Do you take WC referrals for injections?

[painquestions8989]

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If so, do you have any role in assessing disability % and deciding back-to-work status? I have a few referrals for ESIs that have asked me to complete assessments, despite having an IME and a primary WC doc. NY state.

 

[Agast]

the specialist for the specific problem would ideally comment on whether a worker has reached MMI because the designated doctor may not be able to tell that themselves. The percentage impairment is done in a separate paid evaluation and they should pay several hundreds for that report, it is NOT an office visit. In Texas you have to pass the certification course to give an impairment rating and I charge $650 for impairment ratings

 

[BobBarker]

I just do the requested injections. Got harassed a little for referring one to PT when I was not the “treating physician” and was just supposed to be the shot monkey. In our state, it really isn’t worth it.

 

[Status Sciaticus]

I take WC. I dont assess disability status. I only treat the pain - do the ESI, send them to PCP for disability evaluation.

Our WC/DOL pays about 25-40% more than medicare rates.

 

[Chn96]

How much you guys charge for permanent disability form?
In Wisconsin that price is capped at $100 !

 

[A Deep Breath]

Why does anyone fill them out?

 

[Agast]

How much you guys charge for permanent disability form?
In Wisconsin that price is capped at $100 !

I don’t recommend anesthesia-based pain docs get involved in declaring permanent disability unless it’s patently obvious

 

[Ferrismonk]

We accept WC referrals for our pain management program, which often including injections.

We don't participate in routine MMI, back-to-work status evaluation, or other WC paperwork.

My goal is to reduce the pain portion of their functional status. If I truly feel disability is necessary, I don't mind recommending it. I haven't felt that way so far.

 

[VA Hopeful Dr]

I take WC. I dont assess disability status. I only treat the pain - do the ESI, send them to PCP for disability evaluation.

Our WC/DOL pays about 25-40% more than medicare rates.

Do your local PCPs actually do those?

 

[Status Sciaticus]

Do your local PCPs actually do those?

Dont know. All I know is I dont do them.

 

[geauxg8rs]

Dont know. All I know is I dont do them.

This is the correct answer. Also would have accepted i don’t care

 

[Status Sciaticus]

This is the correct answer. Also would have accepted i don’t care

i typed that first, but rephrased it to avoid the professionalism police

 

[Gauss]

We accept WC referrals for our pain management program, which often including injections.

We don't participate in routine MMI, back-to-work status evaluation, or other WC paperwork.

This is the way. Assuming your group and management is in agreement. Note that in order to fully participate in WC, you typically have to get paneled in your state for WC. Some states are 'full' or not accepting new WC physicians. IF you can take referrals like this while not being WC paneled, that is optimal in my experience.

 

[VA Hopeful Dr]

This is the correct answer. Also would have accepted i don’t care

Dont know. All I know is I dont do them.

Both are fair takes.

I will say that in my experience very few of us do them, but worst case is they make an appointment with us so we can say we don't do them either.

 

[Status Sciaticus]

Both are fair takes.

I will say that in my experience very few of us do them, but worst case is they make an appointment with us so we can say we don't do them either.

Best case in my book. Collect the 99204 and send your PCP a referral.

Jokes aside, the reason for the visit is asked by nearly all front desks, so that reason can get screened out pretty quickly.

 

[TIVAndy]

Worth it in our state. E&m 2x medicare, procedures 3x -10x depending on procedure. More headache and paperwork but worth the investment (of time) in our neck of woods

 

[Ferdog27]

WC pays well. Just because they have an HNP doesn’t mean they’re disabled. It’s a 5-6% impairment rating. Now if it’s a life changing injury like a crush or amputation, then sure.

 

[Taus]

WC pays well. Just because they have an HNP doesn’t mean they’re disabled. It’s a 5-6% impairment rating. Now if it’s a life changing injury like a crush or amputation, then sure.

Worth it in our state. E&m 2x medicare, procedures 3x -10x depending on procedure. More headache and paperwork but worth the investment (of time) in our neck of woods

Ugh. I wish. Pays barely above Medicare in PA.

 

[Ferdog27]

Ugh. I wish. Pays barely above Medicare in PA.

Depends on your state I guess.

 

[BobBarker]

Pays worse than Medicare here

 

[Laryngospasm]

I tell them I am not a disability expert and they need a specialized eval by a physiatrist. I also tell them if I did it I would probably mess it up… that usually stops the conversation.

 

[Ferdog27]

I tell them I am not a disability expert and they need a specialized eval by a physiatrist. I also tell them if I did it I would probably mess it up… that usually stops the conversation.

There are at least 2 books to give you impairment ratings for a work injury. Disability is another issue. And if the injury is catastrophic there’s a life plan process.

 

[bedrock]

Pays worse than Medicare here

Ugh. I wish. Pays barely above Medicare in PA.

I would never see WC if it didn’t pay at least 150% of Medicare.

 

[Ferdog27]

I would never see WC if it didn’t pay at least 150% of Medicare.

200% of MC in some states

 

[bedrock]

200% of MC in some states

my state is over 200% of MC for facet procedures, 150% for ESI, not sure why.