Abstract
A worker's compensation claim is frequently a nightmare for the patient (injured worker), the employer (insurance payor), and the physician (health care provider). Because of the wastefulness inherent in the system, the overall cost of providing workers' compensation care in the State of Ohio has increased dramatically and as a result has seen significant reductions in hospital reimbursement levels and patient benefits, such as prescription drug availability. This article provides two clinical examples to highlight the problems with the worker's compensation system in Ohio. The first case example demonstrates what happens when the patient's initial diagnosis upon entering the system is incorrect but later corrected and treated by a physician capable of making a more accurate diagnosis, but the physician does not follow proper protocol in changing the initial diagnosis. The second case example demonstrates what happens when the physician who makes an accurate diagnosis uses the workers' compensation system to correct the diagnosis so that he or she can proceed without fear of not being reimbursed for the procedures performed. The article then makes recommendations for streamlining and improving the workers' compensation system
Recommended Citation
William H. Seitz, Jr., The Ohio Bureau of Workers' Compensation: An Analysis of the Status Quo and a Proposal for Improvement (A Medical Perspective), 20 J.L. & Health 1 (2006-2007)