Posted by Linda Van Dillen on Thu, Dec 08, 2011 @ 02:54 PM
So often we hear horror stories when things go bad in the Worker’s Comp area. We wanted to share with you a recent success that S&H Medical Management Services had with a case in far Southern Illinois.
Mr. X is a 41 year old man employed as a mechanic and was referred to S&H in April of 2009 as a Cat case for Medical Case Management. As is routine at S&H the RN Case Manager foresaw Mr. X, would not be able to return to the employer of injury and obtained authorization for referral to Vocational Services for a little ‘Early Intervention’ as he was approaching conclusion of his medical treatment.
During the Vocational Assessment the Vocational Consultant was able to determine Mr. X’s return to work abilities/interests and guide Mr. X toward appropriate types of positions. By quickly making a determination on appropriate return to work goals and implementing Job Seeking Skills Training that focused on presentation in the interview process, developing and finalizing a skill orientated resume and cover letter, and ongoing support Mr. X was able to acquire two job offers within 30 to 45 days of the initial vocational meeting.
Because S&H stresses continuous access to the Vocational Consultant Mr. X was able to make an appropriate job offer selection and successfully return to the work force. Mr. X was placed in employment in late September 2011 and continues to work through the new employer orientation.
Mr. X has been targeted for a management position at the end of his orientation which will ensure full time employment with an increased wage rate.
By quickly move Mr. X into vocational services a time reduction in benefit cost occurred and potentially quick closure to the claim will occur.
Posted by Linda Van Dillen on Wed, Jun 08, 2011 @ 04:56 PM
After several days of negotiations with Rep. Bradley, Sen. Raoul, and the Governor’s Office with representatives of the Trial Lawyers Association and organized labor, the Illinois Chamber and other members of the Joint Employers were unable to come to an agreement on workers’ compensation reform. The legislators and the Governor’s Office took the two issues which were the obstacles to an agreement, AMA guidelines and physician choice, and presented their version of a compromise on those issues.
All parties were given until Monday 5/23/2011, to decide if they could support the proposal or not. The IL Chamber was advised that if there was not an agreement then legislation to repeal the Workers’ Compensation Act would be pursued.
The Illinois Senate adopted amendments 3 and 5 to HB 1698 and later passed the legislation on a 46-10-3 vote.
Senate amendment 3 was the underlying amendment. Amendment 5 made technical changes to the collective bargaining pilot provisions, the choice of physician section and the provision regarding commission employee process of filing a workers' compensation claim.
SB 1938 which repealed the Act was not called in Senate Executive Committee.
At present, it is important to note, this bill has not been signed by the governor.
Gene Keefe recently wrote a summary of the proposed changes to the IL w/c law. With his permission, here is a link to the summary: http://www.sandhmms.com/2011-Amendments?&t=60634
In addition, Gene officiated a webinar on 6/8/11 that was very detailed in its discussion of these changes. A second webinar is scheduled for 6/21 at 2 pm. I encourage you to register for this second session. Here is the registration page for the webinar: https://www1.gotomeeting.com/register/253639584
Tomorrow I will post some additional information from the IL Chamber. S&H Medical Management Services, Inc. is a Memberof the Illinois Chamber Employment Law Council Workers’ Compensation Committee.
Posted by Linda Van Dillen on Mon, Oct 18, 2010 @ 05:21 PM
One of the S&H Medical Management Nurse Managers attended the 17th Annual SafeWorks Illinois Work Injury Prevention and Control Strategies conference held in Champaign, IL on October 29, 2009 and brought back information about an exciting new program to help manage chronic pain patients.
Dr. David Fletcher presented on the new Illinois Prescription Monitoring Program (PMP). This program allows any licensed physician or pharmacist to determine if a patient is obtaining narcotic prescriptions from multiple physicians, and can also determine if they were receiving narcotics pain medicine prior to a work injury.
This program is only open to licensed pharmacists and physicians in the state of Illinois.
This program is authorized by 710 ILCS 570/321, known as the Illinois Controlled Substances Act and applies to Schedule II, III, IV and V medications, and contains all Schedule drugs listed above, dispensed by Illinois retail pharmacies. All pharmacies must report this data on a weekly basis, and the database is updated every Friday.
In an effort to maximize the benefit of the IME process, S&H will be requesting IME physicians include the data base search results as a part of their report.
Other applications suggested by Gene Keefe in his weekly newsletter:
1. As part of fitness for duty evaluations, the database can be checked to clarify the completeness of information provided by the new hire, during the post job offer physical examination. It makes sense to review the patient’s use of scheduled drugs for the previous six months.
2. If a pattern of excessive use of controlled substances is detected, the physician can alert other providers also.
3. To clarify if the patient is “doctor shopping”.
Considerations:
1. Remember to use a HIPAA compliant release. The information in this database is covered by HIPAA and all confidentiality and disclosure provisions of Illinois law. S&H utilizes this type of release when working with your injured worker.
2. A doctor may also want to review what scripts have been filled for a specific patient, clarifying who wrote each script, if they suspect a patient has obtained one of their prescription pads fraudulently.
The goal for obtaining this information is two-fold. S&H wants to help bring to light inappropriate narcotic usage by the injured worker, hoping to prevent or address narcotic addiction much earlier in a case. Also to put unscrupulous physicians on notice that they are being closely monitored.
For more information on the IL PMP contact: Stan Tylman, 401 North Fourth Street, Springfield, IL, 62702 Phone: 217-524-9074.
Dr. Fletcher can be contacted via http://www.safeworksillinois.com/contact-safeworks.html
Thanks to Gene Keefe and his Newsletter dated 11/1/09. Some of the information in this article was excerpted from this recent newsletter. Gene’s newsletters are stored on his blog. www.keefe-law.com/blog
Gene’s blog just won an award as one of the top 25 W/C blogs http://law.lexisnexis.com/practiceareas/Workers-Compensation-Law-Blog/Workers-Compensation/LexisNexis-Top-25-Blogs-for-Workers-Compensation-and-Workplace-Issues—2009-Honorees
In my next post I will share the results we are seeing as our nurses seek this information. You may be surprised as to the pitfalls we are experiencing