Specialty Solutions Spotlight: Prosthetic Services in Workers’ Comp

What is the costliest type of injury in workers’ compensation?

Amputations are the costliest type of injury in workers’ compensation, both in terms of lost time and long-term expense. Working with experienced prosthetic providers is therefore critical to control costs and achieve the best possible outcome for each injured employee. Manufacturers specialize in certain types of prosthetics, and Apricus gives you access to a wide array of potential providers. In addition, each injured employee must receive complete, comprehensive evaluations to assess their unique needs, and to support not just their return to work but also their activities of daily living, hobbies and lifestyles.

While orders for prosthetics are rare compared with other types of specialty devices, their costs can range from a couple thousand dollars to well over $50,000. Prosthetics are classified as durable medical equipment (DME), though they can be one of the most expensive and long-term costs from specialty programs.

The Complex Nature of Prosthetics

In many cases, because of the nature of a catastrophic injury like an amputation, the injured employee has already been sent to the hospital. Typically, a prosthetic service provider will be brought on early in the process to work with an Apricus specialty care coordinator to begin communicating with key stakeholders. This may include the adjuster along with the treatment team, discharge staff, or catastrophic case manager to ascertain the injured employee’s services, equipment and supply needs.

Injured individuals might have to wait six months to a year or more for swelling to subside before they can be properly fitted for their prosthetic; some will need additional surgery or therapies to prepare. Some injured employees will need a new prosthetic as time passes and disabilities progress or change. And no prosthetic lasts a lifetime, so replacements will eventually be necessary. Additionally, each prosthetic is custom made and often requires multiple moldings and adjustments. Much planning is needed to avoid wasting money on recasting or excessive wear and tear. Apricus works with reliable providers who also offer maintenance and warranties, and our care coordinator will routinely check in with the injured individual to make sure a prosthetic is in good repair and in compliance with its warranty.

Amputations can also carry significant, lifelong feelings of grief and finality, and the psychological and emotional benefits of returning the injured employee to their perception of their old self cannot be overstated. On a positive note, the advancement in prosthetics over the years is nothing short of astonishing. For injured individuals, seeing themselves with their future prosthetic, resuming their everyday lives, can not only improve the grieving process but also decrease their chance of rejection. In the future, the ongoing advancements in technology will result in even better solutions to the traumatic events of amputation and improvements to prosthetics.

Apricus can help sort through the myriad of choices to identify the devices that best meet an injured individual’s needs. Here’s what to look for when choosing a prosthetic service provider:

A Broad Selection of Devices with Targeted Levels of Function:

• Passive Prosthesis
• Conventional Prosthesis
• Myoelectrical (External Powered)
• Specialty Prosthesis
   

An Experienced Team to Consult with the Prosthetist to Meet the Injured Individual’s Needs:

• Design a plan to meet the patient's requirements
• Compare the benefits of various approaches 
• Evaluate the challenges that might remain after fitting a device 
• Work with all parties to achieve the best level of success

Apricus will work with you to help identify and procure the necessary devices and support services required, to ensure the injured individual receives the prosthetic equipment they need to live healthy, productive lives.

This information is meant to serve as a general overview, and any specific questions should be fully reviewed with a health care professional or specialty service provider.

To make a referral for this service and others, call us today at 877.203.9899 or send an email to referrals@apricusinc.com.