,500 internal case managers in January, and the roll out to customers is underway.

The GENEX Transportation Guideline is intended to provide research-based assistance about when and where, as well as what mode and vendor is best for injured workers, including ambulance, helicopter and air transport.

The Transportation Guideline also provides direction on expenses for transportation that have already been incurred as well as for prospective or future transportation expenses.

Much of the guidelines GENEX introduced concerned workers’ compensation injuries of an emergent nature, and discusses which mode of transportation, whether ambulance or helicopter, is the best mode of transportation for a particular type of injury.

For the purpose of medical travel, especially with regard to its implementation into workers’ comp for non-emergent care, as previously quoted in my white paper, the medical tourism industry needs to devise similar guidelines for transportation, especially since much of that transport will be by air, and not by ground transportation, except to and from an airport.

But the fact remains that in order to be able to successfully implement medical travel into workers’ comp, there needs to be guidelines for transporting patients going abroad for knee surgery, hip surgery, shoulder surgery, as well as how you transport patients requiring back surgery, especially on flights lasting more than four hours, or on shorter flights that might be delayed for whatever reason, and the patient is confined to the assigned seat for a long period of time.

These guidelines should already be in place for general health care medical travel, and can be applied to workers’ comp without difficulty. Medical tourism facilitators those whose business is solely focused on orthopedic procedures are best suited to advise on transporting knee repair/replacement patients, hip replacement patients, shoulder surgery patients, etc.

These guidelines would make it more likely that risk managers, claims managers, brokers, attorneys, case managers, and other professionals involved with handling workers’ comp claims will accept the option of medical travel for injured workers requiring surgery.


I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp. Connect with me on LinkedIn and follow my blog at: Share this article, or leave a comment below.

My Response to Rebecca Shafer and Michael Stack

Rebecca Shafer, J.D. and Michael Stack, CPA are the president and principal ofAmaxx Risk Solutions, Inc., respectively.

This morning, on their blog, Rebecca wrote an article about the six things employers should do to avoid being a part of a ProPublica report.

You may be aware that ProPublica and NPR have recently reported on the harm many injured workers have received not only at the hands of medical personnel and the workers compensation industry, but even from their own employers.

I decided to write a response to Rebecca and Michael. Here is the text of my email to them:

Rebecca and Michael,

There should be a seventh item to your list. Employers should respect the health, welfare, dignity and honest hard work of their employees so that the treatment these workers have been subjected to, as stated in the reports, do not occur.

But the problem is, the American employer historically believes he is lord and master of his domain, which includes the workers and the materials he uses to make the employer wealthy.

If you don’t believe me, here is a quote from someone who knew what real industrial hell does to workers and workers’ lives:

“Capital is reckless of the health or length of life of the laborer, unless under compulsion from society.”

Karl Marx

We are seeing a recrudescence of 19th century, laissez-faire industrial capitalism, with its grinding poverty, income inequality, and now thanks to ProPublica and OSHA, a return to the days when workers lost limbs all in the name of ever greater profit for the owner, but misery and despair for the worker who is injured.

There was a case a few years ago about a company in Alabama that had serious injuries to their employees and not even OSHA could shut them down, This company was featured in a series of articles in the New York Times and on PBS, and because the business owner believed that no one had the right to tell him how to run his business, he could do whatever he pleased.

This is libertarianism, or also known as classical liberalism, and was the modus operandi of American business throughout the 19th and early 20th centuries, until reforms such as workers’ comp, unemployment insurance, the eight-hour day and other legislation consigned these problems to the dustheap of history. But one political party, with the backing of big business and billionaires, are taking us back to the bad old days.

Until the American worker is treated with dignity and respect by their employers, there will continue to be more reports from not only ProPublica, but from Mother Jones, PBS, the New York Times, and many other journalistic outlets.

The culture of greed at any cost, the culture of adversarial labor/management relations, and the push for ever greater return on investment for those who sit on their behinds and reap the benefits of the sacrifices made by workers, whether it is an arm, leg, foot, hand, or fingers must end. That will only happen when workers are treated like human beings and not like the machinery that takes their limbs or their lives.

Addressing the problems reported by ProPublica will not be solved merely by telling the employer to do a better job of managing their claims, their TPA’s and carriers, and getting better communication with their employees, but rather the discarding of the mean-spirited, and vindictive attitudes many employers manifest against any employee who gets hurt or files a claim, files a grievance, or any other proactive stance that is seen as a threat to an employer and his precious bottom line.

Without workers, nothing gets done. Without workers, there is no business, no profit, no return on investment. We are still far from a completely automated industrial production system whereby no human will ever be hurt or maimed again, so rather than go back to the bad old days of the Industrial Revolution, as many Libertarians and Republicans, and the Koch Brothers would wish, why not be more respectful and open and honest with your employees and treat them as you would want to be treated if you were them…with dignity.


I am willing to work with any broker, carrier, or employer who is sick and tired of being bled by the Wall Street vulture capitalists and the entire medico-legal system known as workers’ comp, to save money, and to provide the best care for their injured workers or their client’s employees, while at the same time, helping to break the monopoly of the American health care cartel.

Call me for more information, next steps, or connection strategies. Email me at: Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp. Connect with me on LinkedIn and follow my blog at: Share this article, or leave a comment below.

Top 10 Causes of Workplace Injuries: How Medical Tourism Can Save Employers Money

Merrell: “…Can you see a role of medical tourism in workers’ compensation injury?”
Ludwick: “I could, if it were a long-term issue. Many workers’ comp issues are emergent,
so that would take out the medical tourism aspect. However, if it was a long-range issue, I
could see us involving workmen’s comp issues into that, or problems.”
Lazzaro: “I would support that. I don’t know the incidence, for example, of some of the
orthopedic procedures that are non-emergent, such as knee or hip replacement, which would
fall under workmen’s comp. But theoretically, a case could be made for that…”
Merrell: “I was thinking about it in terms of the chronic back injury and the repetitive action
injuries and hernia that are in the workers’ compensation area. An acute injury on the job
would probably not be at issue but a work-associated problem with a potentially surgical
solution might be a matter for medical tourism.”

You may recognize the above quoted dialogue from my white paper on medical tourism and workers’ comp. I am reprinting it here because I came across a report from the Liberty Mutual Research Institute for Safety that highlighted the top ten causes and direct costs of the most disabling workplace injuries in 2012. My thanks goes to Jim Mecham, Continuing Education Director and Return-to-Work Software Developer at OCCUPRO, for bringing this to my attention through his post on LinkedIn.

The report, the 2014 Liberty Mutual Workplace Safety Index is based on information from Liberty Mutual, the US Bureau of Labor Statistics (BLS), and the National Academy of Social Insurance. The Index provides statistics for injuries that occurred in 2012, which is the most recent year for which data was available.

The Index showed that the most disabling injuries and illnesses had a direct workers’ comp cost of $59.58 billion, which translates to over a billion dollars a week spent by business on the most disabling injuries.

The following chart indicates what those ten injuries are, the percentage of each type of injury, and the direct cost.


Source: Bing Images

The top five causes were:

  • Overexertion involving outside source
  • Falls on same level
  • Struck by object or equipment
  • Falls to lower level
  • Other exertions or bodily reactions

Overexertion accounted for 25.3% of injuries, and is further identified as being caused by lifting, pushing, pulling, holding, carrying, or throwing, and cost businesses $15.1 billion in direct costs.

Falls to same level accounted for 15.4% of injuries, costing $9.19 billion.

Struck by object or equipment injuries accounted for 8.9% of injuries and cost $5.3 billion.

Falls to lower level accounted for 8.6% and cost $5.12 billion.

Other exertions and bodily reactions accounted for 7.2% of injuries and cost $4.27 billion. This includes injuries resulting from bending, crawling, reaching, twisting, climbing, stepping, kneeling, sitting, standing, or walking.

The second group of five injury causes accounted for 18.4% of the direct total cost of injuries. These were:

  • Roadway incidents involving motorized land vehicles — 5.3%, $3.18 billion;
  • Slip or trip without fall — 3.6%, $2.17 billion;
  • Caught in/compressed by equipment — 5%, $2.1 billion;
  • Repetitive motions involving micro-tasks — 3.1%, $1.84 billion;
  • Struck against object or equipment — 2.9%, $1.76 billion

These ten injuries comprised 83.8% of the total cost burden for disabling work-related injuries in 2012.

What does this all mean?

For the employer, it means a lot, especially in terms of dollars and cents that can be avoided if there are proper safety programs in place to lessen the frequency and severity of these injuries. However, accidents do occur, and while safety programs do work, they don’t always live up to the promise; nor do workers ever follow safety rules, so when these injuries occur, it would be wise for an employer to find a less expensive way to deal with the injury than expensive surgeries at home.

For the workers’ comp industry, it means that you are not doing a very good job of saving your client’s money, or you are doing a great job making money for yourselves and other workers’ comp service providers.

And finally, for the medical tourism industry, it means you have some work to do to go out and get this business and prove to the American employers, insurance companies and injured workers that when any of these types of injuries occur, you can provide them with the best care and the lowest cost. As I said in my presentation in Reynosa, Mexico last November, “[the] Medical Tourism industry must take [the] lead and go after the market; the market will not come to you”.


I am willing to work with any broker, carrier, or employer willing to save money, and to provide the best care for their injured workers or their client’s employees.

Call me for more information, next steps, or connection strategies. Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp. Connect with and follow me on LinkedIn and my blog. Share this article, or leave a comment below.

Letting Problems Fester


Yesterday, my father was admitted to a local hospital reluctantly by his primary care physician, and on the wishes of my younger brother, who is also a physician. His doctor wanted to put him in a hospice; my brother had the good sense to convince the primary to admit him to the hospital.

My father has been ignoring a very a serious problem with his legs that has left them inflamed, infected and with open wounds and leaking. And despite pleadings and arguments with him from me, my brother, his doctor, and a home health agency we are using to take care of my mother, he has resisted going to the hospital, or even taking responsibility for the state of his health.

For a few years now, he has been treated for this condition by a dermatologist, who has wrapped his legs with bandages and put Calamine lotion on it. They have prescribed compression stockings for him to wear, but he has only worn them whenever he asked an aide to put them on for him.

But because of the leakage and bleeding, the aides and the agency have told him that they cannot do anything for him until his legs are treated.

I have told him that a dermatologist is not the right doctor to treat this problem, but he has insisted on going back there time and again because of the attention they paid to him in the past, especially one young woman who no longer works there who he was infatuated with.

I might add that this doctor was one of doctors in a database the New York Times published online of physicians who received a majority of the payouts from Medicare in 2012.

Hopefully, now that he is in the hospital, he will get the proper treatment and his legs will improve.

The reason I am telling you this is that the workers’ compensation system has so many “health problems” that are being ignored or treated with ineffective and useless treatments.

Sort of like what is wrong with my father…plenty of open wounds and sores, and other underlying issues that is being treated by the wrong kind of doctor.

These problems, as I have discussed in the past, such as the fraud and abuse of injured workers, the opioid abuse problem, general health care plans charged less for the same surgeries under workers’ comp, and so many other issues, have either been ignored, or are being mistreated because some in the workers’ comp industry are infatuated with the service they are receiving from their service providers and cannot understand that these companies are not interested in solving these problems, only prolonging them because they profit from it.

Also, they are pursuing “treatments” that are ineffective and only make the problems worse, as in the case of my father and his dermatologist.

But unlike my father who finally allowed his doctor to admit him to the hospital, the workers’ comp industry is refusing to seek proper treatment.

“Aged statutes and old case law” is one excuse they offer. Another is because doctors and lawyers are milking and gaming the system and they won’t or can’t do anything about this. And finally, they refuse to seek treatment because they are under the delusion that everything they have tried so far, or will try in the future to address these problems will work, if they only keep doing so.

But we have already seen that some states are allowing employers to opt-out of the system. In one state, a judge has ruled that that state’s system unconstitutional. Joe Paduda has been writing on his blog about private equity firms buying up Third Party Administrator companies and workers’ comp service providers in an effort to consolidate the workers’ comp claims process from right after the first report of injury to the management of the claim, to the management of the pharmacy benefits, and all other services.

As this vertical integration proceeds, it is likely that costs will go up, profits will flow to the top, meaning to the private equity firms and their investor clients, and services provided may not be adequate to treat the injured worker because of the demand for greater efficiency in the process and for ever more profits to be squeezed out of the system.

So, do we see if the “patient” still refuses to get the help it desperately needs, or does it go on pretending that there is nothing wrong, and dies a slow death.

I am glad my father finally agreed to get help. I am still waiting for the workers’ comp industry to do the same. It needs to go to the “hospital” not a hospice.