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Editorial: Program for injured workers has promise

Sun., March 29, 2015

Severe workplace injuries are devastating to employees and their families.

In Washington, accidents that put a worker in the hospital for a minimum of four days immediately after an accident, that involve head or spinal injuries, amputations, or cause burns are among those considered catastrophic.

Recovery may take weeks or months, with no guarantee the worker will ever return to the job. Employers lose their skills, and the claims are a costly drain on the Washington workers’ compensation system.

The median cost of a workers’ comp claim is $113,000. The top quartile of all claims cost almost $400,000. The good news: Those claims have been halved in recent years thanks to better safety practices.

But if the Legislature enacts SB 5418, the Department of Labor and Industries will test a program that will bring private medical management firms in to design treatment regimens and oversee their implementation.

Outcomes for individual patients must be guaranteed – at a guaranteed price. The contractor assumes responsibility for paying the medical bills and reports periodically to the department.

The test would be modest in scope; just 10 cases per year in 2016, 2017 and 2018 unless early evidence indicates the program is not working to the benefit of the injured worker, who can choose his or her preferred provider.

If the results are clearly beneficial, the department can expand coverage to all the catastrophically injured.

Washington employers have little regard for L&I’s management of the workers’ comp program and its costs. Some of that is unfair, and the department has experimented with other innovations to bring down costs; some successful, some not.

An effort to entice injured workers to take lump-sum payments in lieu of ongoing workers’ comp checks has fallen short of expectations, despite an adjustment that made the payments available to younger workers who could move on to other jobs.

But a decade-old program co-launched at St. Luke’s Rehabilitation Institute in Spokane has reduced worker down time – by as much as two weeks – and the cost of claims submitted by health care practitioners within the six COHE networks is almost $4,000 less than those that come in from outside the system, according to a January 2015 report.

In a sense, SB 5418 is a modest effort to build on the COHE experience and bring in experienced, private case managers who can improve outcomes. The catastrophically injured may never return to work, but they could have a better, more active life as a result of the treatment they receive.

The bill passed the Senate unanimously March 10. The House Committee on Labor may act this week, and the full House shortly afterward. Everyone involved says the worker will come first every step of the way if it passes.

This is an easy call: yes.