Does Medical Directions Make Any Differences in Workers' Compensation System? Analysis of Employee- and Employer-Directed Medical Care in Relation to Prolonged Physical Therapy and Attorney Involvement Among Rotator Cuff Tear Claims.

Abstract

To explore differences in employee- or employer-directed medical care for workplace injuries, related to the prolonged physical therapy (PT) and attorney involvement in the workers' compensation claim process. Eight thousand eight hundred fourteen rotator cuff tear claims filed to a nationwide insurance carrier from 2007 to 2022 were analyzed for difference in prolonged PT (≥360 days) and attorney involvement by medical direction groups. Employee-directed and shared employee- and employer-directed medical care had odds ratios of 1.41 and 1.58 for prolonged PT compared with employer direction, respectively. Employer-directed and shared employee and employer medical direction had odds ratios of 2.33 and 1.62 for attorney involvement compared with employee direction, respectively. Employee-directed medical care is associated with more PT, and employer-involved direction is associated with more attorney involvement.