January 2012

Your Recovering Employees Are Being Dangerously Over-Medicated

Physicians over-prescribing opioids has led to an increase in indemnity losses, with no corresponding overall reduction in Comp loss history

Hardly news, but worthy of repeating, there’s a critical problem with the impact of narcotics addiction in the Workers’ Comp system; physicians over-prescribing opioids has led to an increase in indemnity losses, including narcotic overdose and deaths, with no corresponding overall reduction in Comp loss history. Masking symptoms with narcotics is not returning employees to work and you’re paying the price.

Improve your Comp experience and avoid bad claim outcomes by requiring your Work Comp adjuster to report on his review of claimant’s prescription history and by your assertion that proper medical guidelines are followed by prescribing physicians. State Comp regulators have taken notice of the problem. But it’s up to you to be vigilant with your Comp insurer. Regulators aren’t capable of policing the problem. There are guidelines for physicians that you can assert to your insurer even if the venue state has no guidelines itself.

Colorado’s Work Comp guidelines are very stringent, requiring all patients placed on long term and chronically abused opioids to undergo a formal psychosocial and physical evaluation by two separate specialists (pain management or physical medicine), and requiring a written informed consent and an opioid contract for all patients. The clear intent is that opioids are to be used only after other treatments have failed, and almost never if the patient is a high risk for abuse. Urine drug screening is a control method strongly encouraged in all patients on opioids.

You should bring this up with your claims handlers. A good discussion point is a survey (see results) prepared in August 2011 by the Western Occupational Medical Association.