GENEX Services, a national managed care provider, recently released a white paper that explores the “tipping point” of a workers’ comp claim. According to a statement from the company, GENEX utilized industry research, as well as its own database covering thousands of claims from close to 400 of the nation’s leading Fortune 500 corporations in order to glean a data set. GENEX identified that there is no single tipping point, but there are claims characteristics that indicate the likelihood a claim may “tip” and then rapidly escalate into excessive costs. These characteristics include: 1) poor initial physician diagnosis 2) doctor hopping (three or more specialty physicians) 3) lack of modified work duty options 4) poor employee/employer relationships 5) psycho-social factors including poor family support 6) pre-existing conditions, and 7) alcohol or drug dependence.
Read full details via WorkCompWire here.