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the production supervisor understands that today’s jobs can create abnormal fatigue and wear damage to working tissues, a change in perspective can be expected. Overcoming the Politics of Work Injury Supervisors’ assumptions that MSD injuries are usually faked can be solved by supervisory training, usually during neck-arm or back school by a workers’ comp claims prevention specialist; they will then realize the ill effects of these suspicions. It is a fact that 90 percent of claims are legitimate, but this becomes complicated because of the conflicts caused by wrong assumptions. Furthermore, when employees receive proper education on MSD, and when they understand that avoiding injuries is a personal responsibility, then reduction of claims can be expected. Top management realization that injured workers don’t have to return to work until they are 100-percent recovered has a big effect on both company profits and morale. Educating non-injured workers during ergonomics team training will show them that most claims are legitimate. Employers’ understanding of the importance of a restricted duty program is important in reducing workers’ comp costs. Wrong assumptions and mentalities in the work place have to be corrected before restricted duty can proceed. Furthermore, specific policies and procedures must be written and the program must be precisely supervised. Companies need to realize the consequences of not providing appropriate medical care and how the employees’ morale can be affected by this. They may need to know that 90 percent of OSHA inspections are generated by a call from an angry worker. Companies should not set a goal of “no reported injuries;” rather, they should use “no lost time” as a goal. Useful Tools Physical therapists can help companies maximize business profit by reducing workers’ compensation claims, cost and lost work days by using rehab programs that can help workers [INDuSTRIAl REHAB] prevent injuries. These programs include: (1) MSD risk analysis; (2) back and neck-arm MSD school; (3) supervisor/management/employee training; (4) on-site problem-solving consulting; (5) on-site pain intervention services (PT and first aid services); (6) new hire training and spine/extremity screening; (7) stretching programs; (8) restrictive duty program development; (9) work conditioning and functional capacity evaluations (10) on-site physical therapy clinics; (11) preferred PT provider agreements, and (12) an OSHA 300 Log Analysis. MSD is a complex and expensive problem. The job of the workers’ comp claims prevention specialist is to improve the effectiveness of the management team in dealing with MSD claims and costs—and to make employees experts on the working body. n Gerry Catapang is president and owner of US Workers’ Compensation Claims Prevention Specialists, a subsidiary of Physical Therapy Care, Manual PT, and Industrial Rehab Center, PC, in Springfield, MO. He can be reached at gerrycatapang@sbcglobal.net. get a competitive advantage with WorkWell Systems Customized solutions for work injury • prevention • early intervention • stay at work • return to work Train in • functional capacity evaluation • functional job analysis • prework screening • workFIT return to work testing • work rehabilitation WorkWell Systems is an industry-leading provider of workforce productivity solutions. Fully integrated support, service and products make WorkWell the Smart Choice Best practice solutions–Evidence/research based Web based software tools and technical support Hands-on training with experts in the fi eld Meet your customer’s needs with solutions from WorkWell Systems Please contact WorkWell for details visit workwell.com or call 866 WWS-WORKS ADVANCE for Physical Therapy & Rehab Medicine 23
[wHEELCHAIR/SEATING] wheel Master Physical therapist runs an individualized wheelchair/ seating program By rebecca Mayer A growing number of people are spending their days in wheelchairs that either do not fit properly or do not allow for an appropriate level of independence. This may be the result of being fitted in a chair with limited controls or an ill-fitted frame or one that is too heavy to maneuver. Being dependent on a wheelchair, either power or manual, can hinder an individual’s level of mobility and independence. “Selecting the proper wheelchair is important as it determines the patient’s ease of movement and level of freedom in all aspects of daily life,” explained Brian A. Mulligan, MPT, wheelchair clinic coordinator at St. Lawrence Rehabilitation Center (SLRC) in Lawrenceville, NJ. As part of the Wheelchair and Seating Clinic’s individualized program, Mulligan assesses each patient’s strength, range of motion, functional mobility, coordination, sensation and posture as they relate to wheeled mobility. Then he is able to identify a seating system that best positions and supports the person for comfort and function. “My work is rewarding because I’m in a position to give patients mobility back,” Mulligan explained. Take a Seat St. Lawrence Rehabilitation Center’s wheelchair clinic team includes a physician, physical 24 ADVANCE for Physical Therapy & Rehab Medicine therapist and wheelchair vendor representative to help patients choose a wheelchair by thoroughly evaluating their individual medical conditions and lifestyles. Mulligan has been running the clinic for nearly 10 years. He completes wheelchair evaluations and assessments for individuals from SLRC’s inpatient and outpatient units. Mulligan completes all patient evaluations with a vendor present. “I’ve witnessed a rotation of vendors over the years for a variety of reasons,” Mulligan relayed. “Currently, I primarily work with vendors that have proven to be reliable.” SLRC is a 166-bed, not-for-profit physical rehabilitation hospital that employs four fulltime physiatrists and houses a 23,000 squarefoot, state-of-the-art Outpatient Health Center. When Mulligan evaluates an individual on the inpatient unit, he works directly with the patient’s physician and physical therapist. Mulligan performs outpatient evaluations for patients who are referred from various physicians. He submits all paperwork to the corresponding physician once the evaluation has been completed. On the outpatient side, he consults with the PT of current SLRC patients or performs a comprehensive evaluation if the patient is currently under care elsewhere. “Most patients come into the clinic for a fitting, some need revisions to a chair they acquired years ago and others need something new because their needs have changed or have never had a chair,” Mulligan explained. Mulligan fields all phone calls to the clinic and personally schedules each appointment with his patients. “While I have them on the when customizing a wheelchair to best fit a patient’s needs, a trained clinician will consider the following: • Power or manual mobility needs • Frame design and weight • Construction, durability, adjustability • Seat cushion and back support for skin integrity and postural needs • Environments and terrains encountered during use Source: St. Lawrence Rehabilitation center’s Wheelchair and Seating clinic phone, I gather background information so I am prepared when they arrive for their appointments,” he shared. The clinic has sample chairs, cushions and backs to use during the evaluation and Mulligan ensures that patients try various products. “I try to give them as many options as possible so they can pick what they want/need,” he explained. “I often take patients outside in their chairs to make sure they meet their needs when navigating curbs and parking lots.” Additionally, Mulligan gathers the patient’s history of ability to propel or maneuver a power chair. The patient’s home and work environments and recreational and social activities will be considered in selecting a wheelchair. When the clinic does not have the right type of chair on hand, Mulligan will find a sample and ask the patient to come back at a later date. “There are plenty of occasions when the patient comes back for a second visit before making a final decision,” he said. According to Mulligan, patients often visit the clinic with definite ideas of what they want and/ or need in a chair but they often don’t identify their own needs properly. A patient may simply need power tilt, for example, but Mulligan will show him extra features that would make him more independent at home. Power chairs have many useful features including power elevating seats, power legs and power recline. Manual chairs can be outfitted with power assist features such as power wheels. Mulligan first decides which frame is best for the patient. Once the frame has been selected, he determines whether the patient requires a simple back with cushion or a cushion intended to treat pressure relief. The clinic offers custom molded seating systems that can be added and adapted for individual needs. CouRTESy ST. lAwRENCE REHABIlITATIoN CENTER
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Page 23: Cut the Claims Physical therapists
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