Pain Management in Workers Compensation

Author: Matthew Foster

Worker’s Compensation patients differ from the average group health claim. Most people on Worker’s Compensation have had some kind of a physical injury that has led to a chronic pain condition. Whereas in group health claims for pain therapy it’s much more focused on management of diseases of either lifestyle or just of ageing – so diabetes, hypertension. Within the Worker’s Compensation system, there are specific treatment guidelines at the national level and also some at the state level that help drive towards the appropriate care of the injured worker. They are similar in some aspects such as identifying the typical medications to be used to treat the injured worker but also they guide on what is inappropriate therapy as well, so that the physicians know which should be avoided. Therapies such as Soma or carisoprodol which is the poster child for a bad muscle relaxant. Those kind of medications could be avoided by not only having some kind of an authorization process in place but to just point out how dangerous this medication can be when used in combination with opioids.

Some of the interesting trends that we’ve seen in Worker’s Compensation is the push towards implementation; putting teeth behind them. One of the ways that this is being done is through the adoption of state-based Worker’s Compensation formularies. There is an emphasis on identifying medications that would be considered first-line therapy versus those that are less safe, maybe less effective, and definitely more expensive, and using those as the second- or third-line therapy. And an approval or review process before moving on to the second-line therapy drugs which would also include long-acting opioids. Whenever a patient is injured, there are appropriate treatment guidelines that we’re using in the Worker’s Compensation market. But these also apply to patients outside of Workers Comp. Whether you’ve sprained your back from putting up your own Christmas lights or because you working for a company that installs Christmas lights, each should be treated in a safe and effective manner using first-line medications and trying to use those therapies that are going to avoid long-term complications.

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