Doctors Affect RTW And Your Bottom

LineNorm Peterson, President, NPA AssociatesJim Libien, Esq., Laughlin, Falbo, Levy, & MoresiJack Blyskal, CPCU, ARM, CSAC EIA

Working Hypothesis• Certain doctors treating 4850-eligible patients did not provide

information to facilitate early RTW, including work restrictions.• City of Oakland example• Two physicians, firefighters only, cost the City $1.4M in 4850 costs

Formed Committee• Committee Makeup• RTW provider• TPA provider• Excess pool manager• Legal counsel• JPA Members• Risk Managers for Public Entities, including City of Oakland

Ideas Considered• Root causes• Doctors affiliated with unions• Doctors not specializing in Occ Med• Patients eligible for 4850 benefits

• Possible approaches• Legislation• Get doctor association to oversee• Approach DIR for oversight

Data Analysis• (See handout)• 4850 was NOT the driver of extended disability• Difference lay between the Occ. Med doctors and Non-Occ.

Med doctors• Cost impacts were found as high as 8-9 times for Non-Occ.

doctors

Solutions Considered• Legislation• Time consuming, complicated, difficult with Senate/Assembly

makeup• Regulatory • Met with Director of DIR• Inability to enforce requirements

• Informal• Met with doctor association

Solutions Considered• Administrative• Implement report specifically addressing work limitations• Allow $25 fee for form completion• Implement on trial basis with three identified customers

• Results

Other Ideas• Open Forum• What do you think?????

Questions?