Managing the Pandora’s Box of Comorbidities
Comorbid conditions are complicating injured worker recovery. This session at the 2017 National Workers’ Compensation & Disability Conference outlined the scope of comorbidity challenges facing employers and strategies to combat them.
Speakers included:
- Eric Patten, Senior Director of Clinical, One Call Care Management
- Richard Graham, Director Workers’ Compensation, SEPTA
Obesity, diabetes, high blood pressure, heart disease, mental health issues, arthritis, tobacco use and substance abuse are all very common comorbid conditions. The workforce as a whole is aging and, as an employee ages, he or she is more likely to have at least one comorbidity. According to NCCI, evidence of comorbidities has tripled in claims over the last ten years.
Harbor Health Systems conducted a survey analyzing more than 7,000 workers’ compensation claim injury dates between 2011-2013. Seven comorbidities were observed: obesity, diabetes, hypertension, addiction, mental health, tobacco use and multiple comorbidities.
According to survey results, claims associated with comorbid conditions experienced:
- Longer claims duration
- Higher medical costs
- More temporary disability (TTD) days
- Increased litigation rates
- Increased surgery rates
Clinical Management Strategy
Workers’ compensation case severity can be tackled by recognizing comorbidities early and taking them into consideration in the treatment and recovery process.
Begin by identifying if comorbidities exist during patient intake. Advanced knowledge of comorbidities helps set realistic expectations for treatment, recovery and return to work. Physicians and nurse case managers can help collect and record comorbid conditions and should take comorbidities into account when developing treatment and rehabilitation plans. If the patient is experiencing complications as a result of their comorbidities, it could impact recovery.
Employer Risk Management Strategy
Many of these comorbidities result from inactivity. In fact, 80% of jobs are sedentary. We have all heard that “sitting is the new smoking”, therefore, it is beneficial for employers to establish pre-incident wellness programs as part of their risk management strategy. After all, health benefit plans have a “carrot” but no “stick” to incentivize the employee to make good lifestyle choices, so more needs to be done.
Employer wellness programs can include items like nutritional counseling, Weight Watchers and discounts/incentives for gym memberships. Aim to get people standing and moving.