Tag Archives: wait times

Major Surgery Wait Times for Workers’ Comp: Can Medical Travel Assist?

Last week, the Workers’ Compensation Research Institute (WCRI) released their FlashReport — Time from Injury to Medical Treatment: How States Compare, and I requested a copy.

While the report is rather lengthy, covering slightly more than fifty pages, I decided to focus on one aspect of the report that related to the length of time from injury to medical treatment with major surgery.

The report examined the time from injury to treatment in 18 states, and each of the services studied were ranked by median number of days from injury to medical service for each service. The report looked at claims from 2015/2016 with more than seven days lost time.

I wanted to make the medical travel industry aware that major surgery under workers’ compensation was not something that happened immediately after an on-the-job injury, and to alert the industry to figure out how they can improve the wait times for such surgeries.

Here is the summary of key findings from the report:

  • Considerable variation across states in the time from injury to first treatment for physical medicine and “specialty” services such as major radiology and pain management injections across injury types.
  • Patterns in time to first medical treatment were fairly consistent for some states; that is, some states tended to show shorter or longer time to first treatment across injuries and services.
  • Little variation in time to first medical treatment for “entry” services (such as emergency, office visits, and minor radiology) for most injury types.
  • Initial medical treatment was slightly faster for objective injuries (like fractures) than for subjective injuries (like sprains and strains).
  • Timing of medical services varies by type of injury, likely a reflection of different treatment patterns.

Based on the analytical approach WCRI used for other services, they identified Indiana, New Jersey, Pennsylvania, Virginia, and Wisconsin as having a shorter median number of days to the first major surgery.

California, Georgia, Iowa, North Carolina, and Texas had the longest median number of days to first major surgery and was based on the number of days average in rank order. Arkansas and Louisiana were excluded due to small cell size.

Major surgery was ranked third by type of non-entry service by maximum number of days from injury to first medical service: 118 days. Major surgery was ranked sixth by percentage of claims receiving medical services by maximum number of days at: 36.5%. Indiana had that distinction.

Major surgery was defined by WCRI as including invasive surgical procedures, as opposed to surgical treatments and pain management injections. The most frequent surgeries in this service group include, but are not limited to, arthroscopic surgeries of the shoulder or knee, laminectomies, laminotomies, discectomies, carpel tunnel surgeries, neuroplasty, and hernia repair.

Five types of injuries had the maximum medium number of days from injury to first major surgery: Neurologic spine pain, Inflammations, Upper extremity neurologic, Other sprains and strains, and Knee derangements.

The table below illustrates the maximum for each injury with the corresponding minimum, in order of maximum number of days.

Type of Injury

Maximum

Minimum

State

Neurologic spine pain

187

105

CA

Inflammations

173

96

CA

Upper extremity neurologic

169

85

CA

Other sprains and strains

140

69

CA

Knee derangements

133

52

CA

What does this mean?

This report is by no means conclusive as it relates to length of time for major surgery in the other states that were not analyzed. Yet, it is instructive to both the workers’ comp industry and the medical travel industry that given predicted shortages of both physicians and nurses, it would be prudent to explore other avenues so that the maximum wait times can be lowered, which would enable the injured employee to return to work faster.

Not doing so will be more expensive in the long run and will be detrimental to the well-being of the patient.

To purchase a copy of the report, click here.