Occupational Health Program Returns Washingtonians To Work Quicker

Injured workers in three Eastern Washington counties were 33 percent less likely to miss work and collect wage-replacement benefits if they were treated by doctors participating in a Department of Labor and Industries (L&I) program that encourages occupational-health best practices.

A University of Washington study of the Eastern Washington Center of Occupational Health and Education (COHE) found that injured workers treated by doctors enrolled in the center had less disability and lower medical costs, saving the state workers’ compensation system an average of $447 per claim.

The study tracked 7,162 injured workers treated by physicians enrolled in the Spokane-based COHE between June 2004 and July 2005 and compared their outcomes to injured workers, with similar injuries, who weren’t treated by a COHE doctor. Workers with back problems, in particular, had better outcomes. In all, the study found that the program saved the workers’ compensation system about $3.1 million.

In some ways, the results are similar to what the UW found a year ago when it studied the Center for Occupational Health and Education sponsored by Valley Medical Center in Renton. The UW found that the Renton center saved an average of $566 per claim, with total savings of nearly $5.6 million on 10,000 claims.

However, the savings and reduced disability came in very different areas. The Renton COHE did very well in getting workers with carpal tunnel injuries back to work with limited disability. The Eastern Washington COHE’s success was with workers suffering back injuries. A further UW study of the two COHEs, comparing their second year in operation, will be completed by the end of this year.

The Eastern Washington COHE is operated by St. Luke’s Rehabilitation Institute in Spokane and paid for by L&I. During the study year, the center only served doctors and workers in Spokane, Grant and Stevens counties. The center is now recruiting 250 physicians in 13 additional counties east of the Cascades.

The centers offer mentoring, educational resources and financial incentives to doctors who treat injured workers but don’t have a background in occupational health. Physicians are paid more when they discuss with the injured worker’s employer light-duty jobs the worker may be capable of doing during recovery, and when they fax the Report of Accident to L&I within two days.

Dr. Daniel Hansen, a chiropractor who directs the Eastern Washington COHE, said the centers are all about getting injured workers the quality treatment they need to recover and get back to a job they are capable of doing as quickly and as safely possible.

“Beginning with the first visit to the doctor, and at each subsequent visit, we reinforce the message that workers’ compensation benefits are temporary,” said Hansen. “The goal is to get injured workers back to their job, back with their friends at work, back to being a productive citizen.”

Dr. Gary Franklin, L&I medical director, said faster recovery from back injuries is particularly important because they often turn into long-term disability claims.

The UW study found that COHE doctors were satisfied with the support they received, and were more likely to treat injured workers, as a result. Workers also expressed satisfaction with the care they received from COHE doctors.

The Renton center was established in 2002 and the Spokane center opened a year later. The community-based centers are part of a cooperative effort by business, labor, health-care providers and L&I to expand access to physicians who understand occupational-health best practices. That’s especially important in Central and Eastern Washington, where very few practicing doctors specialize in occupational medicine.

The Spokane and Renter centers are part of broad-based efforts to change and improve the workers’ compensation system. Said L&I Director Gary Weeks: “I won’t be satisfied until we have done all we can do to make our management of the workers’ compensation system as efficient, fair, timely and helpful as possible for employers, injured workers and providers.” More information about improvements to the system is at www.LNI.wa.gov/ClaimsIns/Insurance/Learn/Projects/ImprovingWorkersComp.

L&I manages the State Fund, which insures about 2.3 million workers for 168,000 employers. Another 830,000 workers are employed by companies that self-insure.

Source: L&I