Workers compensation represents an important and major component of the healthcare system. Nearly all orthopaedic surgeons treat workers compensation patients. The AAOS believes that properly designed and efficiently run workers compensation managed care programs can provide high-quality health care to injured workers and minimize their disabilities.
Obviously, if reimbursement for treating these patients is insufficient, problems can arise. But there are other potential problems with workers compensation. These can include inadequate physician representation on the workers' comp board, problems with the appeals mechanism for difficult workers' comp reimbursement issues, and problems with paying claims promptly.
Other difficulties can include a preauthorization process which delays care, and other administrative hassles. Finally, many areas have experienced problems when out of state physicians are used to review claims.
AAOS Workers Compensation Fact Sheet
- Reductions in Workers Compensation Fee Schedules Threaten Patient Access to Quality Care (in PDF format)