Trang Nguyen MD, PhD and her colleagues from the University of Cincinnati, using their own money to avoid funding bias, conducted an important study to determine whether lumbar fusion was a useful treatment for workers’ compensation patients with herniated or degenerating lumbar discs. Since the FDA approved the use of interbody cages in 1996, the rates of lumbar fusion surgery have increased dramatically. With an average cost per procedure of greater than $60,000, physicians and hospitals have a strong economic incentive to perform the procedure.
Colorado is the only state that still requires physicians to use the out-dated, third edition of the AMA’s Guides to the Evaluation of Permanent Impairment, published in 1990. The most recent, sixth edition of the Guides, was published in 2008. The Guides instruct physicians how to assign percentage ratings of impairment, which is defined as the loss, or loss of use of a body structure or function. The third edition of the Guides was important because it introduced a new way, called the “range of motion method”, to assign impairment to for the lower back. This method relied on the physician using two inclinometers (circular, plastic devices that register motion) simultaneously to record the amount an injured worker could move in flexion, extension, left lateral flexion and right lateral flexion. The method required numerous measures and a series of computations after the measures were recorded. Physicians frequently got it wrong.
A few days ago we hosted a webinar focusing on integrating safety and health to build a return to work program.
Employers who understand the impact of employee absenteeism can take steps to control it. A total absence management program is a very effective tool for managing the issues relating to employee absences.