Monday, May 9, 2011

A Disability System with a Medical Component? Bad Argument

During one of the sessions at Thursday's NCCI Annual Issues Symposium (AIS) one of the panel presenters opined that work comp can not be part of a single payer/source medical system because work comp is a 'disability system with a medical component'.

I couldn't disagree more.

Medical costs now comprise the majority of every dollar spent on a work comp claim. This is true in every study of work comp costs regardless of which alphabet soup organization published the study.

Further, the thinking that work comp is a disability system is what has gotten this industry into trouble, and in fact may be why medical should be removed from work comp and left with the general health system.

Let's take the base argument that work comp is basically a disability system with a medical component - that right there tells us that medical has no particular reason to be a part of work comp other than the delivery of treatment.

The argument was made that work comp is different because general health just focuses on making the patient better, while work comp is focused on returning the injured worker back to work.

Sounds like an disingenuous argument at best. I frankly don't see the difference. If the patient is better, then the patient should be able to do what the patient did prior to injury, whether it's cooking, cleaning, participating in athletics, or working.

Most states use an edition AMA Guides to regulate the indemnity portion of the the system. The AMA Guides focus on "whole person impairment". Some states modify this impairment to come up with a "disability" (which simply means a measure for indemnity) and some don't. The point is that the standard for "impairment" exists whether one is in the work comp system or not. This point is clear in that the Guides are used for lots of other medical-legal issues other than work comp - e.g. auto accident litigation.

So, saying that work comp is somehow different than general medical because it is a disability system with a medical component does not stand the test of logic. If that were the case then all other tort systems that rely on medical-legal standards should also be separate systems.

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